A decision support system for the detection of cutaneous fungal infections using artificial intelligence.

Journal: Pathology, research and practice
Published Date:

Abstract

Cutaneous fungal infections are one of the most common skin conditions, hence, the burden of determining fungal elements upon microscopic examination with periodic acid-Schiff (PAS) and Gomori methenamine silver (GMS) stains, is very time consuming. Despite some morphological variability posing challenges to training artificial intelligence (AI)-based solutions, these structures are favored potential targets, enabling the recruitment of promising AI-based technologies. Herein, we present a novel AI solution for identifying skin fungal infections, potentially providing a decision support system for pathologists. Skin biopsies of patients diagnosed with a cutaneous fungal infection at the Sheba Medical Center, Israel between 2014 and 2023, were used. Samples were stained with PAS and GMS and digitized by the Philips IntelliSite scanner. DeePathology® STUDIO fungal elements were annotated and deemed as ground truth data after an overall revision by two specialist pathologists. Subsequently, they were used to create an AI-based solution, which has been further validated in other regions of interests. The study participants were divided into two cohorts. In the first cohort, the overall sensitivity of the algorithm was 0.8, specificity 0.97, F1 score 0.78; in the second, the overall sensitivity of the algorithm was 0.93, specificity 0.99, F1 score 0.95. The results obtained are encouraging as proof of concept for an AI-based fungi detection algorithm. DeePathology® STUDIO can be employed as a decision support system for pathologists when diagnosing a cutaneous fungal infection using PAS and GMS stains, thereby, saving time and money.

Authors

  • Naama Rappoport
    Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel; Department of Dermatology, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Israel. Electronic address: nimarap123@gmail.com.
  • Gil Goldinger
    Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel. Electronic address: Gil.Goldinger@sheba.health.gov.il.
  • Assaf Debby
    Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel. Electronic address: Assaf.Debby@sheba.health.gov.il.
  • Yosef Molchanov
    Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel. Electronic address: Yossef.Molchanov@sheba.health.gov.il.
  • Yoash Barak
    Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel. Electronic address: Yoash.Barak@sheba.health.gov.il.
  • Jacob Gildenblat
    DeePathology.ai, Raanana, Israel.
  • Ofir Hadar
    DeePathology Ltd., HaTidhar 5, Ra'anana, Israel. Electronic address: ofir@deepathology.ai.
  • Chen Sagiv
    DeePathology Ltd., HaTidhar 5, Ra'anana, Israel. Electronic address: chen@deepathology.ai.
  • Aviv Barzilai
    Department of Dermatology, Sheba Medical Center, Ramat-Gan, affiliated with the Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.