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Identification of misdiagnosis by deep neural networks on a histopathologic review of breast cancer lymph node metastases

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机构: [1]Digital Health China Technologies Corporation Limited, Beijing 100080, China [2]Department of Pathology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinses Academy of MedicalSciences and Peking Union Medical College, Beijing 100021, China [3]Department of Pathology, National CancerCenter/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences,Langfang 065001, China [4]Research Center of Precision Sensing and Control, Institute of Automation, ChineseAcademy of Sciences, Beijing 100190, China [5]Department of Medical Affairs, National Cancer Center/NationalClinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking UnionMedical College, Beijing 100021, China [6]Department of Academic Research, National Cancer Center/NationalClinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking UnionMedical College, Beijing 100021, China [7]Department of Big Data, National Cancer Center/National ClinicalResearch Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union MedicalCollege, Beijing 100021, China [8]Department of Urology, National Cancer Center/National Clinical ResearchCenter for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021, China
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The frozen section (FS) diagnoses of pathology experts are used in China to determine whether sentinel lymph nodes of breast cancer have metastasis during operation. Direct implementation of a deep neural network (DNN) in clinical practice may be hindered by misdiagnosis of the algorithm, which affects a patient's treatment decision. In this study, we first obtained the prediction result of the commonly used patch-DNN, then we present a relative risk classification and regression tree (RRC ART) to identify the misdiagnosed whole-slide images (WSIs) and recommend them to be reviewed by pathologists. Applying this framework to 2362 WSIs of breast cancer lymph node metastasis, test on frozen section results in the mean area under the curve (AUC) reached 0.9851. However, the mean misdiagnosis rate (0.0248), was significantly higher than the pathologists' misdiagnosis rate (p < 0.01). The RRCART distinguished more than 80% of the WSIs as a high-accuracy group with an average accuracy reached to 0.995, but the difference with the pathologists' performance was not significant (p > 0.01). However, the other low-accuracy group included most of the misdiagnoses of DNN models. Our research shows that the misdiagnosis from deep learning model can be further enriched by our method, and that the low-accuracy WSIs must be selected for pathologists to review and the high-accuracy ones may be ready for pathologists to give diagnostic reports.

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出版当年[2022]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
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大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
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Q2 MULTIDISCIPLINARY SCIENCES
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Q1 MULTIDISCIPLINARY SCIENCES

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第一作者机构: [1]Digital Health China Technologies Corporation Limited, Beijing 100080, China
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