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Deep learning can predict lymph node status directly from histology in colorectal cancer

Background - Lymph node status is a prognostic marker and strongly influences therapeutic decisions in colorectal cancer (CRC). - Objectives - The objective of the study is to investigate whether image features extracted by a deep learning model from routine histological slides and/or clinical data...

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Main Authors: Kiehl, Lennard (Author) , Kuntz, Sara (Author) , Höhn, Julia (Author) , Jutzi, Tanja (Author) , Krieghoff-Henning, Eva (Author) , Kather, Jakob Nikolas (Author) , Holland-Letz, Tim (Author) , Kopp-Schneider, Annette (Author) , Chang-Claude, Jenny (Author) , Brobeil, Alexander (Author) , Kalle, Christof von (Author) , Fröhling, Stefan (Author) , Alwers, Elizabeth (Author) , Brenner, Hermann (Author) , Hoffmeister, Michael (Author) , Brinker, Titus Josef (Author)
Format: Article (Journal)
Language:English
Published: 11 October 2021
In: European journal of cancer
Year: 2021, Volume: 157, Pages: 464-473
ISSN:1879-0852
DOI:10.1016/j.ejca.2021.08.039
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ejca.2021.08.039
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0959804921005700
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Author Notes:Lennard Kiehl, Sara Kuntz, Julia Höhn, Tanja Jutzi, Eva Krieghoff-Henning, Jakob N. Kather, Tim Holland-Letz, Annette Kopp-Schneider, Jenny Chang-Claude, Alexander Brobeil, Christof von Kalle, Stefan Fröhling, Elizabeth Alwers, Hermann Brenner, Michael Hoffmeister, Titus J. Brinker
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Summary:Background - Lymph node status is a prognostic marker and strongly influences therapeutic decisions in colorectal cancer (CRC). - Objectives - The objective of the study is to investigate whether image features extracted by a deep learning model from routine histological slides and/or clinical data can be used to predict CRC lymph node metastasis (LNM). - Methods - Using histological whole slide images (WSIs) of primary tumours of 2431 patients in the DACHS cohort, we trained a convolutional neural network to predict LNM. In parallel, we used clinical data derived from the same cases in logistic regression analyses. Subsequently, the slide-based artificial intelligence predictor (SBAIP) score was included in the regression. WSIs and data from 582 patients of the TCGA cohort were used as the external test set. - Results - On the internal test set, the SBAIP achieved an area under receiver operating characteristic (AUROC) of 71.0%, the clinical classifier achieved an AUROC of 67.0% and a combination of the two classifiers yielded an improvement to 74.1%. Whereas the clinical classifier's performance remained stable on the TCGA set, performance of the SBAIP dropped to an AUROC of 61.2%. Performance of the clinical classifier depended strongly on the T stage. - Conclusion - Deep learning-based image analysis may help predict LNM of patients with CRC using routine histological slides. Combination with clinical data such as T stage might be useful. Strategies to increase performance of the SBAIP on external images should be investigated.
Item Description:Gesehen am 22.01.2022
Physical Description:Online Resource
ISSN:1879-0852
DOI:10.1016/j.ejca.2021.08.039

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