Abstract
Colorectal cancer (CRC) is one of the most common cancers requiring early pathologic diagnosis using colonoscopy biopsy samples. Recently, artificial intelligence (AI) has made significant progress and shown promising results in the field of medicine despite several limitations. We performed a systematic review of AI use in CRC pathology image analysis to visualize the state-of-the-art. Studies published between January 2000 and January 2020 were searched in major online databases including MEDLINE (PubMed, Cochrane Library, and EMBASE). Query terms included “colorectal neoplasm,” “histology,” and “artificial intelligence.” Of 9000 identified studies, only 30 studies consisting of 40 models were selected for review. The algorithm features of the models were gland segmentation (n = 25, 62%), tumor classification (n = 8, 20%), tumor microenvironment characterization (n = 4, 10%), and prognosis prediction (n = 3, 8%). Only 20 gland segmentation models met the criteria for quantitative analysis, and the model proposed by Ding et al. (2019) performed the best. Studies with other features were in the elementary stage, although most showed impressive results. Overall, the state-of-the-art is promising for CRC pathological analysis. However, datasets in most studies had relatively limited scale and quality for clinical application of this technique. Future studies with larger datasets and high-quality annotations are required for routine practice-level validation.
Highlights
Colorectal cancer (CRC) is one of the most common cancers and the second leading cause of mortality worldwide
The incidence is still higher in Western countries [2], it is increasing in developing countries due to rapid adoption of the urban lifestyle
9000 records were identified in the initial search (3815 in PubMed, 4953 in EMBASE, 202 in the Cochrane library) and records were identified by cross-referencing
Summary
Colorectal cancer (CRC) is one of the most common cancers and the second leading cause of mortality worldwide. The incidence is still higher in Western countries [2], it is increasing in developing countries due to rapid adoption of the urban lifestyle. In China and India, the incidence of CRC is projected to double by 2025 as compared to that in 2002 [3]. Diagnosis is an important step in reducing CRC mortality, and colonoscopy is one of the most common and powerful screening methods [4]. The number of colonoscopy examinations is enormously increasing [4], and microscopic examination is becoming more labor-intensive and time-consuming. The pathological diagnosis of colonoscopy biopsy samples can be biased by individual pathologists’
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