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Aggarwal A, Bharadwaj S, Corredor G, Pathak T, Badve S, Madabhushi A. Artificial intelligence in digital pathology - time for a reality check. Nat Rev Clin Oncol 2025; 22:283-291. [PMID: 39934323 DOI: 10.1038/s41571-025-00991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2025] [Indexed: 02/13/2025]
Abstract
The past decade has seen the introduction of artificial intelligence (AI)-based approaches aimed at optimizing several workflows across many medical specialties. In clinical oncology, the most promising applications include those involving image analysis, such as digital pathology. In this Perspective, we provide a comprehensive examination of the developments in AI in digital pathology between 2019 and 2024. We evaluate the current landscape from the lens of technological innovations, regulatory trends, deployment and implementation, reimbursement and commercial implications. We assess the technological advances that have driven improvements in AI, enabling more robust and scalable solutions for digital pathology. We also examine regulatory developments, in particular those affecting in-house devices and laboratory-developed tests, which are shaping the landscape of AI-based tools in digital pathology. Finally, we discuss the role of reimbursement frameworks and commercial investment in the clinical adoption of AI-based technologies. In this Perspective, we highlight both the progress and challenges in AI-driven digital pathology over the past 5 years, outlining the path forward for its adoption into routine practice in clinical oncology.
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Affiliation(s)
- Arpit Aggarwal
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Satvika Bharadwaj
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Germán Corredor
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
- Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA
| | - Tilak Pathak
- Department of Biomedical Engineering, Emory University, Atlanta, GA, USA
| | - Sunil Badve
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Anant Madabhushi
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA.
- Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA.
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Mairi A, Hamza L, Touati A. Artificial intelligence and its application in clinical microbiology. Expert Rev Anti Infect Ther 2025:1-22. [PMID: 40131188 DOI: 10.1080/14787210.2025.2484284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 03/12/2025] [Accepted: 03/21/2025] [Indexed: 03/26/2025]
Abstract
INTRODUCTION Traditional microbiological diagnostics face challenges in pathogen identification speed and antimicrobial resistance (AMR) evaluation. Artificial intelligence (AI) offers transformative solutions, necessitating a comprehensive review of its applications, advancements, and integration challenges in clinical microbiology. AREAS COVERED This review examines AI-driven methodologies, including machine learning (ML), deep learning (DL), and convolutional neural networks (CNNs), for enhancing pathogen detection, AMR prediction, and diagnostic imaging. Applications in virology (e.g. COVID-19 RT-PCR optimization), parasitology (e.g. malaria detection), and bacteriology (e.g. automated colony counting) are analyzed. A literature search was conducted using PubMed, Scopus, and Web of Science (2018-2024), prioritizing peer-reviewed studies on AI's diagnostic accuracy, workflow efficiency, and clinical validation. EXPERT OPINION AI significantly improves diagnostic precision and operational efficiency but requires robust validation to address data heterogeneity, model interpretability, and ethical concerns. Future success hinges on interdisciplinary collaboration to develop standardized, equitable AI tools tailored for global healthcare settings. Advancing explainable AI and federated learning frameworks will be critical for bridging current implementation gaps and maximizing AI's potential in combating infectious diseases.
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Affiliation(s)
- Assia Mairi
- Université de Bejaia, Laboratoire d'Ecologie Microbienne, Bejaia, Algeria
| | - Lamia Hamza
- Université de Bejaia, Département d'informatique Laboratoire d'Informatique MEDicale (LIMED), Bejaia, Algeria
| | - Abdelaziz Touati
- Université de Bejaia, Laboratoire d'Ecologie Microbienne, Bejaia, Algeria
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Acs B, Fend F, Guettier C, L'Imperio V, Montezuma D, Zerbe N, Zlobec I. Debating the pros and cons of computational pathology at the European Congress of Pathology (ECP) 2024. Virchows Arch 2025:10.1007/s00428-025-04084-8. [PMID: 40131426 DOI: 10.1007/s00428-025-04084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 03/17/2025] [Accepted: 03/18/2025] [Indexed: 03/27/2025]
Affiliation(s)
- Balazs Acs
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden.
| | - Falko Fend
- Institute of Pathology and Neuropathology, Tübingen University Hospital and Eberhard Karls University Tübingen, Tübingen, Germany
| | - Catherine Guettier
- Department of Pathology, Hopital Bicêtre, Assistance Publique- Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - Vincenzo L'Imperio
- Department of Medicine and Surgery, IRCCS Fondazione San Gerardo Dei Tintori, University of Milano-Bicocca, Pathology, Italy
| | - Diana Montezuma
- Research & Development Unit, IMP Diagnostics, Porto, Portugal
- Cancer Biology and Epigenetics Group, Research Center of IPO Porto (CI-IPO)@RISE (Health Research Network), Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Centre Raquel Seruca (Porto.CCC Raquel Seruca), Porto, Portugal
| | - Norman Zerbe
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
- Institute of Pathology, Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Inti Zlobec
- Institute of Tissue Medicine and Pathology, University of Bern, Murtenstrasse 31, Bern, Switzerland
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Ardila CM, Yadalam PK. AI and dental education. Br Dent J 2025; 238:294. [PMID: 40087417 DOI: 10.1038/s41415-025-8514-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 12/02/2024] [Indexed: 03/17/2025]
Affiliation(s)
- C M Ardila
- PhD Postdoctoral Researcher, Professor, Department of Basic Sciences, Biomedical Stomatology Research Group, Faculty of Dentistry, Universidad de Antioquia, U de A, Medellín, Colombia.
| | - P K Yadalam
- PhD Professor, Department of Periodontics, Saveetha Dental College, SIMATS, Saveetha University, Chennai, Tamil Nadu, India.
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Dangi RR, Sharma A, Vageriya V. Transforming Healthcare in Low-Resource Settings With Artificial Intelligence: Recent Developments and Outcomes. Public Health Nurs 2025; 42:1017-1030. [PMID: 39629887 DOI: 10.1111/phn.13500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 11/10/2024] [Accepted: 11/18/2024] [Indexed: 03/12/2025]
Abstract
BACKGROUND Artificial intelligence now encompasses technologies like machine learning, natural language processing, and robotics, allowing machines to undertake complex tasks traditionally done by humans. AI's application in healthcare has led to advancements in diagnostic tools, predictive analytics, and surgical precision. AIM This comprehensive review aims to explore the transformative impact of AI across diverse healthcare domains, highlighting its applications, advancements, challenges, and contributions to enhancing patient care. METHODOLOGY A comprehensive literature search was conducted across multiple databases, covering publications from 2014 to 2024. Keywords related to AI applications in healthcare were used to gather data, focusing on studies exploring AI's role in medical specialties. RESULTS AI has demonstrated substantial benefits across various fields of medicine. In cardiology, it aids in automated image interpretation, risk prediction, and the management of cardiovascular diseases. In oncology, AI enhances cancer detection, treatment planning, and personalized drug selection. Radiology benefits from improved image analysis and diagnostic accuracy, while critical care sees advancements in patient triage and resource optimization. AI's integration into pediatrics, surgery, public health, neurology, pathology, and mental health has similarly shown significant improvements in diagnostic precision, personalized treatment, and overall patient care. The implementation of AI in low-resource settings has been particularly impactful, enhancing access to advanced diagnostic tools and treatments. CONCLUSION AI is rapidly changing the healthcare industry by greatly increasing the accuracy of diagnoses, streamlining treatment plans, and improving patient outcomes across a variety of medical specializations. This review underscores AI's transformative potential, from early disease detection to personalized treatment plans, and its ability to augment healthcare delivery, particularly in resource-limited settings.
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Affiliation(s)
- Ravi Rai Dangi
- Manikaka Topawala Institute of Nursing, Charotar University of Science and Technology, Changa, Gujarat, India
| | - Anil Sharma
- Manikaka Topawala Institute of Nursing, Charotar University of Science and Technology, Changa, Gujarat, India
| | - Vipin Vageriya
- Manikaka Topawala Institute of Nursing, Charotar University of Science and Technology, Changa, Gujarat, India
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Kawahara T, Sumi Y. GPT-4/4V's performance on the Japanese National Medical Licensing Examination. MEDICAL TEACHER 2025; 47:450-457. [PMID: 38648547 DOI: 10.1080/0142159x.2024.2342545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Recent advances in Artificial Intelligence (AI) are changing the medical world, and AI will likely replace many of the actions performed by medical professionals. The overall clinical ability of the AI has been evaluated by its ability to answer a text-based national medical examination. This study uniquely assesses the performance of Open AI's ChatGPT against all Japanese National Medical Licensing Examination (NMLE), including images, illustrations, and pictures. METHODS We obtained the questions of the past six years of the NMLE (112th to 117th) from the Japanese Ministry of Health, Labour and Welfare website. We converted them to JavaScript Object Notation (JSON) format. We created an application programming interface (API) to output correct answers using GPT-4 for questions without images and GPT4-V(ision) or GPT4 console for questions with images. RESULTS The percentage of image questions was 723/2400 (30.1%) over the past six years. In all years, GPT-4/4V exceeded the minimum score the examinee should score. In total, over the six years, the percentage of correct answers for basic medical knowledge questions was 665/905 (73.5%); for clinical knowledge questions, 1143/1531 (74.7%); and for image questions 497/723 (68.7%), respectively. CONCLUSIONS Regarding medical knowledge, GPT-4/4V met the minimum criteria regardless of whether the questions included images, illustrations, and pictures. Our study sheds light on the potential utility of AI in medical education.
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Affiliation(s)
- Tomoki Kawahara
- Department of Clinical Information Applied Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Sumi
- Department of Clinical Information Applied Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Charette M, Schaffzin G. The intersectional implications of a quantitative epistemology in pain care and research. Can J Pain 2025; 8:2454672. [PMID: 40034188 PMCID: PMC11875474 DOI: 10.1080/24740527.2025.2454672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 01/03/2025] [Accepted: 01/13/2025] [Indexed: 03/05/2025]
Abstract
Background There is a growing interest in understanding the long-standing tension between subjective experience and objective measurement, with a focus on better understanding personal or lived experience. However, quantitative pain measurement is itself a complicated practice that is rarely examined. The method does not exist in a vacuum but along a historical trajectory that we believe to be worth unpacking. Aims We seek to highlight (1) the problematics associated with a systemic reliance on quantitative tools that are themselves validated via statistical methods; (2) what alternatives already exist, regardless of their logistical shortcomings; and (3) the actual and possible consequences of continuing a trajectory of data-based pain rating. Methods We present historical and contemporary case studies through theoretical frames that help the reader understand the social construction of pain as a phenomenon whose quantification has been justified with statistical approaches. Results Relying on quantitative data for a pain rating that is perceived as more valid, reliable, and efficient-a triad that has come to represent the ideal pain measurement instrument-risks entrenching both patient/participant and clinician/researcher in systems of computation and control. This is detrimental to society's most vulnerable populations. Conclusions Patients, practitioners, and social scientists all have an opportunity to reframe their understanding of pain measurement as medical practice to build more equitable spaces in pain medicine.
