Authors: Shih-Chiang Huang, Chi-Chung Chen, Jui Lan, Tsan-Yu Hsieh, Huei-Chieh Chuang, Meng-Yao Chien, Tao-Sheng Ou, Kuang-Hua Chen, Ren-Chin Wu, Yu-Jen Liu, Chi-Tung Cheng, Yu-Jen Huang, Liang-Wei Tao, An-Fong Hwu, I-Chieh Lin, Shih-Hao Hung, Chao-Yuan Yeh, Tse-Ching Chen
Published: 2022-06-10
DOI: 10.1038/s41467-022-30746-1
Source: Full article
AbstractThe pathological identification of lymph node (LN) metastasis is demanding and tedious. Although convolutional neural networks (CNNs) possess considerable potential in improving the process, the ultrahigh-resolution of whole slide images hinders the development of a clinically applicable solution. We design an artificial-intelligence-assisted LN assessment workflow to facilitate the routine counting of metastatic LNs. Unlike previous patch-based approaches, our proposed method trains CNNs by using 5-gigapixel images, obviating the need for lesion-level annotations. Trained on 5907 LN images, our algorithm identifies metastatic LNs in gastric cancer with a slide-level area under the receiver operating characteristic curve (AUC) of 0.9936. Clinical experiments reveal that the workflow significantly improves the sensitivity of micrometastasis identification (81.94% to 95.83%, P < .001) and isolated tumor cells (67.95% to 96.15%, P < .001) in a significantly shorter review time (−31.5%, P < .001). Cross-site evaluation indicates that the algorithm is highly robust (AUC = 0.9829).