Abstract

Simple SummaryIn this pilot study, we aimed to investigate the use of deep learning for the classification of whole-slide images of liquid-based cytology specimens into neoplastic and non-neoplastic. To do so, we used a large training and test sets. Overall, the model achieved good classification performance in classifying whole-slide images, demonstrating the promising potential use of such models for aiding the screening processes for cervical cancer.Liquid-based cytology (LBC) for cervical cancer screening is now more common than the conventional smears, which when digitised from glass slides into whole-slide images (WSIs), opens up the possibility of artificial intelligence (AI)-based automated image analysis. Since conventional screening processes by cytoscreeners and cytopathologists using microscopes is limited in terms of human resources, it is important to develop new computational techniques that can automatically and rapidly diagnose a large amount of specimens without delay, which would be of great benefit for clinical laboratories and hospitals. The goal of this study was to investigate the use of a deep learning model for the classification of WSIs of LBC specimens into neoplastic and non-neoplastic. To do so, we used a dataset of 1605 cervical WSIs. We evaluated the model on three test sets with a combined total of 1468 WSIs, achieving ROC AUCs for WSI diagnosis in the range of 0.89–0.96, demonstrating the promising potential use of such models for aiding screening processes.

Highlights

  • According to the Global Cancer Statistics 2020 [1], cervical cancer is the fourth leading cause of cancer death in women, with an estimated 342,000 deaths worldwide in 2020

  • We evaluated the model on three test sets with a combined total of 1468 whole-slide images (WSIs), achieving ROC AUCs for WSI diagnosis in the range of 0.89–0.96

  • We trained a model that consists of a convolutional and a recurrent neural network using a dataset of 1503 WSIs for training and 150 for validation

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Summary

Introduction

According to the Global Cancer Statistics 2020 [1], cervical cancer is the fourth leading cause of cancer death in women, with an estimated 342,000 deaths worldwide in 2020. The introduction of cervical cancer screening led to a fall in associated mortality rates; there is some evidence that the conventional smear method for screening is not consistent in reliably detecting cervical intraepithelial neoplasia (CIN) [10–12]. This is because conventional cervical smears, when spread on glass slides, tend to have the cells of interest mixed with blood, debris, and exudate. A number of new technologies and procedures are becoming available in various screening programs (e.g., liquid-based cytology (LBC), automated screening devices, computer-assisted microscopy, digital colposcopy with automated image analysis, HPV testing). The ThinPrep collection vial has been approved by the FDA for direct testing for HPV, which is useful for managing women whose Pap smear tests show atypical squamous cells (ASCs) [4,13]

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