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Affiliation(s)
- Michelle Charette
- Graduate Program in Science & Technology Studies, York University, Toronto, Ontario, Canada
| | - Gabi Schaffzin
- Department of Design and Graduate Program in Science & Technology Studies, York University, Toronto, Ontario, Canada
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Hsu CW, Yang SW, Lee YT, Yao KH, Hsu TH, Chung PC, Chu YC, Kuo CT, Lien CY. Mainecoon: Implementing an Open-Source Web Viewer for DICOM Whole Slide Images with AI-Integrated PACS for Digital Pathology. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2025:10.1007/s10278-025-01425-6. [PMID: 39966222 DOI: 10.1007/s10278-025-01425-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 01/10/2025] [Accepted: 01/21/2025] [Indexed: 02/20/2025]
Abstract
The rapid advancement of digital pathology comes with significant challenges due to the diverse data formats from various scanning devices creating substantial obstacles to integrating artificial intelligence (AI) into the pathology imaging workflow. To overcome performance challenges posed by large AI-generated annotations, we developed an open-source project named Mainecoon for whole slide images (WSIs) using the Digital Imaging and Communications in Medicine (DICOM) standard. Our solution incorporates an AI model to detect non-alcoholic steatohepatitis (NASH) features in liver biopsies, validated with the DICOM Workgroup 26 Connectathon dataset. AI-generated results are encoded using the Microscopy Bulk Simple Annotations standard, which provides a standardized method supporting both manual and AI-generated annotations, promoting seamless integration of structured metadata with WSIs. We proposed a method by leveraging streaming and batch processing, significantly improving data loading efficiency, reducing user waiting times, and enhancing frontend performance. The web services of the AI model were implemented via the Flask framework, integrated with our viewer and an open-source medical image archive, Raccoon, with secure authentication provided by Keycloak for OAuth 2.0 authentication and node authentication at the National Cheng Kung University Hospital. Our architecture has demonstrated robustness, interoperability, and practical applicability, addressing real-world digital pathology challenges effectively.
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Affiliation(s)
- Chao-Wei Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Si-Wei Yang
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yu-Ting Lee
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kai-Hsuan Yao
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tzu-Hsuan Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Pau-Choo Chung
- Department of Electrical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yuan-Chia Chu
- Department of Information Management, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chen-Tsung Kuo
- Department of Information Management, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Yueh Lien
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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9
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Laohawetwanit T, Namboonlue C, Apornvirat S. Accuracy of GPT-4 in histopathological image detection and classification of colorectal adenomas. J Clin Pathol 2025; 78:202-207. [PMID: 38199797 DOI: 10.1136/jcp-2023-209304] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
AIMS To evaluate the accuracy of Chat Generative Pre-trained Transformer (ChatGPT) powered by GPT-4 in histopathological image detection and classification of colorectal adenomas using the diagnostic consensus provided by pathologists as a reference standard. METHODS A study was conducted with 100 colorectal polyp photomicrographs, comprising an equal number of adenomas and non-adenomas, classified by two pathologists. These images were analysed by classic GPT-4 for 1 time in October 2023 and custom GPT-4 for 20 times in December 2023. GPT-4's responses were compared against the reference standard through statistical measures to evaluate its proficiency in histopathological diagnosis, with the pathologists further assessing the model's descriptive accuracy. RESULTS GPT-4 demonstrated a median sensitivity of 74% and specificity of 36% for adenoma detection. The median accuracy of polyp classification varied, ranging from 16% for non-specific changes to 36% for tubular adenomas. Its diagnostic consistency, indicated by low kappa values ranging from 0.06 to 0.11, suggested only poor to slight agreement. All of the microscopic descriptions corresponded with their diagnoses. GPT-4 also commented about the limitations in its diagnoses (eg, slide diagnosis best done by pathologists, the inadequacy of single-image diagnostic conclusions, the need for clinical data and a higher magnification view). CONCLUSIONS GPT-4 showed high sensitivity but low specificity in detecting adenomas and varied accuracy for polyp classification. However, its diagnostic consistency was low. This artificial intelligence tool acknowledged its diagnostic limitations, emphasising the need for a pathologist's expertise and additional clinical context.
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Affiliation(s)
- Thiyaphat Laohawetwanit
- Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand
| | | | - Sompon Apornvirat
- Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand
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Zia S, Yildiz-Aktas IZ, Zia F, Parwani AV. An update on applications of digital pathology: primary diagnosis; telepathology, education and research. Diagn Pathol 2025; 20:17. [PMID: 39940046 DOI: 10.1186/s13000-025-01610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 01/30/2025] [Indexed: 02/14/2025] Open
Abstract
Digital Pathology or whole slide imaging (WSI) is a diagnostic evaluation technique that produces digital images of high quality from tissue fragments. These images are formed on glass slides and evaluated by pathologist with the aid of microscope. As the concept of digital pathology is introduced, these high quality images are digitized and produced on-screen whole slide images in the form of digital files. This has paved the way for pathologists to collaborate with other pathology professionals in case of any additional recommendations and also provides remote working opportunities. The application of digital pathology in clinical practice is glazed with several advantages and adopted by pathologists and researchers for clinical, educational and research purposes. Moreover, digital pathology system integration requires an intensive effort from multiple stakeholders. All pathology departments have different needs, case usage, and blueprints, even though the framework elements and variables for effective clinical integration can be applied to any institution aiming for digital transformation. This article reviews the background and developmental phases of digital pathology and its application in clinical services, educational and research activities.
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Affiliation(s)
- Shamail Zia
- Department of Pathology, CorePath Laboratories, San Antonio, TX, USA.
| | - Isil Z Yildiz-Aktas
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
- Department of Pathology, VA CT Healthcare System, West Haven, CT, USA
| | - Fazail Zia
- Department of Pathology, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Anil V Parwani
- Department of Pathology, The Ohio State University, Columbus, OH, USA
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Dankwa-Mullan I, Ndoh K, Akogo D, Rocha HAL, Juaçaba SF. Artificial Intelligence and Cancer Health Equity: Bridging the Divide or Widening the Gap. Curr Oncol Rep 2025; 27:95-111. [PMID: 39753817 DOI: 10.1007/s11912-024-01627-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2024] [Indexed: 02/26/2025]
Abstract
PURPOSE OF REVIEW This review aims to evaluate the impact of artificial intelligence (AI) on cancer health equity, specifically investigating whether AI is addressing or widening disparities in cancer outcomes. RECENT FINDINGS Recent studies demonstrate significant advancements in AI, such as deep learning for cancer diagnosis and predictive analytics for personalized treatment, showing potential for improved precision in care. However, concerns persist about the performance of AI tools across diverse populations due to biased training data. Access to AI technologies also remains limited, particularly in low-income and rural settings. AI holds promise for advancing cancer care, but its current application risks exacerbating existing health disparities. To ensure AI benefits all populations, future research must prioritize inclusive datasets, integrate social determinants of health, and develop ethical frameworks. Addressing these challenges is crucial for AI to contribute positively to cancer health equity and guide future research and policy development.
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Affiliation(s)
- Irene Dankwa-Mullan
- Milken Institute School of Public Health, Department of Health Policy and Management, George Washington University, Washington D.C., USA.
| | - Kingsley Ndoh
- Hurone AI, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, USA
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Singh R, Kim JY, Glassy EF, Dash RC, Brodsky V, Seheult J, de Baca ME, Gu Q, Hoekstra S, Pritt BS. Introduction to Generative Artificial Intelligence: Contextualizing the Future. Arch Pathol Lab Med 2025; 149:112-122. [PMID: 39631430 DOI: 10.5858/arpa.2024-0221-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2024] [Indexed: 12/07/2024]
Abstract
CONTEXT.— Generative artificial intelligence (GAI) is a promising new technology with the potential to transform communication and workflows in health care and pathology. Although new technologies offer advantages, they also come with risks that users, particularly early adopters, must recognize. Given the fast pace of GAI developments, pathologists may find it challenging to stay current with the terminology, technical underpinnings, and latest advancements. Building this knowledge base will enable pathologists to grasp the potential risks and impacts that GAI may have on the future practice of pathology. OBJECTIVE.— To present key elements of GAI development, evaluation, and implementation in a way that is accessible to pathologists and relevant to laboratory applications. DATA SOURCES.— Information was gathered from recent studies and reviews from PubMed and arXiv. CONCLUSIONS.— GAI offers many potential benefits for practicing pathologists. However, the use of GAI in clinical practice requires rigorous oversight and continuous refinement to fully realize its potential and mitigate inherent risks. The performance of GAI is highly dependent on the quality and diversity of the training and fine-tuning data, which can also propagate biases if not carefully managed. Ethical concerns, particularly regarding patient privacy and autonomy, must be addressed to ensure responsible use. By harnessing these emergent technologies, pathologists will be well placed to continue forward as leaders in diagnostic medicine.
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Affiliation(s)
- Rajendra Singh
- From the Department of Pathology, Summit Health, Woodland Park, New Jersey (Singh)
| | - Ji Yeon Kim
- the Department of Pathology, Kaiser Permanente, Los Angeles, California (Kim)
| | - Eric F Glassy
- Affiliated Pathologists Medical Group, Rancho Dominguez, California (Glassy)
| | - Rajesh C Dash
- Department of Pathology, Duke Health, Durham, North Carolina (Dash)
| | - Victor Brodsky
- the Department of Pathology and Immunology, Washington University, St Louis, Missouri (Brodsky)
| | - Jansen Seheult
- the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (Seheult, Pritt)
| | - M E de Baca
- Sysmex America, Lincolnshire, Illinois (de Baca)
| | - Qiangqiang Gu
- the Department of Neurology, Neurosurgery, and Critical Care, Mayo Clinic, Jacksonville, Florida (Gu)
| | - Shannon Hoekstra
- Information Services, College of American Pathologists, Northfield, Illinois (Hoekstra)
| | - Bobbi S Pritt
- the Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (Seheult, Pritt)
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13
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Laohawetwanit T, Apornvirat S, Namboonlue C. Thinking like a pathologist: Morphologic approach to hepatobiliary tumors by ChatGPT. Am J Clin Pathol 2025; 163:3-11. [PMID: 39030695 DOI: 10.1093/ajcp/aqae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/22/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVES This research aimed to evaluate the effectiveness of ChatGPT in accurately diagnosing hepatobiliary tumors using histopathologic images. METHODS The study compared the diagnostic accuracies of the GPT-4 model, providing the same set of images and 2 different input prompts. The first prompt, the morphologic approach, was designed to mimic pathologists' approach to analyzing tissue morphology. In contrast, the second prompt functioned without incorporating this morphologic analysis feature. Diagnostic accuracy and consistency were analyzed. RESULTS A total of 120 photomicrographs, composed of 60 images of each hepatobiliary tumor and nonneoplastic liver tissue, were used. The findings revealed that the morphologic approach significantly enhanced the diagnostic accuracy and consistency of the artificial intelligence (AI). This version was particularly more accurate in identifying hepatocellular carcinoma (mean accuracy: 62.0% vs 27.3%), bile duct adenoma (10.7% vs 3.3%), and cholangiocarcinoma (68.7% vs 16.0%), as well as in distinguishing nonneoplastic liver tissues (77.3% vs 37.5%) (Ps ≤ .01). It also demonstrated higher diagnostic consistency than the other model without a morphologic analysis (κ: 0.46 vs 0.27). CONCLUSIONS This research emphasizes the importance of incorporating pathologists' diagnostic approaches into AI to enhance accuracy and consistency in medical diagnostics. It mainly showcases the AI's histopathologic promise when replicating expert diagnostic processes.
