Hybrid AI-assistive diagnostic model permits rapid TBS classification of cervical liquid-based thin-layer cell smears.

Journal: Nature communications
Published Date:

Abstract

Technical advancements significantly improve earlier diagnosis of cervical cancer, but accurate diagnosis is still difficult due to various factors. We develop an artificial intelligence assistive diagnostic solution, AIATBS, to improve cervical liquid-based thin-layer cell smear diagnosis according to clinical TBS criteria. We train AIATBS with >81,000 retrospective samples. It integrates YOLOv3 for target detection, Xception and Patch-based models to boost target classification, and U-net for nucleus segmentation. We integrate XGBoost and a logical decision tree with these models to optimize the parameters given by the learning process, and we develop a complete cervical liquid-based cytology smear TBS diagnostic system which also includes a quality control solution. We validate the optimized system with >34,000 multicenter prospective samples and achieve better sensitivity compared to senior cytologists, yet retain high specificity while achieving a speed of <180s/slide. Our system is adaptive to sample preparation using different standards, staining protocols and scanners.

Authors

  • Xiaohui Zhu
    Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou, Guangdong Province, PR China.
  • Xiaoming Li
    Department of Radiology, Southwest Hospital, Third Military Medical University (Army Military Medical University), Chongqing, China.
  • Kokhaur Ong
    Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
  • Wenli Zhang
    Comprehensive Testing Center, North China University of Science and Technology, Tangshan, 063210, PR China.
  • Wencai Li
    The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, PR China.
  • Longjie Li
    Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
  • David Young
    Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
  • Yongjian Su
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Bin Shang
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Linggan Peng
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Wei Xiong
    Department of Nutrition and Health, China Agricultural University, Beijing 100193, China; Food Laboratory of Zhongyuan, Luohe, Henan 462300, China. Electronic address: xiongwei910702@126.com.
  • Yunke Liu
    Laboratory Department, Guangzhou Tianhe District Maternal and Child Health Care Hospital, Guangzhou, Guangdong Province, PR China.
  • Wenting Liao
    State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, PR China.
  • Jingjing Xu
    Visionary Intelligence Ltd., Beijing, China.
  • Feifei Wang
    Peking University Institute of Mental Health , Beijing , China.
  • Qing Liao
    Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou, Guangdong Province, PR China.
  • Shengnan Li
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Minmin Liao
    Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou, Guangdong Province, PR China.
  • Yu Li
    Department of Public Health, Shihezi University School of Medicine, 832000, China.
  • Linshang Rao
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Jinquan Lin
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Jianyuan Shi
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Zejun You
    Guangzhou F.Q.PATHOTECH Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Wenlong Zhong
    Guangzhou Huayin medical inspection center Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Xinrong Liang
    Guangzhou Huayin medical inspection center Co., Ltd, Guangzhou, Guangdong Province, PR China.
  • Hao Han
    Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.
  • Yan Zhang
    Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, 110032, China.
  • Na Tang
    State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
  • Aixia Hu
    Department of Pathology, Henan Provincial People's Hospital, Zhengzhou, Henan Province, PR China.
  • Hongyi Gao
    Department of Pathology, Guangdong Provincial Women's and Children's Dispensary, Shenzhen, Guangdong Province, PR China.
  • Zhiqiang Cheng
    Department of Pathology, Shenzhen People's Hospital, Shenzhen, 518020, China.
  • Li Liang
    Duke Clinical Research Institute, Duke University, Durham, North Carolina.
  • Weimiao Yu
    Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore. yu_weimiao@bii.a-star.edu.sg.
  • Yanqing Ding
    Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangzhou, Guangdong Province, PR China. dyqgz@126.com.