Assessing the impact of deep-learning assistance on the histopathological diagnosis of serous tubal intraepithelial carcinoma (STIC) in fallopian tubes.

Journal: The journal of pathology. Clinical research
PMID:

Abstract

In recent years, it has become clear that artificial intelligence (AI) models can achieve high accuracy in specific pathology-related tasks. An example is our deep-learning model, designed to automatically detect serous tubal intraepithelial carcinoma (STIC), the precursor lesion to high-grade serous ovarian carcinoma, found in the fallopian tube. However, the standalone performance of a model is insufficient to determine its value in the diagnostic setting. To evaluate the impact of the use of this model on pathologists' performance, we set up a fully crossed multireader, multicase study, in which 26 participants, from 11 countries, reviewed 100 digitalized H&E-stained slides of fallopian tubes (30 cases/70 controls) with and without AI assistance, with a washout period between the sessions. We evaluated the effect of the deep-learning model on accuracy, slide review time and (subjectively perceived) diagnostic certainty, using mixed-models analysis. With AI assistance, we found a significant increase in accuracy (p < 0.01) whereby the average sensitivity increased from 82% to 93%. Further, there was a significant 44 s (32%) reduction in slide review time (p < 0.01). The level of certainty that the participants felt versus their own assessment also significantly increased, by 0.24 on a 10-point scale (p < 0.01). In conclusion, we found that, in a diverse group of pathologists and pathology residents, AI support resulted in a significant improvement in the accuracy of STIC diagnosis and was coupled with a substantial reduction in slide review time. This model has the potential to provide meaningful support to pathologists in the diagnosis of STIC, ultimately streamlining and optimizing the overall diagnostic process.

Authors

  • Joep Ma Bogaerts
    Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Miranda P Steenbeek
    Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • John-Melle Bokhorst
    Diagnostic Image Analysis Group and the Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Majke Hd van Bommel
    Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Luca Abete
    Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria.
  • Francesca Addante
    Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  • Mariel Brinkhuis
    Department of Pathology, LabPON, Hengelo, Netherlands.
  • Alicja Chrzan
    Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
  • Fleur Cordier
    Department of Pathology, Ghent University Hospital, Ghent, Belgium.
  • Mojgan Devouassoux-Shisheboran
    Centre de Pathologie Sud des Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165, chemin du grand Revoyet, 69495 Pierre Bénite Cedex, France.
  • Juan Fernández-Pérez
    Department of Pathology, University Hospital Virgen de la Arrixaca, Murcia, Spain.
  • Anna Fischer
    Institute for Pathology and Neuropathology, University of Tuebingen Medical Center II, Tuebingen, Germany.
  • C Blake Gilks
    Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
  • Angela Guerriero
    Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy.
  • Marta Jaconi
    Department of Pathology, San Gerardo Hospital, Monza, Italy.
  • Tony G Kleijn
    Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands.
  • Loes Kooreman
    Department of Pathology, and GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands.
  • Spencer Martin
    Department of Pathology and Laboratory Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, Canada.
  • Jakob Milla
    Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.
  • Nadine Narducci
    Pathology Department, Ospedale dell'Angelo, Venezia-Mestre, Italy.
  • Chara Ntala
    Department of Pathology, St. George's University Hospitals, London, UK.
  • Vinita Parkash
    Department of Pathology, Yale School of Medicine and Yale School of Public Health, New Haven, CT, USA.
  • Christophe de Pauw
    Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Joseph T Rabban
    Department of Pathology, University of California San Francisco, San Francisco, CA, USA.
  • Lucia Rijstenberg
    Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands.
  • Robert Rottscholl
    Institute for Pathology and Neuropathology, University of Tuebingen Medical Center II, Tuebingen, Germany.
  • Annette Staebler
    Institute for Pathology and Neuropathology, University of Tuebingen Medical Center II, Tuebingen, Germany.
  • Koen Van de Vijver
    Department of Pathology, UZ Gent, Gent, Belgium.
  • Gian Franco Zannoni
    Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  • Monica van Zanten
    Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
  • Joanne A de Hullu
    Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Michiel Simons
    Department of Pathology, Radboudumc, Nijmegen, the Netherlands. Electronic address: Michiel.Simons@radboudumc.nl.
  • Jeroen Awm van der Laak
    Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.