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Affiliation(s)
- Thiyaphat Laohawetwanit
- Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand
| | - Sompon Apornvirat
- Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand
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Smoła P, Młoźniak I, Wojcieszko M, Zwierczyk U, Kobryn M, Rzepecka E, Duplaga M. Attitudes toward artificial intelligence and robots in healthcare in the general population: a qualitative study. Front Digit Health 2025; 7:1458685. [PMID: 39931116 PMCID: PMC11808042 DOI: 10.3389/fdgth.2025.1458685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 01/06/2025] [Indexed: 02/13/2025] Open
Abstract
Background The growth of the use of artificial intelligence (AI) and robotic solutions in healthcare is accompanied by high expectations for improved efficiency and quality of services. However, the use of such technologies can be a source of anxiety for patients whose expectations and experiences with such technology differ from medical staff's. This study assessed attitudes toward AI and robots in delivering health services and performing various tasks in medicine and related fields in Polish society. Methods 50 semistructured in-depth interviews were conducted with participants of diversified socio-demographic profiles. The interviewees were initially recruited for the interviews in a convenience sample; then, the process was continued using the snowballing technique. The interviews were transcribed and analyzed using the MAXQDA Analytics Pro 2022 program (release 22.7.0). An interpretative approach to qualitative content analysis was applied to the responses to the research questions. Results The analysis of interviews yielded three main themes: positive and negative perceptions of the use of AI and robots in healthcare and ontological concerns about AI, which went beyond objections about the usefulness of the technology. Positive attitudes toward AI and robots were associated with overall higher trust in technology, the need to adequately respond to demographic challenges, and the conviction that AI and robots can lower the workload of medical personnel. Negative attitudes originated from convictions regarding unreliability and the lack of proper technological and political control over AI; an equally important topic was the inability of artificial entities to feel and express emotions. The third theme was that the potential interaction with machines equipped with human-like traits was a source of insecurity. Conclusions The study showed that patients' attitudes toward AI and robots in healthcare vary according to their trust in technology, their recognition of urgent problems in healthcare (staff workload, time of diagnosis), and their beliefs regarding the reliability and functioning of new technologies. Emotional concerns about contact with artificial entities looking or performing like humans are also important to respondents' attitudes.
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Affiliation(s)
- Paulina Smoła
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Iwona Młoźniak
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Wojcieszko
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Urszula Zwierczyk
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Kobryn
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Elżbieta Rzepecka
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
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Ding L, Fan L, Shen M, Wang Y, Sheng K, Zou Z, An H, Jiang Z. Evaluating ChatGPT's diagnostic potential for pathology images. Front Med (Lausanne) 2025; 11:1507203. [PMID: 39917264 PMCID: PMC11798939 DOI: 10.3389/fmed.2024.1507203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 12/27/2024] [Indexed: 02/09/2025] Open
Abstract
Background Chat Generative Pretrained Transformer (ChatGPT) is a type of large language model (LLM) developed by OpenAI, known for its extensive knowledge base and interactive capabilities. These attributes make it a valuable tool in the medical field, particularly for tasks such as answering medical questions, drafting clinical notes, and optimizing the generation of radiology reports. However, keeping accuracy in medical contexts is the biggest challenge to employing GPT-4 in a clinical setting. This study aims to investigate the accuracy of GPT-4, which can process both text and image inputs, in generating diagnoses from pathological images. Methods This study analyzed 44 histopathological images from 16 organs and 100 colorectal biopsy photomicrographs. The initial evaluation was conducted using the standard GPT-4 model in January 2024, with a subsequent re-evaluation performed in July 2024. The diagnostic accuracy of GPT-4 was assessed by comparing its outputs to a reference standard using statistical measures. Additionally, four pathologists independently reviewed the same images to compare their diagnoses with the model's outputs. Both scanned and photographed images were tested to evaluate GPT-4's generalization ability across different image types. Results GPT-4 achieved an overall accuracy of 0.64 in identifying tumor imaging and tissue origins. For colon polyp classification, accuracy varied from 0.57 to 0.75 in different subtypes. The model achieved 0.88 accuracy in distinguishing low-grade from high-grade dysplasia and 0.75 in distinguishing high-grade dysplasia from adenocarcinoma, with a high sensitivity in detecting adenocarcinoma. Consistency between initial and follow-up evaluations showed slight to moderate agreement, with Kappa values ranging from 0.204 to 0.375. Conclusion GPT-4 demonstrates the ability to diagnose pathological images, showing improved performance over earlier versions. Its diagnostic accuracy in cancer is comparable to that of pathology residents. These findings suggest that GPT-4 holds promise as a supportive tool in pathology diagnostics, offering the potential to assist pathologists in routine diagnostic workflows.
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Affiliation(s)
- Liya Ding
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lei Fan
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Pathology, Ninghai County Traditional Chinese Medicine Hospital, Ningbo, China
| | - Miao Shen
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Pathology, Deqing People’s Hospital, Hangzhou, China
| | - Yawen Wang
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Kaiqin Sheng
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zijuan Zou
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huimin An
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhinong Jiang
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Rjoop A, Al-Qudah M, Alkhasawneh R, Bataineh N, Abdaljaleel M, Rjoub MA, Alkhateeb M, Abdelraheem M, Al-Omari S, Bani-Mari O, Alkabalan A, Altulaih S, Rjoub I, Alshimi R. Awareness and Attitude Toward Artificial Intelligence Among Medical Students and Pathology Trainees: Survey Study. JMIR MEDICAL EDUCATION 2025; 11:e62669. [PMID: 39803949 PMCID: PMC11741511 DOI: 10.2196/62669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/21/2024] [Accepted: 11/23/2024] [Indexed: 01/19/2025]
Abstract
Background Artificial intelligence (AI) is set to shape the future of medical practice. The perspective and understanding of medical students are critical for guiding the development of educational curricula and training. Objective This study aims to assess and compare medical AI-related attitudes among medical students in general medicine and in one of the visually oriented fields (pathology), along with illuminating their anticipated role of AI in the rapidly evolving landscape of AI-enhanced health care. Methods This was a cross-sectional study that used a web-based survey composed of a closed-ended questionnaire. The survey addressed medical students at all educational levels across the 5 public medical schools, along with pathology residents in 4 residency programs in Jordan. Results A total of 394 respondents participated (328 medical students and 66 pathology residents). The majority of respondents (272/394, 69%) were already aware of AI and deep learning in medicine, mainly relying on websites for information on AI, while only 14% (56/394) were aware of AI through medical schools. There was a statistically significant difference in awareness among respondents who consider themselves tech experts compared with those who do not (P=.03). More than half of the respondents believed that AI could be used to diagnose diseases automatically (213/394, 54.1% agreement), with medical students agreeing more than pathology residents (P=.04). However, more than one-third expressed fear about recent AI developments (167/394, 42.4% agreed). Two-thirds of respondents disagreed that their medical schools had educated them about AI and its potential use (261/394, 66.2% disagreed), while 46.2% (182/394) expressed interest in learning about AI in medicine. In terms of pathology-specific questions, 75.4% (297/394) agreed that AI could be used to identify pathologies in slide examinations automatically. There was a significant difference between medical students and pathology residents in their agreement (P=.001). Overall, medical students and pathology trainees had similar responses. Conclusions AI education should be introduced into medical school curricula to improve medical students' understanding and attitudes. Students agreed that they need to learn about AI's applications, potential hazards, and legal and ethical implications. This is the first study to analyze medical students' views and awareness of AI in Jordan, as well as the first to include pathology residents' perspectives. The findings are consistent with earlier research internationally. In comparison with prior research, these attitudes are similar in low-income and industrialized countries, highlighting the need for a global strategy to introduce AI instruction to medical students everywhere in this era of rapidly expanding technology.
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Affiliation(s)
- Anwar Rjoop
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan, 962 796958408, 962 2 7095123
| | - Mohammad Al-Qudah
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan, 962 796958408, 962 2 7095123
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Raja Alkhasawneh
- Department of Pulmonary Medicine, King Hussain Medical Center, Royal Medical Services, Amman, Jordan
| | - Nesreen Bataineh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Maram Abdaljaleel
- Department of Pathology, Microbiology, and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Moayad A Rjoub
- Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mustafa Alkhateeb
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Mohammad Abdelraheem
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Salem Al-Omari
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Omar Bani-Mari
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Anas Alkabalan
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Saoud Altulaih
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Iyad Rjoub
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
| | - Rula Alshimi
- Faculty of Medicine, Jordan University for Science and Technology, Irbid, Jordan
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Ahuja S, Zaheer S. Advancements in pathology: Digital transformation, precision medicine, and beyond. J Pathol Inform 2025; 16:100408. [PMID: 40094037 PMCID: PMC11910332 DOI: 10.1016/j.jpi.2024.100408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 10/30/2024] [Accepted: 11/12/2024] [Indexed: 01/02/2025] Open
Abstract
Pathology, a cornerstone of medical diagnostics and research, is undergoing a revolutionary transformation fueled by digital technology, molecular biology advancements, and big data analytics. Digital pathology converts conventional glass slides into high-resolution digital images, enhancing collaboration and efficiency among pathologists worldwide. Integrating artificial intelligence (AI) and machine learning (ML) algorithms with digital pathology improves diagnostic accuracy, particularly in complex diseases like cancer. Molecular pathology, facilitated by next-generation sequencing (NGS), provides comprehensive genomic, transcriptomic, and proteomic insights into disease mechanisms, guiding personalized therapies. Immunohistochemistry (IHC) plays a pivotal role in biomarker discovery, refining disease classification and prognostication. Precision medicine integrates pathology's molecular findings with individual genetic, environmental, and lifestyle factors to customize treatment strategies, optimizing patient outcomes. Telepathology extends diagnostic services to underserved areas through remote digital pathology. Pathomics leverages big data analytics to extract meaningful insights from pathology images, advancing our understanding of disease pathology and therapeutic targets. Virtual autopsies employ non-invasive imaging technologies to revolutionize forensic pathology. These innovations promise earlier diagnoses, tailored treatments, and enhanced patient care. Collaboration across disciplines is essential to fully realize the transformative potential of these advancements in medical practice and research.
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Affiliation(s)
- Sana Ahuja
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sufian Zaheer
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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18
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Gaffney H, Mirza KM. Pathology in the artificial intelligence era: Guiding innovation and implementation to preserve human insight. Acad Pathol 2025; 12:100166. [PMID: 40104157 PMCID: PMC11919318 DOI: 10.1016/j.acpath.2025.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 01/08/2025] [Accepted: 01/09/2025] [Indexed: 03/20/2025] Open
Abstract
The integration of artificial intelligence in pathology has ignited discussions about the role of technology in diagnostics-whether artificial intelligence serves as a tool for augmentation or risks replacing human expertise. This manuscript explores artificial intelligence's evolving contributions to pathology, emphasizing its potential capacity to enhance, rather than eclipse, the pathologist's role. Through historical comparisons, such as the transition from analog to digital in radiology, this paper highlights how technological advancements have historically expanded professional capabilities without diminishing the essential human element. Current applications of artificial intelligence in pathology-from diagnostic standardization to workflow efficiency-demonstrate its potential to augment diagnostic accuracy, expedite processes, and improve consistency across institutions. However, challenges remain in algorithmic bias, regulatory oversight, and maintaining interpretive skills among pathologists. The discussion underscores the importance of comprehensive governance frameworks, evolving educational curricula, and public engagement initiatives to ensure artificial intelligence in pathology remains a collaborative endeavor that empowers professionals, upholds ethical standards, and enhances patient outcomes. This manuscript ultimately advocates for a balanced approach where artificial intelligence and human expertise work in concert to advance the future of diagnostic medicine.
