Skip to main content
Top
Published in: Gastric Cancer 6/2020

01-11-2020 | Ascites | Original Article

Development and validation of a deep learning system for ascites cytopathology interpretation

Authors: Feng Su, Yu Sun, Yajie Hu, Peijiang Yuan, Xinyu Wang, Qian Wang, Jianmin Li, Jia-Fu Ji

Published in: Gastric Cancer | Issue 6/2020

Login to get access

Abstract

Background

Early diagnosis of Peritoneal metastasis (PM) is clinically significant regarding optimal treatment selection and avoidance of unnecessary surgical procedures. Cytopathology plays an important role in early screening of PM. We aimed to develop a deep learning (DL) system to achieve intelligent cytopathology interpretation, especially in ascites cytopathology.

Methods

The original ascites cytopathology image dataset consists of 139 patients’ original hematoxylin–eosin (HE) and Papanicolaou (PAP) Staining images. DL system was developed using transfer learning (TL) to achieve cell detection and classification. Pre-trained alexnet, vgg16, goolenet, resnet18 and resnet50 models were studied. Cell detection dataset consists of 176 cropped images with 6573 annotated cell bounding boxes. Cell classification data set consists of 487 cropped images with 18,558 and 6089 annotated malignant and benign cells in total, respectively.

Results

We established a novel ascites cytopathology image dataset and achieved automatically cell detection and classification. DetectionNet based on Faster R-CNN using pre-trained resnet18 achieved cell detection with 87.22% of cells’ Intersection of Union (IoU) bigger than the threshold of 0.5. The mean average precision (mAP) was 0.8316. The ClassificationNet based on resnet50 achieved the greatest performance in cell classification with AUC = 0.8851, Precision = 96.80%, FNR = 4.73%. The DL system integrating the separately trained DetectionNet and Classificationnet showed great performance in the cytopathology image interpretation.

