Yanhua Gao

Yuanqing Yang, Kai Sun, Yanhua Gao et al.

[Purpose] The pathology is decisive for disease diagnosis, but relies heavily on the experienced pathologists. Recently, pathological artificial intelligence (PAI) is thought to improve diagnostic accuracy and efficiency. However, the high performance of PAI based on deep learning in the laboratory generally cannot be reproduced in the clinic. [Methods] Because the data preparation is important for PAI, the paper has reviewed PAI-related studies in the PubMed database published from January 2017 to February 2022, and 118 studies were included. The in-depth analysis of methods for preparing data is performed, including obtaining slides of pathological tissue, cleaning, screening, and then digitizing. Expert review, image annotation, dataset division for model training and validation are also discussed. We further discuss the reasons why the high performance of PAI is not reproducible in the clinical practices and show some effective ways to improve clinical performances of PAI. [Results] The robustness of PAI depend on randomized collection of representative disease slides, including rigorous quality control and screening, correction of digital discrepancies, reasonable annotation, and the amount of data. The digital pathology is fundamental of clinical-grade PAI, and the techniques of data standardization and weakly supervised learning methods based on whole slide image (WSI) are effective ways to overcome obstacles of performance reproduction. [Conclusion] The representative data, the amount of labeling and consistency from multi-centers is the key to performance reproduction. The digital pathology for clinical diagnosis, data standardization and technique of WSI-based weakly supervised learning hopefully build clinical-grade PAI. Keywords: pathological artificial intelligence; data preparation; clinical-grade; deep learning

Kai Sun, Yanhua Gao, Ting Xie et al.

Background. Digital pathology has aroused widespread interest in modern pathology. The key of digitalization is to scan the whole slide image (WSI) at high magnification. The lager the magnification is, the richer details WSI will provide, but the scanning time is longer and the file size of obtained is larger. Methods. We design a strategy to scan slides with low resolution (5X) and a super-resolution method is proposed to restore the image details when in diagnosis. The method is based on a multi-scale generative adversarial network, which sequentially generates three high-resolution images such as 10X, 20X and 40X. Results. The peak-signal-to-noise-ratio of 10X to 40X generated images are 24.16, 22.27 and 20.44, and the structural-similarity-index are 0.845, 0.680 and 0.512, which are better than other super-resolution networks. Visual scoring average and standard deviation from three pathologists is 3.63 plus-minus 0.52, 3.70 plus-minus 0.57 and 3.74 plus-minus 0.56 and the p value of analysis of variance is 0.37, indicating that generated images include sufficient information for diagnosis. The average value of Kappa test is 0.99, meaning the diagnosis of generated images is highly consistent with that of the real images. Conclusion. This proposed method can generate high-quality 10X, 20X, 40X images from 5X images at the same time, in which the time and storage costs of digitalization can be effectively reduced up to 1/64 of the previous costs. The proposed method provides a better alternative for low-cost storage, faster image share of digital pathology. Keywords. Digital pathology; Super-resolution; Low resolution scanning; Low cost