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Affiliation(s)
- Harry Gaffney
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kamran M Mirza
- The Godfrey D. Stobbe Professor of Pathology Education, Assistant Chair for Education and Director of the Division of Training, Programs and Communication, University of Michigan (Michigan Medicine) Department of Pathology, Ann Arbor, MI, USA
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19
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Xia L, Xu T, Zheng Y, Li B, Ao Y, Li X, Wu W, Lian J. Lymph Node Metastasis Prediction From In Situ Lung Squamous Cell Carcinoma Histopathology Images Using Deep Learning. J Transl Med 2025; 105:102187. [PMID: 39542104 DOI: 10.1016/j.labinv.2024.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 10/30/2024] [Accepted: 11/07/2024] [Indexed: 11/17/2024] Open
Abstract
Lung squamous cell carcinoma (LUSC), a subtype of non-small cell lung cancer, represents a significant portion of lung cancer cases with distinct histologic patterns impacting prognosis and treatment. The current pathological assessment methods face limitations such as interobserver variability, necessitating more reliable techniques. This study seeks to predict lymph node metastasis in LUSC using deep learning models applied to histopathology images of primary tumors, offering a more accurate and objective method for diagnosis and prognosis. Whole slide images (WSIs) from the Outdo-LUSC and the cancer genome atlas cohorts were used to train and validate deep learning models. Multiinstance learning was applied, with patch-level predictions aggregated into WSI-level outcomes. The study employed the ResNet-18 network, transfer learning, and rigorous data preprocessing. To represent WSI features, innovative techniques like patch likelihood histogram and bag of words were used, followed by training of machine learning classifiers, including the ExtraTrees algorithm. The diagnostic model for lymph node metastasis showed strong performance, particularly using the ExtraTrees algorithm, as demonstrated by receiver operating characteristic curves and gradient-weighted class activation mapping visualizations. The signature generated by the ExtraTrees algorithm, named lymph node status-related in situ LUSC histopathology (LN_ISLUSCH), achieved an area under the curve of 0.941 (95% CI: 0.926-0.955) in the training set and 0.788 (95% CI: 0.748-0.827) in the test set. Kaplan-Meier analyses confirmed that the LN_ISLUSCH model was a significant prognostic factor (P = .02). This study underscores the potential of artificial intelligence in enhancing diagnostic precision in pathology. The LN_ISLUSCH model stands out as a promising tool for predicting lymph node metastasis and prognosis in LUSC. Future studies should focus on larger and more diverse cohorts and explore the integration of additional omics data to further refine predictive accuracy and clinical utility.
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Affiliation(s)
- Lu Xia
- Xiamen Cell Therapy Research Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Center for Precision Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
| | - Tao Xu
- Department of Pathology, Yuncheng Central Hospital affiliated to Shanxi Medical University, Yuncheng, China
| | - Yongsheng Zheng
- Department of Endoscopy Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Baohua Li
- Department of Pathology, Xinglin Campus, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Yongfang Ao
- Department of Pathology, Yuncheng Central Hospital affiliated to Shanxi Medical University, Yuncheng, China; Changzhi Medical College, Changzhi, China
| | - Xun Li
- Center for Precision Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Weijing Wu
- Laboratory of nutrition and food safety, Xiamen Medical College, Xiamen, China.
| | - Jiabian Lian
- Xiamen Cell Therapy Research Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Center for Precision Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
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20
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Gopal P, Hu X, Robert ME, Zhang X. The evolving role of liver biopsy: Current applications and future prospects. Hepatol Commun 2025; 9:e0628. [PMID: 39774070 PMCID: PMC11717517 DOI: 10.1097/hc9.0000000000000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2024] [Accepted: 12/04/2024] [Indexed: 01/11/2025] Open
Abstract
Histopathologic evaluation of liver biopsy has played a longstanding role in the diagnosis and management of liver disease. However, the utility of liver biopsy has been questioned by some, given the improved imaging modalities, increased availability of noninvasive serologic tests, and development of artificial intelligence over the past several years. In this review, we discuss the current and future role of liver biopsy in both non-neoplastic and neoplastic liver diseases in the era of improved noninvasive laboratory, radiologic, and digital technologies.
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Affiliation(s)
- Purva Gopal
- Deparment of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Xiaobang Hu
- Department of Pathology and Laboratory Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Marie E. Robert
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xuchen Zhang
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
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21
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Sagiv C, Hadar O, Najjar A, Pahnke J. Artificial intelligence in surgical pathology - Where do we stand, where do we go? EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024:109541. [PMID: 39694737 DOI: 10.1016/j.ejso.2024.109541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 11/14/2024] [Accepted: 12/10/2024] [Indexed: 12/20/2024]
Abstract
Surgical and neuropathologists continuously search for new and disease-specific features, such as independent predictors of tumor prognosis or determinants of tumor entities and sub-entities. This is a task where artificial intelligence (AI)/machine learning (ML) systems could significantly contribute to help with tumor outcome prediction and the search for new diagnostic or treatment stratification biomarkers. AI systems are increasingly integrated into routine pathology workflows to improve accuracy, reproducibility, productivity and to reveal difficult-to-see features in complicated histological slides, including the quantification of important markers for tumor grading and staging. In this article, we review the infrastructure needed to facilitate digital and computational pathology. We address the barriers for its full deployment in the clinical setting and describe the use of AI in intraoperative or postoperative settings were frozen or formalin-fixed, paraffin-embedded materials are used. We also summarize quality assessment issues of slide digitization, new spatial biology approaches, and the determination of specific gene-expression from whole slide images. Finally, we highlight new innovative and future technologies, such as large language models, optical biopsies, and mass spectrometry imaging.
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Affiliation(s)
- Chen Sagiv
- DeePathology Ltd., HaTidhar 5, P. O. Box 2622, Ra'anana, IL-4365104, Israel.
| | - Ofir Hadar
- DeePathology Ltd., HaTidhar 5, P. O. Box 2622, Ra'anana, IL-4365104, Israel
| | - Abderrahman Najjar
- Department of Pathology, Rabin Medical Center (RMC), Ze'ev Jabotinsky 39, Petah Tikva, IL-4941492, Israel
| | - Jens Pahnke
- Translational Neurodegeneration Research and Neuropathology Lab, Department of Clinical Medicine (KlinMed), Medical Faculty, University of Oslo (UiO) and Section of Neuropathology Research, Department of Pathology, Clinics for Laboratory Medicine (KLM), Oslo University Hospital (OUS), Sognsvannsveien 20, NO-0372, Oslo, Norway; Institute of Nutritional Medicine (INUM) and Lübeck Institute of Dermatology (LIED), University of Lübeck (UzL) and University Medical Center Schleswig-Holstein (UKSH), Ratzeburger Allee 160, D-23538, Lübeck, Germany; Department of Pharmacology, Faculty of Medicine and Life Sciences, University of Latvia, Jelgavas iela 3, LV-1004, Rīga, Latvia; Department of Neurobiology, School of Neurobiology, Biochemistry and Biophysics, The Georg S. Wise Faculty of Life Sciences, Tel Aviv University, Ramat Aviv, IL-6997801, Israel.
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22
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Kurowski K, Timme S, Föll MC, Backhaus C, Holzner PA, Bengsch B, Schilling O, Werner M, Bronsert P. AI-Assisted High-Throughput Tissue Microarray Workflow. Methods Protoc 2024; 7:96. [PMID: 39728616 DOI: 10.3390/mps7060096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Revised: 11/14/2024] [Accepted: 11/20/2024] [Indexed: 12/28/2024] Open
Abstract
Immunohistochemical (IHC) studies of formalin-fixed paraffin-embedded (FFPE) samples are a gold standard in oncology for tumor characterization, and the identification of prognostic and predictive markers. However, despite the abundance of archived FFPE samples, their research use is limited due to the labor-intensive nature of IHC on large cohorts. This study aimed to create a high-throughput workflow using modern technologies to facilitate IHC biomarker studies on large patient groups. Semiautomatic constructed tissue microarrays (TMAs) were created for two tumor patient cohorts and IHC stained for seven antibodies (ABs). AB expression in the tumor and surrounding stroma was quantified using the AI-supported image analysis software QuPath. The data were correlated with clinicopathological information using an R-script, all results were automatically compiled into formatted reports. By minimizing labor time to 7.7%-compared to whole-slide studies-the established workflow significantly reduced human and material resource consumption. It successfully correlated AB expression with overall patient survival and additional clinicopathological data, providing publication-ready figures and tables. The AI-assisted high-throughput TMA workflow, validated on two patient cohorts, streamlines modern histopathological research by offering cost and time efficiency compared to traditional whole-slide studies. It maintains research quality and preserves patient tissue while significantly reducing material and human resources, making it ideal for high-throughput research centers and collaborations.
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Affiliation(s)
- Konrad Kurowski
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Core Facility Histopathology and Digital Pathology Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- Tumorbank Comprehensive Cancer Center Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Sylvia Timme
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Melanie Christine Föll
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Clara Backhaus
- Department of Obstetrics & Gynecology Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Philipp Anton Holzner
- Department of General and Visceral Surgery, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Bertram Bengsch
- Clinic for Internal Medicine II, Gastroenterology, Hepatology, Endocrinology, and Infectious Disease, Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Oliver Schilling
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Martin Werner
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Core Facility Histopathology and Digital Pathology Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- Tumorbank Comprehensive Cancer Center Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Peter Bronsert
- Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Core Facility Histopathology and Digital Pathology Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- Tumorbank Comprehensive Cancer Center Freiburg, Medical Center, University of Freiburg, 79106 Freiburg, Germany
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Hirosawa T, Suzuki T, Shiraishi T, Hayashi A, Fujii Y, Harada T, Shimizu T. Adapting Artificial Intelligence Concepts to Enhance Clinical Decision-Making: A Hybrid Intelligence Framework. Int J Gen Med 2024; 17:5417-5422. [PMID: 39582919 PMCID: PMC11585294 DOI: 10.2147/ijgm.s497753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 11/17/2024] [Indexed: 11/26/2024] Open
Abstract
Purpose Artificial intelligence (AI) holds great potential for revolutionizing health care by providing clinicians with data-driven insights that support more accurate and efficient clinical decisions. However, applying AI in clinical settings is often challenging due to the complexity and vastness of medical information. This perspective article explores how AI development methodologies can be adapted to support clinicians in their decision-making processes, emphasizing the importance of a hybrid approach that combines AI capabilities with clinicians' expertise. Patients and Methods We developed a conceptual framework designed to integrate AI-driven hybrid intelligence into clinical practice to enhance decision-making. This framework focuses on adapting key AI concepts, such as backpropagation, quantization, and avoiding overfitting, to help clinicians better interpret complex medical data and improve diagnosis and treatment planning. Results Several AI methodologies were adapted to enhance clinical decision-making. First, backpropagation allows clinicians to refine initial assessments by revisiting them as new data emerges, improving diagnostic accuracy over time. Second, quantization helps break down complex medical problems into manageable components, enabling clinicians to prioritize critical elements of care. Finally, avoiding overfitting encourages clinicians to balance rare diagnoses with more common explanations, reducing the risk of diagnostic errors and unnecessary complexity. Conclusion The integration of AI-driven hybrid intelligence has the potential to enhance clinical decision-making. By adapting AI methodologies, clinicians can enhance their ability to analyze data, prioritize treatments, and make more accurate diagnoses while preserving the essential human aspect of health care. This framework highlights the importance of combining AI's strengths with clinicians' expertise for more effective and balanced decision-making in clinical practice. This perspective highlights the value of hybrid intelligence in achieving more balanced, effective, and patient-centered decision-making in health care.
