AI-assisted cervical cytology precancerous screening for high-risk population in resource-limited regions using a compact microscope.

Journal: Nature communications
Published Date:

Abstract

Insufficient coverage of cervical cytology screening in resource-limited areas remains a major bottleneck for women's health, as traditional centralized methods require significant investment and many qualified pathologists. Using consumer-grade electronic hardware and aspherical lenses, we design an ultra-low-cost and compact microscope. Given the microscope's low resolution, which hinders accurate identification of lesion cells in cervical samples, we train a coarse instance classifier to screen and extract feature sequences of the top 200 instances containing potential lesions from a slide. We further develop Att-Transformer to focus on and integrate the sparse lesion information from these sequences, enabling slide grading. Our model is trained and validated using 3510 low-resolution slides from female patients at four hospitals, and subsequently evaluated on four independent datasets. The system achieves area under the receiver operating characteristic curve values of 0.87 and 0.89 for detecting squamous intraepithelial lesions on 364 slides from female patients at two external primary hospitals, 0.89 on 391 newly collected slides from female patients at the original four hospitals, and 0.85 on 570 human papillomavirus positive slides from female patients. These findings demonstrate the feasibility of our AI-assisted approach for effective detection of high-risk cervical precancer among women in resource-limited regions.

Authors

  • Jiaxin Bai
    MOE Key Laboratory for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China.
  • Ning Li
    Department of Respiratory and Critical Care Medicine, Center for Respiratory Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
  • Hua Ye
    Department of Pulmonary and Critical Care Medicine, Affiliated Yueqing Hospital, Wenzhou Medical University, Yueqing 325600, China.
  • Xu Li
    Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
  • Li Chen
    Department of Endocrinology and Metabolism, Qilu Hospital, Shandong University, Jinan, China.
  • Junbo Hu
    Department of Pathology, Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. cqjbhu@163.com.
  • Baochuan Pang
    Landing Artificial Intelligence Center for Pathological Diagnosis, Wuhan University, Wuhan, China.
  • Xiaodong Chen
  • Gong Rao
    Collaborative Innovation Center for Biomedical Engineering, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Qinglei Hu
    Tinyphoton (Wuhan) Technology Co., Ltd., Wuhan, China.
  • Shijie Liu
    Department of Chemical Engineering, SUNY College of Environmental Science and Forestry, Syracuse, NY 13210 USA.
  • Si Sun
    Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Cheng Li
    College of Food and Bioengineering, Henan University of Science and Technology, Luoyang, China.
  • Xiaohua Lv
    Collaborative Innovation Center for Biomedical Engineering, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Shaoqun Zeng
    Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, 430074, Hubei, China.
  • Jing Cai
    Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China.
  • Shenghua Cheng
    School of Hydraulic and Environmental Engineering, Changsha University of Science and Technology, Changsha 410114, China.
  • Xiuli Liu
    Washington University School of Medicine, St Louis, MO, USA.