Conclusions

We demonstrate that the integration of DL can improve the efficiency of healthcare. The DL system we developed using TL techniques achieved accurate cytopathology interpretation, and had great potential to be integrated into clinician workflow.
Literature
1.
go back to reference Mnih V, Kavukcuoglu K, Silver D, Rusu AA, Veness J, Bellemare MG, et al. Human-level control through deep reinforcement learning. Nature. 2015;518:529.CrossRef Mnih V, Kavukcuoglu K, Silver D, Rusu AA, Veness J, Bellemare MG, et al. Human-level control through deep reinforcement learning. Nature. 2015;518:529.CrossRef
2.
go back to reference Weng J, McClelland J, Pentland A, Sporns O, Stockman I, Sur M, et al. Autonomous mental development by robots and animals Science (80-). Am Assoc Adv Sci. 2001;291:599–600. Weng J, McClelland J, Pentland A, Sporns O, Stockman I, Sur M, et al. Autonomous mental development by robots and animals Science (80-). Am Assoc Adv Sci. 2001;291:599–600.
3.
go back to reference Gil Y, Greaves M, Hendler J, Hirsh H. Amplify scientific discovery with artificial intelligence Science (80- ). Am Assoc Adv Sci. 2014;346:171–2. Gil Y, Greaves M, Hendler J, Hirsh H. Amplify scientific discovery with artificial intelligence Science (80- ). Am Assoc Adv Sci. 2014;346:171–2.
4.
go back to reference Rosé CP. Artificial intelligence: a social spin on language analysis. Nature. Nat Publ Group. 2017;545:166. Rosé CP. Artificial intelligence: a social spin on language analysis. Nature. Nat Publ Group. 2017;545:166.
5.
go back to reference Silver D, Huang A, Maddison CJ, Guez A, Sifre L, Van Den Driessche G, et al. Mastering the game of go with deep neural networks and tree search. Nature. Nat Publ Group. 2016;529:484. Silver D, Huang A, Maddison CJ, Guez A, Sifre L, Van Den Driessche G, et al. Mastering the game of go with deep neural networks and tree search. Nature. Nat Publ Group. 2016;529:484.
11.
go back to reference Nabi J. Artificial intelligence can augment global pathology initiatives. Lancet Elsevier. 2018;392:2351–2.CrossRef Nabi J. Artificial intelligence can augment global pathology initiatives. Lancet Elsevier. 2018;392:2351–2.CrossRef
12.
go back to reference Wilson ML, Sayed S, Horton S, Fleming KA. Artificial intelligence can augment global pathology initiatives: authors’ reply. Lancet Elsevier. 2018;392:2352.CrossRef Wilson ML, Sayed S, Horton S, Fleming KA. Artificial intelligence can augment global pathology initiatives: authors’ reply. Lancet Elsevier. 2018;392:2352.CrossRef
13.
go back to reference Maeda H, Kobayashi M, Sakamoto J. Evaluation and treatment of malignant ascites secondary to gastric cancer. World J Gastroenterol WJG Baishideng Publishing Group Inc. 2015;21(39):10936–47.CrossRef Maeda H, Kobayashi M, Sakamoto J. Evaluation and treatment of malignant ascites secondary to gastric cancer. World J Gastroenterol WJG Baishideng Publishing Group Inc. 2015;21(39):10936–47.CrossRef
14.
go back to reference Lim JS, Kim M-J, Oh YT, Kim JH, Hwang HS, Park M-S, et al. Comparison of CT and 18F-FDG pet for detecting peritoneal metastasis on the preoperative evaluation for gastric carcinoma. Korean J Radiol. 2006;7:249–56.CrossRef Lim JS, Kim M-J, Oh YT, Kim JH, Hwang HS, Park M-S, et al. Comparison of CT and 18F-FDG pet for detecting peritoneal metastasis on the preoperative evaluation for gastric carcinoma. Korean J Radiol. 2006;7:249–56.CrossRef
15.
go back to reference Li Z, Ji J. Application of laparoscopy in the diagnosis and treatment of gastric cancer. Ann Transl Med AME Publications. 2015;3(9):126. Li Z, Ji J. Application of laparoscopy in the diagnosis and treatment of gastric cancer. Ann Transl Med AME Publications. 2015;3(9):126.
16.
go back to reference Yonemura Y, Bandou E, Kawamura T, Endou Y, Sasaki T. Quantitative prognostic indicators of peritoneal dissemination of gastric cancer. Eur J Surg Oncol Elsevier. 2006;32:602–6.CrossRef Yonemura Y, Bandou E, Kawamura T, Endou Y, Sasaki T. Quantitative prognostic indicators of peritoneal dissemination of gastric cancer. Eur J Surg Oncol Elsevier. 2006;32:602–6.CrossRef
17.
go back to reference Lee SD, Ryu KW, Eom BW, Lee JH, Kook MC, Kim Y-W. Prognostic significance of peritoneal washing cytology in patients with gastric cancer. Br J Surg Wiley Online Library. 2012;99:397–403. Lee SD, Ryu KW, Eom BW, Lee JH, Kook MC, Kim Y-W. Prognostic significance of peritoneal washing cytology in patients with gastric cancer. Br J Surg Wiley Online Library. 2012;99:397–403.
18.
go back to reference Win KY, Choomchuay S, Hamamoto K (2017). Automated segmentation and isolation of touching cell nuclei in cytopathology smear images of pleural effusion using distance transform watershed method. Second Int Work Pattern Recognit. 104430Q Win KY, Choomchuay S, Hamamoto K (2017). Automated segmentation and isolation of touching cell nuclei in cytopathology smear images of pleural effusion using distance transform watershed method. Second Int Work Pattern Recognit. 104430Q