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Affiliation(s)
- Takanobu Hirosawa
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Tomoharu Suzuki
- Department of Hospital Medicine, Urasoe General Hospital, Okinawa, Japan
| | - Tastuya Shiraishi
- Higashinihonbashinaika clinic, Tokyo, Japan / Ubie, inc, Tokyo, Japan
| | - Arisa Hayashi
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
| | - Yoichi Fujii
- General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan
| | - Taku Harada
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
- General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan
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Jacobs A, Al-Juboori SI, Dobrinskikh E, Bolt MA, Sammel MD, Lijewski V, Post MD, Small JM, Su EJ. Placental differences between severe fetal growth restriction and hypertensive disorders of pregnancy requiring early preterm delivery: morphometric analysis of the villous tree supported by artificial intelligence. Am J Obstet Gynecol 2024; 231:552.e1-552.e13. [PMID: 38423447 PMCID: PMC11347726 DOI: 10.1016/j.ajog.2024.02.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The great obstetrical syndromes of fetal growth restriction and hypertensive disorders of pregnancy can occur individually or be interrelated. Placental pathologic findings often overlap between these conditions, regardless of whether 1 or both diagnoses are present. Quantification of placental villous structures in each of these settings may identify distinct differences in developmental pathways. OBJECTIVE This study aimed to determine how the quantity and surface area of placental villi and vessels differ between severe, early-onset fetal growth restriction with absent or reversed umbilical artery Doppler indices and hypertensive disorders of pregnancy or the 2 conditions combined among subjects with disease severity that warrant early preterm delivery. We hypothesized that the trajectories of placental morphogenesis diverge after a common initiating insult of deep defective placentation. Specifically, we postulated that only villi are affected in pregnancy-related hypertension, whereas both villous and vascular structures are proportionally diminished in severe fetal growth restriction with no additional effect when hypertension is concomitantly present. STUDY DESIGN In this retrospective cohort study, paraffin-embedded placental tissue was obtained from 4 groups, namely (1) patients with severe fetal growth restriction with absent or reversed umbilical artery end-diastolic velocities and hypertensive disorders of pregnancy, (2) patients with severe fetal growth restriction with absent or reversed umbilical artery Doppler indices and no hypertension, (3) gestational age-matched, appropriately grown pregnancies with hypertensive disease, and (4) gestational age-matched, appropriately grown pregnancies without hypertension. Dual immunohistochemistry for cytokeratin-7 (trophoblast) and CD34 (endothelial cells) was performed, followed by artificial intelligence-driven morphometric analyses. The number of villi, total villous area, number of fetoplacental vessels, and total vascular area across villi within a uniform region of interest were quantified. Quantitative analyses of placental structures were modeled using linear regression. RESULTS Placentas from pregnancies complicated by hypertensive disorders of pregnancy exhibited significantly fewer stem villi (-282 stem villi; 95% confidence interval, -467 to -98; P<.01), a smaller stem villous area (-4.3 mm2; 95% confidence interval, -7.3 to -1.2; P<.01), and fewer stem villous vessels (-4967 stem villous vessels; 95% confidence interval, -8501 to -1433; P<.01) with no difference in the total vascular area. In contrast, placental abnormalities in cases with severe growth restriction were limited to terminal villi with global decreases in the number of villi (-873 terminal villi; 95% confidence interval, -1501 to -246; P<.01), the villous area (-1.5 mm2; 95% confidence interval, -2.7 to -0.4; P<.01), the number of blood vessels (-5165 terminal villous vessels; 95% confidence interval, -8201 to -2128; P<.01), and the vascular area (-0.6 mm2; 95% confidence interval, -1.1 to -0.1; P=.02). The combination of hypertension and growth restriction had no additional effect beyond the individual impact of each state. CONCLUSION Pregnancies complicated by hypertensive disorders of pregnancy exhibited defects in the stem villi only, whereas placental abnormalities in severely growth restricted pregnancies with absent or reversed umbilical artery end-diastolic velocities were limited to the terminal villi. There were no significant statistical interactions in the combination of growth restriction and hypertension, suggesting that distinct pathophysiological pathways downstream of the initial insult of defective placentation are involved in each entity and do not synergize to lead to more severe pathologic consequences. Delineating mechanisms that underly the divergence in placental development after a common inciting event of defective deep placentation may shed light on new targets for prevention or treatment.
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Affiliation(s)
- Anna Jacobs
- Rocky Vista University College of Osteopathic Medicine, Parker, CO
| | - Saif I Al-Juboori
- Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Evgenia Dobrinskikh
- Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Matthew A Bolt
- Center for Innovative Design and Analysis, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO
| | - Mary D Sammel
- Center for Innovative Design and Analysis, Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO
| | - Virginia Lijewski
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO
| | - Miriam D Post
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO
| | - James M Small
- Department of Biomedical Sciences; Rocky Vista University College of Osteopathic Medicine, Parker, CO
| | - Emily J Su
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO; Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO.
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25
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Mroz P, Ewalt MD, Harley SE, Tsang PC, Xian RR, Soderquist CR. The Era of Molecular Hematopathology: Back to the Future. J Mol Diagn 2024; 26:945-949. [PMID: 39461758 DOI: 10.1016/j.jmoldx.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 10/29/2024] Open
Affiliation(s)
- Pawel Mroz
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.
| | - Mark D Ewalt
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan E Harley
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Laboratory Services, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Patricia C Tsang
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, MedStar Health, Washington, District of Columbia
| | - Rena R Xian
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Craig R Soderquist
- The Hematopathology Subdivision Leadership of the Association for Molecular Pathology, Rockville, Maryland; Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York
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26
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Prassas I, Clarke B, Youssef T, Phlamon J, Dimitrakopoulos L, Rofaeil A, Yousef GM. Computational pathology: an evolving concept. Clin Chem Lab Med 2024; 62:2148-2155. [PMID: 38646706 DOI: 10.1515/cclm-2023-1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
The initial enthusiasm about computational pathology (CP) and artificial intelligence (AI) was that they will replace pathologists entirely on the way to fully automated diagnostics. It is becoming clear that currently this is not the immediate model to pursue. On top of the legal and regulatory complexities surrounding its implementation, the majority of tested machine learning (ML)-based predictive algorithms do not display the exquisite performance needed to render them unequivocal, standalone decision makers for matters with direct implications to human health. We are thus moving into a different model of "computer-assisted diagnostics", where AI is there to provide support, rather than replacing, the pathologist. Herein we focus on the practical aspects of CP, from a pathologist perspective. There is a wide range of potential applications where CP can enhance precision of pathology diagnosis, tailor prognostic and predictive information, as well as save time. There are, however, a number of potential limitations for CP that currently hinder their wider adoption in the clinical setting. We address the key necessary steps towards clinical implementation of computational pathology, discuss the significant obstacles that hinders its adoption in the clinical context and summarize some proposed solutions. We conclude that the advancement of CP in the clinic is a promising resource-intensive endeavour that requires broad and inclusive collaborations between academia, industry, and regulatory bodies.
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Affiliation(s)
- Ioannis Prassas
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Blaise Clarke
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Timothy Youssef
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
| | - Juliana Phlamon
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
| | | | - Andrew Rofaeil
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
| | - George M Yousef
- Laboratory Medicine Program, 7989 University Health Network , Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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27
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Shimada S, Tanimoto K, Sasaki H, Taga T, Sasaki T, Imagawa T, Sasaki N. Automated scoring of glomerular injury in TNS2-deficient nephropathy. Exp Anim 2024; 73:370-375. [PMID: 38644233 PMCID: PMC11534489 DOI: 10.1538/expanim.24-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024] Open
Abstract
Several artificial intelligence (AI) systems have been developed for glomerular pathology analysis in clinical settings. However, the application of AI systems in nonclinical fields remains limited. In this study, we trained a convolutional neural network model, which is an AI algorithm, to classify the severity of Tensin 2 (TNS2)-deficient nephropathy into seven categories. A dataset consisting of 803 glomerular images was generated from kidney sections of TNS2-deficient and wild-type mice. Manual evaluations of the images were conducted to assess their glomerular injury scores. The trained AI achieved approximately 70% accuracy in predicting the glomerular injury score for TNS2-deficient nephropathy. However, the AI achieved approximately 100% accuracy when considering predictions within one score of the true label as correct. The AI's predicted mean score closely matched the true mean score. In conclusion, while the AI model may not replace human judgment entirely, it can serve as a reliable second assessor in scoring glomerular injury, offering potential benefits in enhancing the accuracy and objectivity of such assessments.
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Affiliation(s)
- Shuji Shimada
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Kyosuke Tanimoto
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Hayato Sasaki
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Takumi Taga
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Takeru Sasaki
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Tomomi Imagawa
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
| | - Nobuya Sasaki
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University, 35-1, Higashi-23, Towada, Aomori 034-8628 Japan
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28
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Tądel K, Dudek A, Bil-Lula I. AI Algorithms for Modeling the Risk, Progression, and Treatment of Sepsis, Including Early-Onset Sepsis-A Systematic Review. J Clin Med 2024; 13:5959. [PMID: 39408019 PMCID: PMC11478112 DOI: 10.3390/jcm13195959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/17/2024] [Accepted: 10/03/2024] [Indexed: 10/20/2024] Open
Abstract
Sepsis remains a significant contributor to neonatal mortality worldwide. However, the nonspecific nature of sepsis symptoms in neonates often leads to the necessity of empirical treatment, placing a burden of ineffective treatment on patients. Furthermore, the global challenge of antimicrobial resistance is exacerbating the situation. Artificial intelligence (AI) is transforming medical practice and in hospital settings. AI shows great potential for assessing sepsis risk and devising optimal treatment strategies. Background/Objectives: This review aims to investigate the application of AI in the detection and management of neonatal sepsis. Methods: A systematic literature review (SLR) evaluating AI methods in modeling and classifying sepsis between 1 January 2014, and 1 January 2024, was conducted. PubMed, Scopus, Cochrane, and Web of Science were systematically searched for English-language studies focusing on neonatal sepsis. Results: The analyzed studies predominantly utilized retrospective electronic medical record (EMR) data to develop, validate, and test AI models to predict sepsis occurrence and relevant parameters. Key predictors included low gestational age, low birth weight, high results of C-reactive protein and white blood cell counts, and tachycardia and respiratory failure. Machine learning models such as logistic regression, random forest, K-nearest neighbor (KNN), support vector machine (SVM), and XGBoost demonstrated effectiveness in this context. Conclusions: The summarized results of this review highlight the great promise of AI as a clinical decision support system for diagnostics, risk assessment, and personalized therapy selection in managing neonatal sepsis.
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Affiliation(s)
- Karolina Tądel
- Department of Medical Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, 211 Borowska Street, 50-556 Wroclaw, Poland;
- Institute of Mother and Child, 17a Kasprzaka Street, 01-211 Warsaw, Poland
| | - Andrzej Dudek
- Department of Econometrics and Informatics, Faculty of Economics and Finance, Wroclaw University of Economics, Nowowiejska Street, 58-500 Jelenia Góra, Poland;
| | - Iwona Bil-Lula
- Department of Medical Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, 211 Borowska Street, 50-556 Wroclaw, Poland;
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Cazzato G, Rongioletti F. Artificial intelligence in dermatopathology: Updates, strengths, and challenges. Clin Dermatol 2024; 42:437-442. [PMID: 38909860 DOI: 10.1016/j.clindermatol.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Artificial intelligence (AI) has evolved to become a significant force in various domains, including medicine. We explore the role of AI in pathology, with a specific focus on dermatopathology and neoplastic dermatopathology. AI, encompassing machine learning and deep learning, has demonstrated its potential in tasks ranging from diagnostic applications on whole slide imaging to predictive and prognostic functions in skin pathology. In dermatopathology, studies have assessed AI's ability to identify skin lesions, classify melanomas, and improve diagnostic accuracy. Results indicate that AI, particularly convolutional neural networks, can outperform human pathologists in terms of sensitivity and specificity. AI aids in predicting disease outcomes, identifying aggressive tumors, and differentiating between various skin conditions. Neoplastic dermatopathology showcases AI's prowess in classifying melanocytic lesions, discriminating between melanomas and nevi, and aids dermatopathologists in making accurate diagnoses. Studies emphasize the reproducibility and diagnostic aid that AI provides, especially in challenging cases. In inflammatory and lymphoproliferative dermatopathology, limited research exists, but studies show attempts to use AI to differentiate conditions such as mycosis fungoides and eczema. Although some results are promising, further exploration is needed in these areas. We highlight the extraordinary interest AI has garnered in the scientific community and its potential to assist clinicians and pathologists. Despite the advancements, we have stressed the importance of collaboration between medical professionals, computer scientists, bioinformaticians, and engineers to harness AI's benefits and acknowledging its limitations and risks. The integration of AI into dermatopathology holds great promise, positioning it as a valuable tool rather than as a replacement for human expertise.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy.
