Identification of areas of grading difficulties in prostate cancer and comparison with artificial intelligence assisted grading

被引：27

作者：

Egevad, Lars ^{[1
]}

Swanberg, Daniela ^{[1
]}

Delahunt, Brett ^{[2
]}

Strom, Peter ^{[3
]}

Kartasalo, Kimmo ^{[3
]}

Olsson, Henrik ^{[3
]}

Berney, Dan M. ^{[4
]}

Bostwick, David G. ^{[5
]}

Evans, Andrew J. ^{[6
]}

Humphrey, Peter A. ^{[7
]}

Iczkowski, Kenneth A. ^{[8
]}

Kench, James G. ^{[9
,10
]}

Kristiansen, Glen ^{[11
]}

Leite, Katia R. M. ^{[12
]}

McKenney, Jesse K. ^{[13
]}

Oxley, Jon ^{[14
]}

Pan, Chin-Chen ^{[15
]}

Samaratunga, Hemamali ^{[16
,17
]}

Srigley, John R. ^{[18
]}

Takahashi, Hiroyuki ^{[19
]}

Tsuzuki, Toyonori ^{[20
]}

van der Kwast, Theo ^{[6
]}

Varma, Murali ^{[21
]}

Zhou, Ming ^{[22
,23
]}

Clements, Mark ^{[3
]}

Eklund, Martin ^{[3
]}

机构：

[1] Karolinska Inst, Karolinska Univ Hosp, Dept Oncol Pathol, Radiumhemmet P1-02, S-17176 Stockholm, Sweden

[2] Univ Otago, Wellington Sch Med & Hlth Sci, Dept Pathol & Mol Med, Wellington, New Zealand

[3] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[4] Queen Mary Univ London, Barts Canc Inst, London, England

[5] Bostwick Labs, Orlando, FL USA

[6] Univ Hlth Network, Lab Med Program, Toronto, ON, Canada

[7] Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06510 USA

[8] Med Coll Wisconsin, Dept Pathol, Milwaukee, WI 53226 USA

[9] Univ Sydney, Royal Prince Alfred Hosp, Dept Tissue Pathol & Diagnost Oncol, Sydney, NSW, Australia

[10] Univ Sydney, Cent Clin Sch, Sydney, NSW, Australia

[11] Univ Hosp Bonn, Inst Pathol, Bonn, Germany

[12] Univ Sao Paulo, Med Sch, Lab Med Res, Dept Urol, Sao Paulo, Brazil

[13] Cleveland Clin, Pathol & Lab Med Inst, Cleveland, OH 44106 USA

[14] Southmead Hosp, Dept Cellular Pathol, Bristol, Avon, England

[15] Taipei Vet Gen Hosp, Dept Pathol, Taipei, Taiwan

[16] Aquesta Uropathol, Brisbane, Qld, Australia

[17] Univ Queensland, Brisbane, Qld, Australia

[18] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[19] Jikei Univ, Dept Pathol, Sch Med, Tokyo, Japan

[20] Aichi Med Univ, Sch Med, Dept Surg Pathol, Nagoya, Aichi, Japan

[21] Univ Hosp Wales, Dept Cellular Pathol, Cardiff, Wales

[22] Tufts Med Ctr, Dept Pathol & Lab Med, Boston, MA 02111 USA

[23] Tufts Sch Med, Boston, MA USA

来源：

VIRCHOWS ARCHIV | 2020年 / 477卷 / 06期

关键词：

Pathology; Standardization; Grading; Reproducibility; Artificial intelligence; Prostate cancer; 2014 INTERNATIONAL SOCIETY; ISUP CONSENSUS CONFERENCE; INTEROBSERVER-REPRODUCIBILITY; PATHOLOGY; ADENOCARCINOMA; CARCINOMA; BIOPSIES; STANDARDIZATION; VALIDATION; AGREEMENT;

D O I：

10.1007/s00428-020-02858-w

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

The International Society of Urological Pathology (ISUP) hosts a reference image database supervised by experts with the purpose of establishing an international standard in prostate cancer grading. Here, we aimed to identify areas of grading difficulties and compare the results with those obtained from an artificial intelligence system trained in grading. In a series of 87 needle biopsies of cancers selected to include problematic cases, experts failed to reach a 2/3 consensus in 41.4% (36/87). Among consensus and non-consensus cases, the weighted kappa was 0.77 (range 0.68-0.84) and 0.50 (range 0.40-0.57), respectively. Among the non-consensus cases, four main causes of disagreement were identified: the distinction between Gleason score 3 + 3 with tangential cutting artifacts vs. Gleason score 3 + 4 with poorly formed or fused glands (13 cases), Gleason score 3 + 4 vs. 4 + 3 (7 cases), Gleason score 4 + 3 vs. 4 + 4 (8 cases) and the identification of a small component of Gleason pattern 5 (6 cases). The AI system obtained a weighted kappa value of 0.53 among the non-consensus cases, placing it as the observer with the sixth best reproducibility out of a total of 24. AI may serve as a decision support and decrease inter-observer variability by its ability to make consistent decisions. The grading of these cancer patterns that best predicts outcome and guides treatment warrants further clinical and genetic studies. Results of such investigations should be used to improve calibration of AI systems.

引用

页码：777 / 786

页数：10

共 25 条

[1] Interobserver reproducibility of Gleason grading of prostatic carcinoma: Urologic pathologists [J].

Allsbrook, WC ;

Mangold, KA ;

Johnson, MH ;

Lane, RB ;

Lane, CG ;

Amin, MB ;

Bostwick, DG ;

Humphrey, PA ;

Jones, EC ;

Reuter, VE ;

Sakr, W ;

Sesterhenn, IA ;

Troncoso, P ;

Wheeler, TM ;

Epstein, JI .

