Abstract

Simple SummaryProstate cancer has very varied appearances when examined under the microscope, and it is difficult to distinguish clinically significant cancer from indolent disease. In this study, we use computer analyses inspired by neurons, so-called ‘neural networks’, to gain new insights into the connection between how tissue looks and underlying genes which program the function of prostate cells. Neural networks are ‘trained’ to carry out specific tasks, and training requires large numbers of training examples. Here, we show that a network pre-trained on different data can still identify biologically meaningful regions, without the need for additional training. The neural network interpretations matched independent manual assessment by human pathologists, and even resulted in more refined interpretation when considering the relationship with the underlying genes. This is a new way to automatically detect prostate cancer and its genetic characteristics without the need for human supervision, which means it could possibly help in making better treatment decisions.Prostate cancer is a common cancer type in men, yet some of its traits are still under-explored. One reason for this is high molecular and morphological heterogeneity. The purpose of this study was to develop a method to gain new insights into the connection between morphological changes and underlying molecular patterns. We used artificial intelligence (AI) to analyze the morphology of seven hematoxylin and eosin (H&E)-stained prostatectomy slides from a patient with multi-focal prostate cancer. We also paired the slides with spatially resolved expression for thousands of genes obtained by a novel spatial transcriptomics (ST) technique. As both spaces are highly dimensional, we focused on dimensionality reduction before seeking associations between them. Consequently, we extracted morphological features from H&E images using an ensemble of pre-trained convolutional neural networks and proposed a workflow for dimensionality reduction. To summarize the ST data into genetic profiles, we used a previously proposed factor analysis. We found that the regions were automatically defined, outlined by unsupervised clustering, associated with independent manual annotations, in some cases, finding further relevant subdivisions. The morphological patterns were also correlated with molecular profiles and could predict the spatial variation of individual genes. This novel approach enables flexible unsupervised studies relating morphological and genetic heterogeneity using AI to be carried out.

Highlights

  • Prostate cancer is the second most commonly diagnosed cancer and the fifth most common cause of cancer death in men worldwide [1]

  • To the best of our knowledge, studies aiming to directly correlate automatically extracted quantitative representations of morphology given by histology to transcriptomics signature are lacking for prostate cancer, which may be precisely due to its high heterogeneity

  • Despite the models being blind to spatial transcriptomics (ST) data, the correlation of morphological descriptors with gene expression were comparable with previous studies which trained a model to predict individual gene expression [14]

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Summary

Introduction

Prostate cancer is the second most commonly diagnosed cancer and the fifth most common cause of cancer death in men worldwide [1]. The relationship between genetic and morphological heterogeneity has been previously suggested, and gene expression differences relate to clinical traits of prostate cancer [3]. Higher Gleason grades [4], which evaluate prostate morphology in hematoxylin and eosin (H&E) slides, have been shown to correlate with an increasing number of genetic alterations [5]. Advances in spatially resolved transcriptomics enable spatial profiling of gene expression [7], permitting the simultaneous study of tissue histology and transcriptomics. Berglund et al used factor analysis on spatial transcriptomics (ST) data to define transcriptomics profiles that identified diseased prostate areas [8]. To the best of our knowledge, studies aiming to directly correlate automatically extracted quantitative representations of morphology given by histology to transcriptomics signature are lacking for prostate cancer, which may be precisely due to its high heterogeneity

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