| | - Franco Rongioletti
- Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
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30
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Chen S, Zhang P, Duan X, Bao A, Wang B, Zhang Y, Li H, Zhang L, Liu S. Lesion Localization and Pathological Diagnosis of Ovine Pulmonary Adenocarcinoma Based on MASK R-CNN. Animals (Basel) 2024; 14:2488. [PMID: 39272273 PMCID: PMC11393988 DOI: 10.3390/ani14172488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/15/2024] Open
Abstract
Ovine pulmonary adenocarcinoma (OPA) is a contagious lung tumour caused by the Jaagsiekte Sheep Retrovirus (JSRV). Histopathological diagnosis is the gold standard for OPA diagnosis. However, interpretation of traditional pathology images is complex and operator dependent. The mask regional convolutional neural network (Mask R-CNN) has emerged as a valuable tool in pathological diagnosis. This study utilized 54 typical OPA whole slide images (WSI) to extract 7167 typical lesion images containing OPA to construct a Common Objects in Context (COCO) dataset for OPA pathological images. The dataset was categorized into training and test sets (8:2 ratio) for model training and validation. Mean average specificity (mASp) and average sensitivity (ASe) were used to evaluate model performance. Six WSI-level pathological images (three OPA and three non-OPA images), not included in the dataset, were used for anti-peeking model validation. A random selection of 500 images, not included in the dataset establishment, was used to compare the performance of the model with assessment by pathologists. Accuracy, sensitivity, specificity, and concordance rate were evaluated. The model achieved a mASp of 0.573 and an ASe of 0.745, demonstrating effective lesion detection and alignment with expert annotation. In Anti-Peeking verification, the model showed good performance in locating OPA lesions and distinguished OPA from non-OPA pathological images. In the random 500-image diagnosis, the model achieved 92.8% accuracy, 100% sensitivity, and 88% specificity. The agreement rates between junior and senior pathologists were 100% and 96.5%, respectively. In conclusion, the Mask R-CNN-based OPA diagnostic model developed for OPA facilitates rapid and accurate diagnosis in practical applications.
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Affiliation(s)
- Sixu Chen
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Pei Zhang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Xujie Duan
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Anyu Bao
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Buyu Wang
- College of Computer and Information Engineering, Inner Mongolia Agricultural University, Hohhot 010010, China
| | - Yufei Zhang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Huiping Li
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Liang Zhang
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
| | - Shuying Liu
- College of Veterinary Medicine, Inner Mongolia Agricultural University, Zhao Wu Da Road No. 306, Hohhot 010018, China
- Inner Mongolia Key Laboratory of Basic Veterinary Science, Hohhot 010018, China
- Key Laboratory of Clinical Diagnosis and Treatment Technology in Animal Disease, Ministry of Agriculture, Hohhot 010018, China
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Siarov J, Siarov A, Kumar D, Paoli J, Mölne J, Neittaanmäki N. Deep learning model shows pathologist-level detection of sentinel node metastasis of melanoma and intra-nodal nevi on whole slide images. Front Med (Lausanne) 2024; 11:1418013. [PMID: 39238597 PMCID: PMC11374739 DOI: 10.3389/fmed.2024.1418013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/29/2024] [Indexed: 09/07/2024] Open
Abstract
Introduction Nodal metastasis (NM) in sentinel node biopsies (SNB) is crucial for melanoma staging. However, an intra-nodal nevus (INN) may often be misclassified as NM, leading to potential misdiagnosis and incorrect staging. There is high discordance among pathologists in assessing SNB positivity, which may lead to false staging. Digital whole slide imaging offers the potential for implementing artificial intelligence (AI) in digital pathology. In this study, we assessed the capability of AI to detect NM and INN in SNBs. Methods A total of 485 hematoxylin and eosin whole slide images (WSIs), including NM and INN from 196 SNBs, were collected and divided into training (279 WSIs), validation (89 WSIs), and test sets (117 WSIs). A deep learning model was trained with 5,956 manual pixel-wise annotations. The AI and three blinded dermatopathologists assessed the test set, with immunohistochemistry serving as the reference standard. Results The AI model showed excellent performance with an area under the curve receiver operating characteristic (AUC) of 0.965 for detecting NM. In comparison, the AUC for NM detection among dermatopathologists ranged between 0.94 and 0.98. For the detection of INN, the AUC was lower for both AI (0.781) and dermatopathologists (range of 0.63-0.79). Discussion In conclusion, the deep learning AI model showed excellent accuracy in detecting NM, achieving dermatopathologist-level performance in detecting both NM and INN. Importantly, the AI model showed the potential to differentiate between these two entities. However, further validation is warranted.
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Affiliation(s)
- Jan Siarov
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Angelica Siarov
- Department of Clinical Pathology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | | | - John Paoli
- Department of Dermatology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Johan Mölne
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Noora Neittaanmäki
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Mubarak M, Rashid R, Sapna F, Shakeel S. Expanding role and scope of artificial intelligence in the field of gastrointestinal pathology. Artif Intell Gastroenterol 2024; 5:91550. [DOI: 10.35712/aig.v5.i2.91550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/06/2024] [Accepted: 07/29/2024] [Indexed: 08/08/2024] Open
Abstract
Digital pathology (DP) and its subsidiaries including artificial intelligence (AI) are rapidly making inroads into the area of diagnostic anatomic pathology (AP) including gastrointestinal (GI) pathology. It is poised to revolutionize the field of diagnostic AP. Historically, AP has been slow to adopt digital technology, but this is changing rapidly, with many centers worldwide transitioning to DP. Coupled with advanced techniques of AI such as deep learning and machine learning, DP is likely to transform histopathology from a subjective field to an objective, efficient, and transparent discipline. AI is increasingly integrated into GI pathology, offering numerous advancements and improvements in overall diagnostic accuracy, efficiency, and patient care. Specifically, AI in GI pathology enhances diagnostic accuracy, streamlines workflows, provides predictive insights, integrates multimodal data, supports research, and aids in education and training, ultimately improving patient care and outcomes. This review summarized the latest developments in the role and scope of AI in AP with a focus on GI pathology. The main aim was to provide updates and create awareness among the pathology community.
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Affiliation(s)
- Muhammed Mubarak
- Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Rahma Rashid
- Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Fnu Sapna
- Department of Pathology, Montefiore Medical Center, The University Hospital for Albert Einstein School of Medicine, Bronx, NY 10461, United States
| | - Shaheera Shakeel
- Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
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Maddox A, Fowler R, Solomon E, Rao A. Undergraduate Education in Computational Pathology Through Global Health Inspired Projects. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2024; 2024:1-4. [PMID: 40039320 DOI: 10.1109/embc53108.2024.10782173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2025]
Abstract
Recent technological advancements are revolutionizing the field of pathology as the practice adopts digital workflows and computational tools to augment the analysis of tissue and enhance its role in patient care. These advancements are poised to make a particularly significant impact in low-income and middle-income countries, which are disproportionately affected by worsening pathology service shortages and rising cancer rates. Courses targeted towards undergraduate students interested in this emergent field of computational pathology (CPATH) are required to prepare the next generation of innovators and leaders in this space. However, such training courses have mostly been lacking and their design presents with several challenges. CPATH exists at the intersection of multiple complex specialties and so, following a traditional bottom-up curriculum, courses are often limited to the graduate level. In addition, standard didactic courses struggle to keep with the rapid pace of advancements driving the field, build the essential multidisciplinary teamwork skills, train the technical skillsets required for success, or emphasize innovation. Structured experiential learning (EL) has a long track record of success in addressing these issues and presents as a natural modality for early CPATH education. We have designed and piloted a project based EL course targeted towards undergraduates to address these limitations in CPATH education. At the core of the course experience, students work together to conceptualize, design, and implement innovative solutions to leverage CPATH towards addressing global health inequity. Here we present our design of the course, review insights from our first two years of piloting this course and share plans for course improvement drawn from these insights.Clinical relevance- CPATH is making a significant impact on the practice of pathology and is poised to play a major role in addressing global health inequities. This course is designed to prepare undergraduate and graduate students to innovate in this rapidly growing and developing field as members of multidisciplinary teams through structured project based EL. While open to students at the undergraduate and master's level from all backgrounds, it is directed at undergraduate biomedical engineering, computer science, and pre medicine students who are interested in future careers in this field.
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Steinbach TJ, Tokarz DA, Co CA, Harris SF, McBride SJ, Shockley KR, Lokhande A, Srivastava G, Ugalmugle R, Kazi A, Singletary E, Cesta MF, Thomas HC, Chen VS, Hobbie K, Crabbs TA. Inter-Rater and Intra-Rater Agreement in Scoring Severity of Rodent Cardiomyopathy and Relation to Artificial Intelligence-Based Scoring. Toxicol Pathol 2024; 52:258-265. [PMID: 38907685 PMCID: PMC11412787 DOI: 10.1177/01926233241259998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
We previously developed a computer-assisted image analysis algorithm to detect and quantify the microscopic features of rodent progressive cardiomyopathy (PCM) in rat heart histologic sections and validated the results with a panel of five veterinary toxicologic pathologists using a multinomial logistic model. In this study, we assessed both the inter-rater and intra-rater agreement of the pathologists and compared pathologists' ratings to the artificial intelligence (AI)-predicted scores. Pathologists and the AI algorithm were presented with 500 slides of rodent heart. They quantified the amount of cardiomyopathy in each slide. A total of 200 of these slides were novel to this study, whereas 100 slides were intentionally selected for repetition from the previous study. After a washout period of more than six months, the repeated slides were examined to assess intra-rater agreement among pathologists. We found the intra-rater agreement to be substantial, with weighted Cohen's kappa values ranging from k = 0.64 to 0.80. Intra-rater variability is not a concern for the deterministic AI. The inter-rater agreement across pathologists was moderate (Cohen's kappa k = 0.56). These results demonstrate the utility of AI algorithms as a tool for pathologists to increase sensitivity and specificity for the histopathologic assessment of the heart in toxicology studies.
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Affiliation(s)
- Thomas J Steinbach
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
| | - Debra A Tokarz
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
| | - Caroll A Co
- Social & Scientific Systems, Inc., Durham, North Carolina, USA
| | - Shawn F Harris
- Social & Scientific Systems, Inc., Durham, North Carolina, USA
| | | | - Keith R Shockley
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | | | | | | | - Emily Singletary
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
| | - Mark F Cesta
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Heath C Thomas
- Aclairo Pharmaceutical Development Group, Vienna, Virginia, USA
| | - Vivian S Chen
- Charles River Laboratories, Durham, North Carolina, USA
- Biogen, Cambridge, Massachusetts, USA
| | | | - Torrie A Crabbs
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina, USA
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Ekloh W, Asafu-Adjaye A, Tawiah-Mensah CNL, Ayivi-Tosuh SM, Quartey NKA, Aiduenu AF, Gayi BK, Koudonu JAM, Basing LA, Yamoah JAA, Dofuor AK, Osei JHN. A comprehensive exploration of schistosomiasis: Global impact, molecular characterization, drug discovery, artificial intelligence and future prospects. Heliyon 2024; 10:e33070. [PMID: 38988508 PMCID: PMC11234110 DOI: 10.1016/j.heliyon.2024.e33070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/12/2024] Open
Abstract
Schistosomiasis, one of the neglected tropical diseases which affects both humans and animals, is caused by trematode worms of the genus Schistosoma. The disease is caused by several species of Schistosoma which affect several organs such as urethra, liver, bladder, intestines, skin and bile ducts. The life cycle of the disease involves an intermediate host (snail) and a mammalian host. It affects people who are in close proximity to water bodies where the intermediate host is abundant. Common clinical manifestations of the disease at various stages include fever, chills, headache, cough, dysuria, hyperplasia and hydronephrosis. To date, most of the control strategies are dependent on effective diagnosis, chemotherapy and public health education on the biology of the vectors and parasites. Microscopy (Kato-Katz) is considered the golden standard for the detection of the parasite, while praziquantel is the drug of choice for the mass treatment of the disease since no vaccines have yet been developed. Most of the previous reviews on schistosomiasis have concentrated on epidemiology, life cycle, diagnosis, control and treatment. Thus, a comprehensive review that is in tune with modern developments is needed. Here, we extend this domain to cover historical perspectives, global impact, symptoms and detection, biochemical and molecular characterization, gene therapy, current drugs and vaccine status. We also discuss the prospects of using plants as potential and alternative sources of novel anti-schistosomal agents. Furthermore, we highlight advanced molecular techniques, imaging and artificial intelligence that may be useful in the future detection and treatment of the disease. Overall, the proper detection of schistosomiasis using state-of-the-art tools and techniques, as well as development of vaccines or new anti-schistosomal drugs may aid in the elimination of the disease.