19.
go back to reference Ren S, He K, Girshick R, Sun J (2015) Faster R-CNN: towards real-time object detection with region proposal networks. Int Conf Neural Inf Process Syst. 91–9 Ren S, He K, Girshick R, Sun J (2015) Faster R-CNN: towards real-time object detection with region proposal networks. Int Conf Neural Inf Process Syst. 91–9
20.
go back to reference Bejnordi BE, Veta M, Van Diest PJ, Van Ginneken B, Karssemeijer N, Litjens G, et al. Diagnostic assessment of deep learning algorithms for detection of lymph node metastases in women with breast cancer. Jama Am Med Assoc. 2017;318:2199–210.CrossRef Bejnordi BE, Veta M, Van Diest PJ, Van Ginneken B, Karssemeijer N, Litjens G, et al. Diagnostic assessment of deep learning algorithms for detection of lymph node metastases in women with breast cancer. Jama Am Med Assoc. 2017;318:2199–210.CrossRef
21.
go back to reference Kather JN, Krisam J, Charoentong P, Luedde T, Herpel E, Weis C-A, et al. Predicting survival from colorectal cancer histology slides using deep learning: a retrospective multicenter study. PLoS Med Publ Library Sci. 2019;16:e1002730. Kather JN, Krisam J, Charoentong P, Luedde T, Herpel E, Weis C-A, et al. Predicting survival from colorectal cancer histology slides using deep learning: a retrospective multicenter study. PLoS Med Publ Library Sci. 2019;16:e1002730.
22.
go back to reference Yu K-H, Zhang C, Berry GJ, Altman RB, Ré C, Rubin DL, et al. Predicting non-small cell lung cancer prognosis by fully automated microscopic pathology image features. Nat Commun Nat Publ Group. 2016;7:12474.CrossRef Yu K-H, Zhang C, Berry GJ, Altman RB, Ré C, Rubin DL, et al. Predicting non-small cell lung cancer prognosis by fully automated microscopic pathology image features. Nat Commun Nat Publ Group. 2016;7:12474.CrossRef
23.
go back to reference Mobadersany P, Yousefi S, Amgad M, Gutman DA, Barnholtz-Sloan JS, Vega JEV, et al. Predicting cancer outcomes from histology and genomics using convolutional networks. Proc Natl Acad Sci Natl Acad Sci. 2018;115:E2970–E29792979.CrossRef Mobadersany P, Yousefi S, Amgad M, Gutman DA, Barnholtz-Sloan JS, Vega JEV, et al. Predicting cancer outcomes from histology and genomics using convolutional networks. Proc Natl Acad Sci Natl Acad Sci. 2018;115:E2970–E29792979.CrossRef
24.
go back to reference Hanna MG, Pantanowitz L. Why is digital pathology in cytopathology lagging behind surgical pathology? Cancer Cytopathol Wiley Online Library. 2017;125:519–20.CrossRef Hanna MG, Pantanowitz L. Why is digital pathology in cytopathology lagging behind surgical pathology? Cancer Cytopathol Wiley Online Library. 2017;125:519–20.CrossRef
25.
go back to reference Sato A, Kawasaki T, Abo-Yashima A, Yoshida T, Kobayashi S, Kashiwaba M, et al. Cytological features of lymphoepithelioma-like carcinoma of the breast. Cytopathol Wiley Online Library. 2017;28:169–72. Sato A, Kawasaki T, Abo-Yashima A, Yoshida T, Kobayashi S, Kashiwaba M, et al. Cytological features of lymphoepithelioma-like carcinoma of the breast. Cytopathol Wiley Online Library. 2017;28:169–72.
26.
go back to reference Kinsey CM. The evolving role of cytopathology in the era of advanced diagnostic and therapeutic bronchoscopy. Cancer Cytopathol Wiley Online Library. 2015;123:687–8.CrossRef Kinsey CM. The evolving role of cytopathology in the era of advanced diagnostic and therapeutic bronchoscopy. Cancer Cytopathol Wiley Online Library. 2015;123:687–8.CrossRef
27.
go back to reference Emoto S, Kitayama J, Ishigami H, Yamaguchi H, Watanabe T. Clinical significance of cytological status of peritoneal lavage fluid during intraperitoneal chemotherapy for gastric cancer with overt peritoneal dissemination. Ann Surg Oncol Springer. 2015;22:780–6.CrossRef Emoto S, Kitayama J, Ishigami H, Yamaguchi H, Watanabe T. Clinical significance of cytological status of peritoneal lavage fluid during intraperitoneal chemotherapy for gastric cancer with overt peritoneal dissemination. Ann Surg Oncol Springer. 2015;22:780–6.CrossRef
28.
go back to reference Hollerbach S, Willert J, Topalidis T, Reiser M, Schmiegel W (2003). Endoscopic ultrasound-guided fine-needle aspiration biopsy of liver lesions: histological and cytological assessment. Endoscopy. {\copyright} Georg Thieme Verlag Stuttgart·New York. 35:743–9. Hollerbach S, Willert J, Topalidis T, Reiser M, Schmiegel W (2003). Endoscopic ultrasound-guided fine-needle aspiration biopsy of liver lesions: histological and cytological assessment. Endoscopy. {\copyright} Georg Thieme Verlag Stuttgart·New York. 35:743–9.
29.
go back to reference Pitman MB, Layfield LJ. Guidelines for pancreaticobiliary cytology from the papanicolaou society of cytopathology: a review. Cancer Cytopathol Wiley Online Library. 2014;122:399–411.CrossRef Pitman MB, Layfield LJ. Guidelines for pancreaticobiliary cytology from the papanicolaou society of cytopathology: a review. Cancer Cytopathol Wiley Online Library. 2014;122:399–411.CrossRef
