Training high-performance deep learning classifier for diagnosis in oral cytology using diverse annotations.

Journal: Scientific reports
Published Date:

Abstract

The uncertainty of true labels in medical images hinders diagnosis owing to the variability across professionals when applying deep learning models. We used deep learning to obtain an optimal convolutional neural network (CNN) by adequately annotating data for oral exfoliative cytology considering labels from multiple oral pathologists. Six whole-slide images were processed using QuPath for segmenting them into tiles. The images were labeled by three oral pathologists, resulting in 14,535 images with the corresponding pathologists' annotations. Data from three pathologists who provided the same diagnosis were labeled as ground truth (GT) and used for testing. We investigated six models trained using the annotations of (1) pathologist A, (2) pathologist B, (3) pathologist C, (4) GT, (5) majority voting, and (6) a probabilistic model. We divided the test by cross-validation per slide dataset and examined the classification performance of the CNN with a ResNet50 baseline. Statistical evaluation was performed repeatedly and independently using every slide 10 times as test data. For the area under the curve, three cases showed the highest values (0.861, 0.955, and 0.991) for the probabilistic model. Regarding accuracy, two cases showed the highest values (0.988 and 0.967). For the models using the pathologists and GT annotations, many slides showed very low accuracy and large variations across tests. Hence, the classifier trained with probabilistic labels provided the optimal CNN for oral exfoliative cytology considering diagnoses from multiple pathologists. These results may lead to trusted medical artificial intelligence solutions that reflect diverse diagnoses of various professionals.

Authors

  • Shintaro Sukegawa
    Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa 760-8557, Japan.
  • Futa Tanaka
    Department of Electrical, Electronic and Computer Engineering, Faculty of Engineering, Gifu University, Gifu, Gifu, Japan.
  • Keisuke Nakano
    Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan.
  • Takeshi Hara
    Department of Psychosomatic Medicine, Endocrinology and Diabetes Mellitus, Fukuoka Tokushukai Hospital, Kasuga, Fukuoka, Japan.
  • Takanaga Ochiai
    Division of Oral Pathogenesis and Disease Control, Department of Oral Pathology, Asahi University School of Dentistry, Mizuho, 501-0296, Japan.
  • Katsumitsu Shimada
    Department of Oral Pathology, Graduate School of Oral Medicine, Matsumoto Dental University, 1780 Hirooka-Gobara, Shiojiri, Nagano, 399-0781, Japan.
  • Yuta Inoue
    Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Yoshihiro Taki
    Department of Electrical, Electronic and Computer Engineering, Faculty of Engineering, Gifu University, 1-1 Yanagido, Gifu, Gifu, 501-1193, Japan.
  • Fumi Nakai
    Department of Oral and Maxillofacial Surgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
  • Yasuhiro Nakai
    Department of Oral and Maxillofacial Surgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
  • Takanori Ishihama
    Department of Oral and Maxillofacial Surgery, Kagawa University Faculty of Medicine, 1750-1, Ikenobe, Miki-Cho, Kita-Gun, Kagawa, 761-0793, Japan.
  • Ryo Miyazaki
    Department of Oral and Maxillofacial Surgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.
  • Satoshi Murakami
    Department of Oral Pathology, Graduate School of Oral Medicine, Matsumoto Dental University, 1780 Hirooka-Gobara, Shiojiri, Nagano, 399-0781, Japan.
  • Hitoshi Nagatsuka
    Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8525, Japan.
  • Minoru Miyake
    Department of Oral and Maxillofacial Surgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki, Kagawa, 761-0793, Japan.