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Affiliation(s)
- William Ekloh
- Department of Biochemistry, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Andy Asafu-Adjaye
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Christopher Nii Laryea Tawiah-Mensah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Naa Kwarley-Aba Quartey
- Department of Food Science and Technology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Fynn Aiduenu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Blessing Kwabena Gayi
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | | | - Laud Anthony Basing
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jennifer Afua Afrifa Yamoah
- Animal Health Division, Council for Scientific and Industrial Research-Animal Research Institute, Adenta-Frafraha, Accra, Ghana
| | - Aboagye Kwarteng Dofuor
- Department of Biological Sciences, School of Natural and Environmental Sciences, University of Environment and Sustainable Development, Somanya, Ghana
| | - Joseph Harold Nyarko Osei
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Klock C, Soares FA. Cancer diagnosis in the post-coronavirus disease era: the promising role of telepathology and artificial intelligence. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S127. [PMID: 38865546 PMCID: PMC11164283 DOI: 10.1590/1806-9282.2024s127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/30/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Clóvis Klock
- Brazilian Society of Pathology (President 2023-2024), Department of Diagnostic Medicine – São Paulo (SP), Brazil
- Medicina Diagnóstica Ltda – Erechim (RS), Brazil
| | - Fernando Augusto Soares
- D'Or IDOR Network Research Institute, Department of Pathology – São Paulo (SP), Brazil
- Universidade de São Paulo, Faculty of Dentistry, Department of Stomatology – São Paulo (SP), Brazil
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Ou DX, Lu CW, Chen LW, Lee WY, Hu HW, Chuang JH, Lin MW, Chen KY, Chiu LY, Chen JS, Chen CM, Hsieh MS. Deep Learning Analysis for Predicting Tumor Spread through Air Space in Early-Stage Lung Adenocarcinoma Pathology Images. Cancers (Basel) 2024; 16:2132. [PMID: 38893251 PMCID: PMC11172106 DOI: 10.3390/cancers16112132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
The presence of spread through air spaces (STASs) in early-stage lung adenocarcinoma is a significant prognostic factor associated with disease recurrence and poor outcomes. Although current STAS detection methods rely on pathological examinations, the advent of artificial intelligence (AI) offers opportunities for automated histopathological image analysis. This study developed a deep learning (DL) model for STAS prediction and investigated the correlation between the prediction results and patient outcomes. To develop the DL-based STAS prediction model, 1053 digital pathology whole-slide images (WSIs) from the competition dataset were enrolled in the training set, and 227 WSIs from the National Taiwan University Hospital were enrolled for external validation. A YOLOv5-based framework comprising preprocessing, candidate detection, false-positive reduction, and patient-based prediction was proposed for STAS prediction. The model achieved an area under the curve (AUC) of 0.83 in predicting STAS presence, with 72% accuracy, 81% sensitivity, and 63% specificity. Additionally, the DL model demonstrated a prognostic value in disease-free survival compared to that of pathological evaluation. These findings suggest that DL-based STAS prediction could serve as an adjunctive screening tool and facilitate clinical decision-making in patients with early-stage lung adenocarcinoma.
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Affiliation(s)
- De-Xiang Ou
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 10617, Taiwan; (D.-X.O.); (L.-W.C.); (K.-Y.C.)
| | - Chao-Wen Lu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (C.-W.L.); (J.-H.C.)
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Li-Wei Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 10617, Taiwan; (D.-X.O.); (L.-W.C.); (K.-Y.C.)
| | - Wen-Yao Lee
- Division of Thoracic Surgery, Department of Surgery, Fu Jen Catholic University Hospital, No. 69, Guizi Road, Taishan District, New Taipei City 24352, Taiwan;
| | - Hsiang-Wei Hu
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan;
| | - Jen-Hao Chuang
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (C.-W.L.); (J.-H.C.)
| | - Mong-Wei Lin
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (C.-W.L.); (J.-H.C.)
| | - Kuan-Yu Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 10617, Taiwan; (D.-X.O.); (L.-W.C.); (K.-Y.C.)
| | - Ling-Ying Chiu
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan; (C.-W.L.); (J.-H.C.)
| | - Chung-Ming Chen
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei 10617, Taiwan; (D.-X.O.); (L.-W.C.); (K.-Y.C.)
| | - Min-Shu Hsieh
- Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan;
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Ivanova M, Pescia C, Trapani D, Venetis K, Frascarelli C, Mane E, Cursano G, Sajjadi E, Scatena C, Cerbelli B, d’Amati G, Porta FM, Guerini-Rocco E, Criscitiello C, Curigliano G, Fusco N. Early Breast Cancer Risk Assessment: Integrating Histopathology with Artificial Intelligence. Cancers (Basel) 2024; 16:1981. [PMID: 38893102 PMCID: PMC11171409 DOI: 10.3390/cancers16111981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Effective risk assessment in early breast cancer is essential for informed clinical decision-making, yet consensus on defining risk categories remains challenging. This paper explores evolving approaches in risk stratification, encompassing histopathological, immunohistochemical, and molecular biomarkers alongside cutting-edge artificial intelligence (AI) techniques. Leveraging machine learning, deep learning, and convolutional neural networks, AI is reshaping predictive algorithms for recurrence risk, thereby revolutionizing diagnostic accuracy and treatment planning. Beyond detection, AI applications extend to histological subtyping, grading, lymph node assessment, and molecular feature identification, fostering personalized therapy decisions. With rising cancer rates, it is crucial to implement AI to accelerate breakthroughs in clinical practice, benefiting both patients and healthcare providers. However, it is important to recognize that while AI offers powerful automation and analysis tools, it lacks the nuanced understanding, clinical context, and ethical considerations inherent to human pathologists in patient care. Hence, the successful integration of AI into clinical practice demands collaborative efforts between medical experts and computational pathologists to optimize patient outcomes.
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Affiliation(s)
- Mariia Ivanova
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
| | - Carlo Pescia
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
| | - Dario Trapani
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, 20141 Milan, Italy; (D.T.); (C.C.); (G.C.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Konstantinos Venetis
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
| | - Chiara Frascarelli
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Eltjona Mane
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
| | - Giulia Cursano
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Elham Sajjadi
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Cristian Scatena
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Giulia d’Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Francesca Maria Porta
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
| | - Elena Guerini-Rocco
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Carmen Criscitiello
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, 20141 Milan, Italy; (D.T.); (C.C.); (G.C.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Giuseppe Curigliano
- Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, 20141 Milan, Italy; (D.T.); (C.C.); (G.C.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Nicola Fusco
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.I.); (C.P.); (K.V.); (C.F.); (E.M.); (G.C.); (E.S.); (F.M.P.); (E.G.-R.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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Buruiană A, Şerbănescu MS, Pop B, Gheban BA, Georgiu C, Crişan D, Crişan M. Automated cutaneous squamous cell carcinoma grading using deep learning with transfer learning. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2024; 65:243-250. [PMID: 39020538 PMCID: PMC11384044 DOI: 10.47162/rjme.65.2.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
INTRODUCTION Histological grading of cutaneous squamous cell carcinoma (cSCC) is crucial for prognosis and treatment decisions, but manual grading is subjective and time-consuming. AIM This study aimed to develop and validate a deep learning (DL)-based model for automated cSCC grading, potentially improving diagnostic accuracy (ACC) and efficiency. MATERIALS AND METHODS Three deep neural networks (DNNs) with different architectures (AlexNet, GoogLeNet, ResNet-18) were trained using transfer learning on a dataset of 300 histopathological images of cSCC. The models were evaluated on their ACC, sensitivity (SN), specificity (SP), and area under the curve (AUC). Clinical validation was performed on 60 images, comparing the DNNs' predictions with those of a panel of pathologists. RESULTS The models achieved high performance metrics (ACC>85%, SN>85%, SP>92%, AUC>97%) demonstrating their potential for objective and efficient cSCC grading. The high agreement between the DNNs and pathologists, as well as among different network architectures, further supports the reliability and ACC of the DL models. The top-performing models are publicly available, facilitating further research and potential clinical implementation. CONCLUSIONS This study highlights the promising role of DL in enhancing cSCC diagnosis, ultimately improving patient care.
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Affiliation(s)
- Alexandra Buruiană
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, Romania;
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Naseri S, Shukla S, Hiwale KM, Jagtap MM, Gadkari P, Gupta K, Deshmukh M, Sagar S. From Pixels to Prognosis: A Narrative Review on Artificial Intelligence's Pioneering Role in Colorectal Carcinoma Histopathology. Cureus 2024; 16:e59171. [PMID: 38807833 PMCID: PMC11129955 DOI: 10.7759/cureus.59171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 04/27/2024] [Indexed: 05/30/2024] Open
Abstract
Colorectal carcinoma, a prevalent and deadly malignancy, necessitates precise histopathological assessment for effective diagnosis and prognosis. Artificial intelligence (AI) emerges as a transformative force in this realm, offering innovative solutions to enhance traditional histopathological methods. This narrative review explores AI's pioneering role in colorectal carcinoma histopathology, encompassing its evolution, techniques, and advancements. AI algorithms, notably machine learning and deep learning, have revolutionized image analysis, facilitating accurate diagnosis and prognosis prediction. Furthermore, AI-driven histopathological analysis unveils potential biomarkers and therapeutic targets, heralding personalized treatment approaches. Despite its promise, challenges persist, including data quality, interpretability, and integration. Collaborative efforts among researchers, clinicians, and AI developers are imperative to surmount these hurdles and realize AI's full potential in colorectal carcinoma care. This review underscores AI's transformative impact and implications for future oncology research, clinical practice, and interdisciplinary collaboration.
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Affiliation(s)
- Suhit Naseri
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Samarth Shukla
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - K M Hiwale
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Miheer M Jagtap
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pravin Gadkari
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Kartik Gupta
- Radiation Oncology, Delhi State Cancer Institute, Delhi, IND
| | - Mamta Deshmukh
- Pathology, Indian Institute of Medical Sciences and Research, Jalna, IND
| | - Shakti Sagar
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Cheng J. Applications of Large Language Models in Pathology. Bioengineering (Basel) 2024; 11:342. [PMID: 38671764 PMCID: PMC11047860 DOI: 10.3390/bioengineering11040342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Large language models (LLMs) are transformer-based neural networks that can provide human-like responses to questions and instructions. LLMs can generate educational material, summarize text, extract structured data from free text, create reports, write programs, and potentially assist in case sign-out. LLMs combined with vision models can assist in interpreting histopathology images. LLMs have immense potential in transforming pathology practice and education, but these models are not infallible, so any artificial intelligence generated content must be verified with reputable sources. Caution must be exercised on how these models are integrated into clinical practice, as these models can produce hallucinations and incorrect results, and an over-reliance on artificial intelligence may lead to de-skilling and automation bias. This review paper provides a brief history of LLMs and highlights several use cases for LLMs in the field of pathology.
