Abstract

OBJECTIVES:This study aims to evaluate the ability of deep learning algorithms to detect and grade prostate cancer (PCa) in radical prostatectomy specimens.METHODS:We selected 12 whole-slide images of radical prostatectomy specimens. These images were divided into patches, and then, analyzed and annotated. The annotated areas were categorized as follows: stroma, normal glands, and Gleason patterns 3, 4, and 5. Two analyses were performed: i) a categorical image classification method that labels each image as benign or as Gleason 3, Gleason 4, or Gleason 5, and ii) a scanning method in which distinct areas representative of benign and different Gleason patterns are delineated and labeled separately by a pathologist. The Inception v3 Convolutional Neural Network architecture was used in categorical model training, and a Mask Region-based Convolutional Neural Network was used to train the scanning method. After training, we selected three new whole-slide images that were not used during the training to evaluate the model as our test dataset. The analysis results of the images using deep learning algorithms were compared with those obtained by the pathologists.RESULTS:In the categorical classification method, the trained model obtained a validation accuracy of 94.1% during training; however, the concordance with our expert uropathologists in the test dataset was only 44%. With the image-scanning method, our model demonstrated a validation accuracy of 91.2%. When the test images were used, the concordance between the deep learning method and uropathologists was 89%.CONCLUSION:Deep learning algorithms have a high potential for use in the diagnosis and grading of PCa. Scanning methods are likely to be superior to simple classification methods.

Highlights

  • The high prevalence and complex management of prostate cancer (PCa) have imposed significant amounts of investment in healthcare systems [1,2]

  • From the 1,525 images, the pathologists made 1,982 annotations, which were divided into 559 normal glands, 535 stroma, 273 Gleason 3, 281

  • In comparison to the results recorded by experienced uropathologists, using the proposed deep learning scanning method, we demonstrated an accuracy of 89% in real-world images in the PCa diagnosis and determination of the Gleason/ISUP grading

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Summary

Introduction

The high prevalence and complex management of prostate cancer (PCa) have imposed significant amounts of investment in healthcare systems [1,2]. The wide spectrum of aggressiveness of PCa, ranging from an indolent disease that can be managed with surveillance to an aggressive disease with a poor prognosis, necessitates accurate diagnosis and classification. Tumor grading using the Gleason/ISUP score is the main prognostic factor, and together with staging, indicates the choice of treatment and probable outcome [3,4]. Histological analysis and Gleason/ISUP grading are currently. Received for publication on May 29, 2021. Accepted for publication on September 21, 2021

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