Weakly supervised annotation-free cancer detection and prediction of genotype in routine histopathology

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Peter Leonard Schrammen - , University Hospital Aachen (Author)
  • Narmin Ghaffari Laleh - , Else Kröner Fresenius Center for Digital Health, University Hospital Aachen (Author)
  • Amelie Echle - , University Hospital Aachen (Author)
  • Daniel Truhn - , University Hospital Aachen (Author)
  • Volkmar Schulz - , University Hospital Aachen (Author)
  • Titus J Brinker - , German Cancer Research Center (DKFZ) (Author)
  • Hermann Brenner - , German Cancer Research Center (DKFZ) (Author)
  • Jenny Chang-Claude - , German Cancer Research Center (DKFZ) (Author)
  • Elizabeth Alwers - , German Cancer Research Center (DKFZ) (Author)
  • Alexander Brobeil - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Matthias Kloor - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Lara R Heij - , Maastricht University (Author)
  • Dirk Jäger - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Christian Trautwein - , University Hospital Aachen (Author)
  • Heike I Grabsch - , Maastricht University (Author)
  • Philip Quirke - , University of Leeds (Author)
  • Nicholas P West - , University of Leeds (Author)
  • Michael Hoffmeister - , German Cancer Research Center (DKFZ) (Author)
  • Jakob Nikolas Kather - , German Cancer Consortium (Partner: DKTK, DKFZ), Else Kröner Fresenius Center for Digital Health, University Hospital Aachen, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT) Heidelberg, Leeds Teaching Hospitals NHS Trust, University of Leeds (Author)

Abstract

Deep learning is a powerful tool in computational pathology: it can be used for tumor detection and for predicting genetic alterations based on histopathology images alone. Conventionally, tumor detection and prediction of genetic alterations are two separate workflows. Newer methods have combined them, but require complex, manually engineered computational pipelines, restricting reproducibility and robustness. To address these issues, we present a new method for simultaneous tumor detection and prediction of genetic alterations: The Slide-Level Assessment Model (SLAM) uses a single off-the-shelf neural network to predict molecular alterations directly from routine pathology slides without any manual annotations, improving upon previous methods by automatically excluding normal and non-informative tissue regions. SLAM requires only standard programming libraries and is conceptually simpler than previous approaches. We have extensively validated SLAM for clinically relevant tasks using two large multicentric cohorts of colorectal cancer patients, Darmkrebs: Chancen der Verhütung durch Screening (DACHS) from Germany and Yorkshire Cancer Research Bowel Cancer Improvement Programme (YCR-BCIP) from the UK. We show that SLAM yields reliable slide-level classification of tumor presence with an area under the receiver operating curve (AUROC) of 0.980 (confidence interval 0.975, 0.984; n = 2,297 tumor and n = 1,281 normal slides). In addition, SLAM can detect microsatellite instability (MSI)/mismatch repair deficiency (dMMR) or microsatellite stability/mismatch repair proficiency with an AUROC of 0.909 (0.888, 0.929; n = 2,039 patients) and BRAF mutational status with an AUROC of 0.821 (0.786, 0.852; n = 2,075 patients). The improvement with respect to previous methods was validated in a large external testing cohort in which MSI/dMMR status was detected with an AUROC of 0.900 (0.864, 0.931; n = 805 patients). In addition, SLAM provides human-interpretable visualization maps, enabling the analysis of multiplexed network predictions by human experts. In summary, SLAM is a new simple and powerful method for computational pathology that could be applied to multiple disease contexts. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.

Details

Original languageEnglish
Pages (from-to)50-60
Number of pages11
JournalThe Journal of pathology
Volume256
Issue number1
Publication statusPublished - Jan 2022
Peer-reviewedYes

External IDs

Scopus 85117502319

Keywords

Sustainable Development Goals

Keywords

  • Adult, Aged, Aged, 80 and over, Brain Neoplasms/diagnosis, Cohort Studies, Colorectal Neoplasms/diagnosis, Deep Learning, Female, Genotype, Humans, Male, Microsatellite Instability, Middle Aged, Mutation/genetics, Neoplastic Syndromes, Hereditary/diagnosis, Reproducibility of Results