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Affiliation(s)
- Jerome Cheng
- Department of Pathology, University of Michigan, Ann Arbor, MI 48105, USA
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Díaz del Arco C, Fernández Aceñero MJ, Ortega Medina L. Liquid biopsy for gastric cancer: Techniques, applications, and future directions. World J Gastroenterol 2024; 30:1680-1705. [PMID: 38617733 PMCID: PMC11008373 DOI: 10.3748/wjg.v30.i12.1680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/01/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
After the study of circulating tumor cells in blood through liquid biopsy (LB), this technique has evolved to encompass the analysis of multiple materials originating from the tumor, such as nucleic acids, extracellular vesicles, tumor-educated platelets, and other metabolites. Additionally, research has extended to include the examination of samples other than blood or plasma, such as saliva, gastric juice, urine, or stool. LB techniques are diverse, intricate, and variable. They must be highly sensitive, and pre-analytical, patient, and tumor-related factors significantly influence the detection threshold, diagnostic method selection, and potential results. Consequently, the implementation of LB in clinical practice still faces several challenges. The potential applications of LB range from early cancer detection to guiding targeted therapy or immunotherapy in both early and advanced cancer cases, monitoring treatment response, early identification of relapses, or assessing patient risk. On the other hand, gastric cancer (GC) is a disease often diagnosed at advanced stages. Despite recent advances in molecular understanding, the currently available treatment options have not substantially improved the prognosis for many of these patients. The application of LB in GC could be highly valuable as a non-invasive method for early diagnosis and for enhancing the management and outcomes of these patients. In this comprehensive review, from a pathologist's perspective, we provide an overview of the main options available in LB, delve into the fundamental principles of the most studied techniques, explore the potential utility of LB application in the context of GC, and address the obstacles that need to be overcome in the future to make this innovative technique a game-changer in cancer diagnosis and treatment within clinical practice.
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Affiliation(s)
- Cristina Díaz del Arco
- Department of Surgical Pathology, Health Research Institute of the Hospital Clínico San Carlos, Hospital Clínico San Carlos, Madrid 28040, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - M Jesús Fernández Aceñero
- Department of Surgical Pathology, Health Research Institute of the Hospital Clínico San Carlos, Hospital Clínico San Carlos, Madrid 28040, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Luis Ortega Medina
- Department of Surgical Pathology, Health Research Institute of the Hospital Clínico San Carlos, Hospital Clínico San Carlos, Madrid 28040, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28040, Spain
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Chandwar K, Prasanna Misra D. What does artificial intelligence mean in rheumatology? Arch Rheumatol 2024; 39:1-9. [PMID: 38774703 PMCID: PMC11104749 DOI: 10.46497/archrheumatol.2024.10664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 05/24/2024] Open
Abstract
Intelligence is the ability of humans to learn from experiences to ascribe conscious weights and unconscious biases to modulate their outputs from given inputs. Transferring this ability to computers is artificial intelligence (AI). The ability of computers to understand data in an intelligent manner is machine learning. When such learning is with images and videos, which involves deeper layers of artificial neural networks, it is described as deep learning. Large language models are the latest development in AI which incorporate self-learning into deep learning through transformers. AI in Rheumatology has immense potential to revolutionize healthcare and research. Machine learning could aid clinical diagnosis and decision-making, and deep learning could extend this to analyze images of radiology or positron emission tomography scans or histopathology images to aid a clinician's diagnosis. Analysis of routinely obtained patient data or continuously collected information from wearables could predict disease flares. Analysis of high-volume genomics, transcriptomics, proteomics, or metabolomics data from patients could help identify novel markers of disease prognosis. AI might identify newer therapeutic targets based on in-silico modelling of omics data. AI could help automate medical administrative work such as inputting information into electronic health records or transcribing clinic notes. AI could help automate patient education and counselling. Beyond the clinic, AI has the potential to aid medical education. The ever-expanding capabilities of AI models bring along with them considerable ethical challenges, particularly related to risks of misuse. Nevertheless, the widespread use of AI in Rheumatology is inevitable and a progress with great potential.
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Affiliation(s)
- Kunal Chandwar
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | - Durga Prasanna Misra
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
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Mukherjee S, Vagha S, Gadkari P. Navigating the Future: A Comprehensive Review of Artificial Intelligence Applications in Gastrointestinal Cancer. Cureus 2024; 16:e54467. [PMID: 38510911 PMCID: PMC10953838 DOI: 10.7759/cureus.54467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
This comprehensive review explores the transformative role of artificial intelligence (AI) in the realm of gastrointestinal cancer. Gastrointestinal cancers present unique challenges, necessitating precise diagnostic tools and personalized treatment strategies. Leveraging AI, particularly machine learning and deep learning algorithms, has demonstrated remarkable potential in revolutionizing early detection, treatment planning, prognosis, and drug development. The analysis of current research and technological advancements underscores the capacity of AI to unravel intricate patterns within extensive datasets, providing actionable insights that enhance diagnostic accuracy and treatment efficacy. The transformative impact of AI on the landscape of gastrointestinal cancer is emphasized, signaling a paradigm shift towards more precise and targeted cancer care. The conclusion emphasizes the need for sustained research efforts and collaborative initiatives among AI researchers, healthcare professionals, and policymakers. By fostering interdisciplinary collaboration, we can navigate the evolving field of gastrointestinal cancer care, embracing the potential of AI to improve patient outcomes and contribute to a more effective and personalized approach to cancer management.
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Affiliation(s)
- Sreetama Mukherjee
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunita Vagha
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pravin Gadkari
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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45
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Doğan RS, Yılmaz B. Histopathology image classification: highlighting the gap between manual analysis and AI automation. Front Oncol 2024; 13:1325271. [PMID: 38298445 PMCID: PMC10827850 DOI: 10.3389/fonc.2023.1325271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/19/2023] [Indexed: 02/02/2024] Open
Abstract
The field of histopathological image analysis has evolved significantly with the advent of digital pathology, leading to the development of automated models capable of classifying tissues and structures within diverse pathological images. Artificial intelligence algorithms, such as convolutional neural networks, have shown remarkable capabilities in pathology image analysis tasks, including tumor identification, metastasis detection, and patient prognosis assessment. However, traditional manual analysis methods have generally shown low accuracy in diagnosing colorectal cancer using histopathological images. This study investigates the use of AI in image classification and image analytics using histopathological images using the histogram of oriented gradients method. The study develops an AI-based architecture for image classification using histopathological images, aiming to achieve high performance with less complexity through specific parameters and layers. In this study, we investigate the complicated state of histopathological image classification, explicitly focusing on categorizing nine distinct tissue types. Our research used open-source multi-centered image datasets that included records of 100.000 non-overlapping images from 86 patients for training and 7180 non-overlapping images from 50 patients for testing. The study compares two distinct approaches, training artificial intelligence-based algorithms and manual machine learning models, to automate tissue classification. This research comprises two primary classification tasks: binary classification, distinguishing between normal and tumor tissues, and multi-classification, encompassing nine tissue types, including adipose, background, debris, stroma, lymphocytes, mucus, smooth muscle, normal colon mucosa, and tumor. Our findings show that artificial intelligence-based systems can achieve 0.91 and 0.97 accuracy in binary and multi-class classifications. In comparison, the histogram of directed gradient features and the Random Forest classifier achieved accuracy rates of 0.75 and 0.44 in binary and multi-class classifications, respectively. Our artificial intelligence-based methods are generalizable, allowing them to be integrated into histopathology diagnostics procedures and improve diagnostic accuracy and efficiency. The CNN model outperforms existing machine learning techniques, demonstrating its potential to improve the precision and effectiveness of histopathology image analysis. This research emphasizes the importance of maintaining data consistency and applying normalization methods during the data preparation stage for analysis. It particularly highlights the potential of artificial intelligence to assess histopathological images.
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Affiliation(s)
- Refika Sultan Doğan
- Department of Bioengineering, Abdullah Gül University, Kayseri, Türkiye
- Biomedical Instrumentation and Signal Analysis Laboratory, Abdullah Gül University, Kayseri, Türkiye
| | - Bülent Yılmaz
- Biomedical Instrumentation and Signal Analysis Laboratory, Abdullah Gül University, Kayseri, Türkiye
- Department of Electrical and Computer Engineering, Abdullah Gul University, Kayseri, Türkiye
- Department of Electrical Engineering, Gulf University for Science and Technology, Mishref, Kuwait
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S Alshuhri M, Al-Musawi SG, Al-Alwany AA, Uinarni H, Rasulova I, Rodrigues P, Alkhafaji AT, Alshanberi AM, Alawadi AH, Abbas AH. Artificial intelligence in cancer diagnosis: Opportunities and challenges. Pathol Res Pract 2024; 253:154996. [PMID: 38118214 DOI: 10.1016/j.prp.2023.154996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/22/2023]
Abstract
Since cancer is one of the world's top causes of death, early diagnosis is critical to improving patient outcomes. Artificial intelligence (AI) has become a viable technique for cancer diagnosis by using machine learning algorithms to examine large volumes of data for accurate and efficient diagnosis. AI has the potential to alter the way cancer is detected fundamentally. Still, it has several disadvantages, such as requiring a large amount of data, technological limitations, and ethical concerns. This overview looks at the possibilities and restrictions of AI in cancer detection, as well as current applications and possible future developments. We can better understand how to use AI to improve patient outcomes and reduce cancer mortality rates by looking at its potential for cancer detection.
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Affiliation(s)
- Mohammed S Alshuhri
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
| | | | | | - Herlina Uinarni
- Department of Anatomy, School of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia, Indonesia; Radiology department of Pantai Indah Kapuk Hospital Jakarta, Jakarta, Indonesia.
| | - Irodakhon Rasulova
- School of Humanities, Natural & Social Sciences, New Uzbekistan University, 54 Mustaqillik Ave., Tashkent 100007, Uzbekistan; Department of Public Health, Samarkand State Medical University, Amir Temur Street 18, Samarkand, Uzbekistan
| | - Paul Rodrigues
- Department of Computer Engineering, College of Computer Science, King Khalid University, Al-Faraa, Abha, Asir, Kingdom of Saudi Arabia
| | | | - Asim Muhammed Alshanberi
- Department of Community Medicine & Pilgrim Healthcare, Umm Alqura University, Makkah 24382, Saudi Arabia; General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Ahmed Hussien Alawadi
- College of Technical Engineering, the Islamic University, Najaf, Iraq; College of Technical Engineering, the Islamic University of Al Diwaniyah, Iraq; College of Technical Engineering, the Islamic University of Babylon, Iraq
| | - Ali Hashim Abbas
- College of Technical Engineering, Imam Ja'afar Al-Sadiq University, Al-Muthanna 66002, Iraq
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Malik S, Zaheer S. ChatGPT as an aid for pathological diagnosis of cancer. Pathol Res Pract 2024; 253:154989. [PMID: 38056135 DOI: 10.1016/j.prp.2023.154989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/08/2023]
Abstract
Diagnostic workup of cancer patients is highly reliant on the science of pathology using cytopathology, histopathology, and other ancillary techniques like immunohistochemistry and molecular cytogenetics. Data processing and learning by means of artificial intelligence (AI) has become a spearhead for the advancement of medicine, with pathology and laboratory medicine being no exceptions. ChatGPT, an artificial intelligence (AI)-based chatbot, that was recently launched by OpenAI, is currently a talk of the town, and its role in cancer diagnosis is also being explored meticulously. Pathology workflow by integration of digital slides, implementation of advanced algorithms, and computer-aided diagnostic techniques extend the frontiers of the pathologist's view beyond a microscopic slide and enables effective integration, assimilation, and utilization of knowledge that is beyond human limits and boundaries. Despite of it's numerous advantages in the pathological diagnosis of cancer, it comes with several challenges like integration of digital slides with input language parameters, problems of bias, and legal issues which have to be addressed and worked up soon so that we as a pathologists diagnosing malignancies are on the same band wagon and don't miss the train.
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Affiliation(s)
- Shaivy Malik
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sufian Zaheer
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
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