Development and prospective validation of a prostate cancer detection, grading, and workflow optimization system at an academic medical center

Fuente: arXiv
Saved in:
Bibliographic Details
Main Authors: Nateghi, Ramin, Zhou, Ruoji, Saft, Madeline, Schnauss, Marina, Neill, Clayton, Alam, Ridwan, Handa, Nicole, Huang, Mitchell, Li, Eric V, Goldstein, Jeffery A, Schaeffer, Edward M, Nadim, Menatalla, Pourakpour, Fattaneh, Isaila, Bogdan, Felicelli, Christopher, Mehta, Vikas, Nezami, Behtash G, Ross, Ashley, Yang, Ximing, Cooper, Lee AD
Format: Preprint
Published: 2024
Subjects:
Online Access:
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1866910876405071872
author Nateghi, Ramin
Zhou, Ruoji
Saft, Madeline
Schnauss, Marina
Neill, Clayton
Alam, Ridwan
Handa, Nicole
Huang, Mitchell
Li, Eric V
Goldstein, Jeffery A
Schaeffer, Edward M
Nadim, Menatalla
Pourakpour, Fattaneh
Isaila, Bogdan
Felicelli, Christopher
Mehta, Vikas
Nezami, Behtash G
Ross, Ashley
Yang, Ximing
Cooper, Lee AD
author_facet Nateghi, Ramin
Zhou, Ruoji
Saft, Madeline
Schnauss, Marina
Neill, Clayton
Alam, Ridwan
Handa, Nicole
Huang, Mitchell
Li, Eric V
Goldstein, Jeffery A
Schaeffer, Edward M
Nadim, Menatalla
Pourakpour, Fattaneh
Isaila, Bogdan
Felicelli, Christopher
Mehta, Vikas
Nezami, Behtash G
Ross, Ashley
Yang, Ximing
Cooper, Lee AD
contents Artificial intelligence may assist healthcare systems in meeting increasing demand for pathology services while maintaining diagnostic quality and reducing turnaround time and costs. We aimed to investigate the performance of an institutionally developed system for prostate cancer detection, grading, and workflow optimization and to contrast this with commercial alternatives. From August 2021 to March 2023, we scanned 21,396 slides from 1,147 patients receiving prostate biopsy. We developed models for cancer detection, grading, and screening of equivocal cases for IHC ordering. We compared the performance of task-specific prostate models with general-purpose foundation models in a prospectively collected dataset that reflects our patient population. We also evaluated the contributions of a bespoke model designed to improve sensitivity to small cancer foci and perception of low-resolution patterns. We found high concordance with pathologist ground-truth in detection (area under curve 98.5%, sensitivity 95.0%, and specificity 97.8%), ISUP grading (Cohen's kappa 0.869), grade group 3 or higher classification (area under curve 97.5%, sensitivity 94.9%, specificity 96.6%). Screening models could correctly classify 55% of biopsy blocks where immunohistochemistry was ordered with a 1.4% error rate. No statistically significant differences were observed between task-specific and foundation models in cancer detection, although the task-specific model is significantly smaller and faster. Institutions like academic medical centers that have high scanning volumes and report abstraction capabilities can develop highly accurate computational pathology models for internal use. These models have the potential to aid in quality control role and to improve resource allocation and workflow in the pathology lab to help meet future challenges in prostate cancer diagnosis.
format Preprint
id arxiv_https___arxiv_org_abs_2410_23642
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Development and prospective validation of a prostate cancer detection, grading, and workflow optimization system at an academic medical center
Nateghi, Ramin
Zhou, Ruoji
Saft, Madeline
Schnauss, Marina
Neill, Clayton
Alam, Ridwan
Handa, Nicole
Huang, Mitchell
Li, Eric V
Goldstein, Jeffery A
Schaeffer, Edward M
Nadim, Menatalla
Pourakpour, Fattaneh
Isaila, Bogdan
Felicelli, Christopher
Mehta, Vikas
Nezami, Behtash G
Ross, Ashley
Yang, Ximing
Cooper, Lee AD
Image and Video Processing
Computer Vision and Pattern Recognition
Artificial intelligence may assist healthcare systems in meeting increasing demand for pathology services while maintaining diagnostic quality and reducing turnaround time and costs. We aimed to investigate the performance of an institutionally developed system for prostate cancer detection, grading, and workflow optimization and to contrast this with commercial alternatives. From August 2021 to March 2023, we scanned 21,396 slides from 1,147 patients receiving prostate biopsy. We developed models for cancer detection, grading, and screening of equivocal cases for IHC ordering. We compared the performance of task-specific prostate models with general-purpose foundation models in a prospectively collected dataset that reflects our patient population. We also evaluated the contributions of a bespoke model designed to improve sensitivity to small cancer foci and perception of low-resolution patterns. We found high concordance with pathologist ground-truth in detection (area under curve 98.5%, sensitivity 95.0%, and specificity 97.8%), ISUP grading (Cohen's kappa 0.869), grade group 3 or higher classification (area under curve 97.5%, sensitivity 94.9%, specificity 96.6%). Screening models could correctly classify 55% of biopsy blocks where immunohistochemistry was ordered with a 1.4% error rate. No statistically significant differences were observed between task-specific and foundation models in cancer detection, although the task-specific model is significantly smaller and faster. Institutions like academic medical centers that have high scanning volumes and report abstraction capabilities can develop highly accurate computational pathology models for internal use. These models have the potential to aid in quality control role and to improve resource allocation and workflow in the pathology lab to help meet future challenges in prostate cancer diagnosis.
title Development and prospective validation of a prostate cancer detection, grading, and workflow optimization system at an academic medical center
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2410.23642