A deep-learning classifier identifies patients with clinical heart failure using whole-slide images of H&E tissue.

Journal: PloS one
Published Date:

Abstract

Over 26 million people worldwide suffer from heart failure annually. When the cause of heart failure cannot be identified, endomyocardial biopsy (EMB) represents the gold-standard for the evaluation of disease. However, manual EMB interpretation has high inter-rater variability. Deep convolutional neural networks (CNNs) have been successfully applied to detect cancer, diabetic retinopathy, and dermatologic lesions from images. In this study, we develop a CNN classifier to detect clinical heart failure from H&E stained whole-slide images from a total of 209 patients, 104 patients were used for training and the remaining 105 patients for independent testing. The CNN was able to identify patients with heart failure or severe pathology with a 99% sensitivity and 94% specificity on the test set, outperforming conventional feature-engineering approaches. Importantly, the CNN outperformed two expert pathologists by nearly 20%. Our results suggest that deep learning analytics of EMB can be used to predict cardiac outcome.

Authors

  • Jeffrey J Nirschl
    Department of Physiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
  • Andrew Janowczyk
    Biomedical Engineering Department, Case Western Reserve University, Cleveland, Ohio.
  • Eliot G Peyster
    Cardiovascular Research Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
  • Renee Frank
    Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
  • Kenneth B Margulies
    Cardiovascular Research Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
  • Michael D Feldman
    Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
  • Anant Madabhushi
    Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.