30.
go back to reference Samulski TD, Taylor LA, La T, Mehr CR, McGrath CM, Wu RI. The utility of adaptive eLearning in cervical cytopathology education. Cancer Cytopathol Wiley Online Library. 2018;126:129–35.CrossRef Samulski TD, Taylor LA, La T, Mehr CR, McGrath CM, Wu RI. The utility of adaptive eLearning in cervical cytopathology education. Cancer Cytopathol Wiley Online Library. 2018;126:129–35.CrossRef
31.
go back to reference Wilson ML, Fleming KA, Kuti MA, Looi LM, Lago N, Ru K. Access to pathology and laboratory medicine services: a crucial gap. Lancet Elsevier. 2018;391:1927–38.CrossRef Wilson ML, Fleming KA, Kuti MA, Looi LM, Lago N, Ru K. Access to pathology and laboratory medicine services: a crucial gap. Lancet Elsevier. 2018;391:1927–38.CrossRef
32.
go back to reference Powers CN, Kaminsky DB. Cytopathology is the Nexus for patient-centered care. Cancer Cytopathol Wiley Online Library. 2017;125:443–5.CrossRef Powers CN, Kaminsky DB. Cytopathology is the Nexus for patient-centered care. Cancer Cytopathol Wiley Online Library. 2017;125:443–5.CrossRef
33.
go back to reference Chapman CN, Otis CN. From critical values to critical diagnoses: a review with an emphasis on cytopathology. Cancer Cytopathol Wiley Online Library. 2011;119:148–57.CrossRef Chapman CN, Otis CN. From critical values to critical diagnoses: a review with an emphasis on cytopathology. Cancer Cytopathol Wiley Online Library. 2011;119:148–57.CrossRef
34.
go back to reference Wright AM, Smith D, Dhurandhar B, Fairley T, Scheiber-Pacht M, Chakraborty S, et al. Digital slide imaging in cervicovaginal cytology: a pilot study. Arch Pathol Lab Med Coll Am Pathol. 2012;137:618–24.CrossRef Wright AM, Smith D, Dhurandhar B, Fairley T, Scheiber-Pacht M, Chakraborty S, et al. Digital slide imaging in cervicovaginal cytology: a pilot study. Arch Pathol Lab Med Coll Am Pathol. 2012;137:618–24.CrossRef
35.
go back to reference Cucoranu IC, Parwani AV, Pantanowitz L. Digital whole slide imaging in cytology. Arch Pathol Lab Med Coll Am Pathol. 2014;138:300.CrossRef Cucoranu IC, Parwani AV, Pantanowitz L. Digital whole slide imaging in cytology. Arch Pathol Lab Med Coll Am Pathol. 2014;138:300.CrossRef
36.
go back to reference Tareef A, Song Y, Huang H, Wang Y, Feng D, Chen M, et al. Optimizing the cervix cytological examination based on deep learning and dynamic shape modeling. Neurocomputing. 2017;248:28–40.CrossRef Tareef A, Song Y, Huang H, Wang Y, Feng D, Chen M, et al. Optimizing the cervix cytological examination based on deep learning and dynamic shape modeling. Neurocomputing. 2017;248:28–40.CrossRef
37.
go back to reference Song Y, Zhang L, Chen S, Ni D, Lei B, Wang T. Accurate segmentation of cervical cytoplasm and nuclei based on multiscale convolutional network and graph partitioning. IEEE Trans Biomed Eng. 2015;62:2421.CrossRef Song Y, Zhang L, Chen S, Ni D, Lei B, Wang T. Accurate segmentation of cervical cytoplasm and nuclei based on multiscale convolutional network and graph partitioning. IEEE Trans Biomed Eng. 2015;62:2421.CrossRef
38.
go back to reference Liu J, Wang D, Lu L, Wei Z, Kim L, Turkbey EB, et al. Detection and diagnosis of colitis on computed tomography using deep convolutional neural networks. Med Phys United States. 2017;44:4630–42. Liu J, Wang D, Lu L, Wei Z, Kim L, Turkbey EB, et al. Detection and diagnosis of colitis on computed tomography using deep convolutional neural networks. Med Phys United States. 2017;44:4630–42.
39.
go back to reference Han SS, Kim MS, Lim W, Park GH, Park I, Chang SE. Classification of the clinical images for benign and malignant cutaneous tumors using a deep learning algorithm. J Invest Dermatol United States. 2018;138:1529–38.CrossRef Han SS, Kim MS, Lim W, Park GH, Park I, Chang SE. Classification of the clinical images for benign and malignant cutaneous tumors using a deep learning algorithm. J Invest Dermatol United States. 2018;138:1529–38.CrossRef
40.
go back to reference Sayed S, Cherniak W, Lawler M, Tan SY, El Sadr W, Wolf N, et al. Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions. Lancet Elsevier. 2018;391:1939–52.CrossRef Sayed S, Cherniak W, Lawler M, Tan SY, El Sadr W, Wolf N, et al. Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions. Lancet Elsevier. 2018;391:1939–52.CrossRef
Metadata
Title
Development and validation of a deep learning system for ascites cytopathology interpretation
Authors
Feng Su
Yu Sun
Yajie Hu
Peijiang Yuan
Xinyu Wang
Qian Wang
Jianmin Li
Jia-Fu Ji
Publication date
01-11-2020
Publisher
Springer Singapore
Keyword
Ascites
Published in
Gastric Cancer / Issue 6/2020
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-020-01093-1

Other articles of this Issue 6/2020

Gastric Cancer 6/2020 Go to the issue