Abstract

The role of tumor infiltrating lymphocytes (TILs) as a biomarker to predict disease progression and clinical outcomes has generated tremendous interest in translational cancer research. We present an updated and enhanced deep learning workflow to classify 50x50 um tiled image patches (100x100 pixels at 20x magnification) as TIL positive or negative based on the presence of 2 or more TILs in gigapixel whole slide images (WSIs) from the Cancer Genome Atlas (TCGA). This workflow generates TIL maps to study the abundance and spatial distribution of TILs in 23 different types of cancer. We trained three state-of-the-art, popular convolutional neural network (CNN) architectures (namely VGG16, Inception-V4, and ResNet-34) with a large volume of training data, which combined manual annotations from pathologists (strong annotations) and computer-generated labels from our previously reported first-generation TIL model for 13 cancer types (model-generated annotations). Specifically, this training dataset contains TIL positive and negative patches from cancers in additional organ sites and curated data to help improve algorithmic performance by decreasing known false positives and false negatives. Our new TIL workflow also incorporates automated thresholding to convert model predictions into binary classifications to generate TIL maps. The new TIL models all achieve better performance with improvements of up to 13% in accuracy and 15% in F-score. We report these new TIL models and a curated dataset of TIL maps, referred to as TIL-Maps-23, for 7983 WSIs spanning 23 types of cancer with complex and diverse visual appearances, which will be publicly available along with the code to evaluate performance.Code Available at: https://github.com/ShahiraAbousamra/til_classification.

Highlights

  • Tumor infiltrating lymphocytes (TILs) have gained importance as a biomarker in translational cancer research for predicting clinical outcomes and guiding treatment

  • These findings have led to efforts to characterize the abundance and spatial distribution of TILs in cancer tissue samples to further our understanding of tumor immune interactions and help develop precision medicine applications in oncology [7–11]

  • After we evaluated the performance of these TIL models and visually confirmed how well TILs were being classified in whole slide images (WSIs) across 23 types of cancer, the step was to utilize the best TIL model to analyze all of the available diagnostic DX1 the Cancer Genome Atlas (TCGA) WSIs in these types of cancer to characterize the abundance and spatial distribution of TILs as a potential biomarker

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Summary

Introduction

Tumor infiltrating lymphocytes (TILs) have gained importance as a biomarker in translational cancer research for predicting clinical outcomes and guiding treatment. Studies suggest that the spatial distribution of TILs within complex tumor microenvironments may play an important role in cancer prognosis [4–6]. These findings have led to efforts to characterize the abundance and spatial distribution of TILs in cancer tissue samples to further our understanding of tumor immune interactions and help develop precision medicine applications in oncology [7–11]. Computational image analysis of whole slide images (WSIs) of cancer tissue samples has become a very active area of translational biomedical research. Deep learning-based image analysis workflows have been shown to consistently produce more accurate results and generalize to new datasets better than previous image analysis methods in computational pathology

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