Abstract

Identifying the lung carcinoma subtype in small biopsy specimens is an important part of determining a suitable treatment plan but is often challenging without the help of special and/or immunohistochemical stains. Pathology image analysis that tackles this issue would be helpful for diagnoses and subtyping of lung carcinoma. In this study, we developed AI models to classify multinomial patterns of lung carcinoma; ADC, LCNEC, SCC, SCLC, and non-neoplastic lung tissue based on convolutional neural networks (CNN or ConvNet). Four CNNs that were pre-trained using transfer learning and one CNN built from scratch were used to classify patch images from pathology whole-slide images (WSIs). We first evaluated the diagnostic performance of each model in the test sets. The Xception model and the CNN built from scratch both achieved the highest performance with a macro average AUC of 0.90. The CNN built from scratch model obtained a macro average AUC of 0.97 on the dataset of four classes excluding LCNEC, and 0.95 on the dataset of three subtypes of lung carcinomas; NSCLC, SCLC, and non-tumor, respectively. Of particular note is that the relatively simple CNN built from scratch may be an approach for pathological image analysis.

Highlights

  • Identifying the lung carcinoma subtype in small biopsy specimens is an important part of determining a suitable treatment plan but is often challenging without the help of special and/ or immunohistochemical stains

  • Lung carcinomas are classified as adenocarcinoma (ADC), squamous cell carcinoma (SCC), small cell lung cancer (SCLC), large cell neuroendocrine carcinoma (LCNEC), or “non-small cell carcinoma (NSCC), not otherwise specified (NOS)”, etc. by additional special and/or immunohistochemical stains, if necessary

  • There are several deep learning studies that have proposed technologies that are capable of distinguishing non-neoplastic lung tissue and lung carcinoma subtype including adenocarcinoma, squamous cell carcinoma, and small cell lung cancer, which are frequently seen in lung ­biopsy[8,10,12], LCNEC was not included in the studies

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Summary

Introduction

Identifying the lung carcinoma subtype in small biopsy specimens is an important part of determining a suitable treatment plan but is often challenging without the help of special and/ or immunohistochemical stains. We developed AI models to classify multinomial patterns of lung carcinoma; ADC, LCNEC, SCC, SCLC, and non-neoplastic lung tissue based on convolutional neural networks (CNN or ConvNet). The CNN built from scratch model obtained a macro average AUC of 0.97 on the dataset of four classes excluding LCNEC, and 0.95 on the dataset of three subtypes of lung carcinomas; NSCLC, SCLC, and non-tumor, respectively. We propose a CNN model built from scratch along with pre-trained CNN models for classification of subtypes including LCNEC in lung cancer biopsy slides as an efficient method for pathology image analysis

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