Artificial intelligence modelling in differentiating core biopsies of fibroadenoma from phyllodes tumor.

Journal: Laboratory investigation; a journal of technical methods and pathology
PMID:

Abstract

Breast fibroepithelial lesions (FEL) are biphasic tumors which consist of benign fibroadenomas (FAs) and the rarer phyllodes tumors (PTs). FAs and PTs have overlapping features, but have different clinical management, which makes correct core biopsy diagnosis important. This study used whole-slide images (WSIs) of 187 FA and 100 PT core biopsies, to investigate the potential role of artificial intelligence (AI) in FEL diagnosis. A total of 9228 FA patches and 6443 PT patches was generated from WSIs of the training subset, with each patch being 224 × 224 pixel in size. Our model employed a two-stage architecture comprising a convolutional neural network (CNN) component for feature extraction from the patches, and a recurrent neural network (RNN) component for whole-slide classification using activation values from the global average pooling layer in the CNN model. It achieved an overall slide-level accuracy of 87.5%, with accuracies of 80% and 95% for FA and PT slides respectively. This affirms the potential role of AI in diagnostic discrimination between FA and PT on core biopsies which may be further refined for use in routine practice.

Authors

  • Chee Leong Cheng
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Nur Diyana Md Nasir
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Gary Jian Zhe Ng
    AI Singapore, Singapore, Singapore.
  • Kenny Wei Jie Chua
    AI Singapore, Singapore, Singapore.
  • Yier Li
    AI Singapore, Singapore, Singapore.
  • Joshua Rodrigues
    AI Singapore, Singapore, Singapore.
  • Aye Aye Thike
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Seow Ye Heng
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Valerie Cui Yun Koh
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Johnathan Xiande Lim
    Division of Pathology, Singapore General Hospital, Singapore, Singapore.
  • Venice Jing Ning Hiew
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Ruoyu Shi
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Benjamin Yongcheng Tan
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Timothy Kwang Yong Tay
    Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.
  • Sudha Ravi
    AI Singapore, Singapore, Singapore.
  • Kim Hock Ng
    AI Singapore, Singapore, Singapore.
  • Kevin Seng Loong Oh
    AI Singapore, Singapore, Singapore.
  • Puay Hoon Tan
    Daniel Aitor Holdbrook, Malay Singh, Emarene Mationg Kalaw, and Hwee Kuan Lee, Bioinformatics Institute; Malay Singh and Hwee Kuan Lee, National University of Singapore; Yukti Choudhury and Min-Han Tan, Lucence Diagnostics; Yukti Choudhury and Min-Han Tan, Institute of Bioengineering and Nanotechnology; Valerie Koh, Puay Hoon Tan, and John Yuen Shyi Peng, Singapore General Hospital; Hui Shan Tan, Ravindran Kanesvaran, and Min-Han Tan, National Cancer Center Singapore; and Hwee Kuan Lee, Institute for Infocomm Research, Singapore.