HUMAN PATHOLOGY, 2001, 32 (01) :74-80

[2] Interobserver reproducibility of Gleason grading of prostatic carcinoma: General pathologists [J].

Allsbrook, WC ;

Mangold, KA ;

Johnson, MH ;

Lane, RB ;

Lane, CG ;

Epstein, JI .

HUMAN PATHOLOGY, 2001, 32 (01) :81-88

[3] Validation of a contemporary prostate cancer grading system using prostate cancer death as outcome [J].

Berney, Daniel M. ;

Beltran, Luis ;

Fisher, Gabrielle ;

North, Bernard V. ;

Greenberg, David ;

Moller, Henrik ;

Soosay, Geraldine ;

Scardino, Peter ;

Cuzick, Jack .

BRITISH JOURNAL OF CANCER, 2016, 114 (10) :1078-1083

[4] Validation of International Society of Urological Pathology (ISUP) grading for prostatic adenocarcinoma in thin core biopsies using TROG 03.04 'RADAR' trial clinical data [J].

Delahunt, B. ;

Egevad, L. ;

Srigley, J. R. ;

Steigler, A. ;

Murray, J. D. ;

Atkinson, C. ;

Matthews, J. ;

Duchesne, G. ;

Spry, N. A. ;

Christie, D. ;

Joseph, D. ;

Attia, J. ;

Denham, J. W. .

PATHOLOGY, 2015, 47 (06) :520-525

[5] Architectural Heterogeneity and Cribriform Pattern Predict Adverse Clinical Outcome for Gleason Grade 4 Prostatic Adenocarcinoma [J].

Dong, Fei ;

Yang, Ping ;

Wang, Chaofu ;

Wu, Shulin ;

Xiao, Yu ;

McDougal, W. Scott ;

Young, Robert H. ;

Wu, Chin-Lee .

AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2013, 37 (12) :1855-1861

[6] Utility of Pathology Imagebase for standardisation of prostate cancer grading [J].

Egevad, Lars ;

Delahunt, Brett ;

Berney, Daniel M. ;

Bostwick, David G. ;

Cheville, John ;

Comperat, Eva ;

Evans, Andrew J. ;

Fine, Samson W. ;

Grignon, David J. ;

Humphrey, Peter A. ;

Hornblad, Jonas ;

Iczkowski, Kenneth A. ;

Kench, James G. ;

Kristiansen, Glen ;

Leite, Katia R. M. ;

Magi-Galluzzi, Cristina ;

McKenney, Jesse K. ;

Oxley, Jon ;

Pan, Chin-Chen ;

Samaratunga, Hemamali ;

Srigley, John R. ;

Takahashi, Hiroyuki ;

True, Lawrence D. ;

Tsuzuki, Toyonori ;

van der Kwast, Theo ;

Varma, Murali ;

Zhou, Ming ;

Clements, Mark .

HISTOPATHOLOGY, 2018, 73 (01) :8-18

[7] Pathology Imagebase-a reference image database for standardization of pathology [J].

Egevad, Lars ;

Cheville, John ;

Evans, Andrew J. ;

Hornblad, Jonas ;

Kench, James G. ;

Kristiansen, Glen ;

Leite, Katia R. M. ;

Magi-Galluzzi, Cristina ;

Pan, Chin-Chen ;

Samaratunga, Hemamali ;

Srigley, John R. ;

True, Lawrence ;

Zhou, Ming ;

Clements, Mark ;

Delahunt, Brett .

HISTOPATHOLOGY, 2017, 71 (05) :677-685

[8] Standardization of Gleason grading among 337 European pathologists [J].

Egevad, Lars ;

Ahmad, Amar S. ;

Algaba, Ferran ;

Berney, Daniel M. ;

Boccon-Gibod, Liliane ;

Comperat, Eva ;

Evans, Andrew J. ;

Griffiths, David ;

Grobholz, Rainer ;

Kristiansen, Glen ;

Langner, Cord ;

Lopez-Beltran, Antonio ;

Montironi, Rodolfo ;

Moss, Sue ;

Oliveira, Pedro ;

Vainer, Ben ;

Varma, Murali ;

Camparo, Philippe .

HISTOPATHOLOGY, 2013, 62 (02) :247-256

[9] Reproducibility and reliability of tumor grading in urological neoplasms [J].

Engers, Rainer .

WORLD JOURNAL OF UROLOGY, 2007, 25 (06) :595-605

[10] The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma [J].

Epstein, JI ;

Allsbrook, WC ;

Amin, MB ;

Egevad, LL ;

Bastacky, S ;

Beltrán, AL ;

Berner, A ;

Billis, A ;

Boccon-Gibod, L ;

Cheng, L ;

Civantos, F ;

Cohen, C ;

Cohen, MB ;

Datta, M ;

Davis, C ;

Delahunt, B ;

Delprado, W ;

Eble, JN ;

Foster, CS ;

Furusato, M ;

Gaudin, PB ;

Grignon, DJ ;

Humphrey, PA ;

Iczkowski, KA ;

Jones, EC ;

Lucia, S ;

McCue, PA ;

Nazeer, T ;

Oliva, E ;

Pan, CC ;

Pizov, G ;

Reuter, V ;

Samaratunga, H ;

Sebo, T ;

Sesterhenn, I ;

Shevchuk, M ;

Srigley, JR ;

Suzigan, S ;

Takahashi, H ;

Tamboli, P ;

Tan, PH ;

Têtu, B ;

Tickoo, S ;

Tomaszewski, JE ;

Troncoso, P ;

Tsuzuki, T ;

True, LD ;

van der Kwast, T ;

Wheeler, TM ;

Wojno, KJ .

AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2005, 29 (09) :1228-1242

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