Geongyu Lee

Yesung Cho, Dongmyung Shin, Sujeong Hong et al.

Prostate cancer is one of the most frequently diagnosed malignancies in men worldwide. However, precise prediction of biochemical recurrence (BCR) after radical prostatectomy remains challenging due to the multifocality of tumors distributed throughout the prostate gland. In this paper, we propose a novel AI framework that simultaneously processes a series of multi-section pathology slides to capture the comprehensive tumor landscape across the entire prostate gland. To develop this predictive AI model, we curated a large-scale dataset of 23,451 slides from 789 patients. The proposed framework demonstrated strong predictive performance for 1- and 2-year BCR prediction, substantially outperforming established clinical benchmarks. The AI-derived risk score was validated as the most potent independent prognostic factor in a multivariable Cox proportional hazards analysis, surpassing conventional clinical markers such as pre-operative PSA and Gleason score. Furthermore, we demonstrated that integrating patch and slide sub-sampling strategies significantly reduces computational cost during both training and inference without compromising predictive performance, and generalizability of AI was confirmed through external validation. Collectively, these results highlight the clinical feasibility and prognostic value of the proposed AI-based multi-section slide analysis as a scalable tool for post-operative management in prostate cancer.

Ruining Deng, Tianyuan Yao, Yucheng Tang et al.

Chronic kidney disease (CKD) is a major global health issue, affecting over 10% of the population and causing significant mortality. While kidney biopsy remains the gold standard for CKD diagnosis and treatment, the lack of comprehensive benchmarks for kidney pathology segmentation hinders progress in the field. To address this, we organized the Kidney Pathology Image Segmentation (KPIs) Challenge, introducing a dataset that incorporates preclinical rodent models of CKD with over 10,000 annotated glomeruli from 60+ Periodic Acid Schiff (PAS)-stained whole slide images. The challenge includes two tasks, patch-level segmentation and whole slide image segmentation and detection, evaluated using the Dice Similarity Coefficient (DSC) and F1-score. By encouraging innovative segmentation methods that adapt to diverse CKD models and tissue conditions, the KPIs Challenge aims to advance kidney pathology analysis, establish new benchmarks, and enable precise, large-scale quantification for disease research and diagnosis.

Yesung Cho, Sungmin Lee, Geongyu Lee et al.

Recent studies in pathology foundation models have shown that scaling training data, diversifying cancer types, and increasing model size consistently improve their performance. However, giga-scale foundation models, which are trained on hundreds of thousands of slides covering tens of cancer types and contain billions of parameters, pose significant challenges for practical use due to their tremendous computational costs in both development and deployment. In this work, we present a novel strategy, named the G2L framework, to increase the performance of large-scale foundation models, which consist of only $15\%$ of the parameters of giga-scale models, to a comparable performance level of giga-scale models in cancer-specific tasks. Our approach applies knowledge distillation, transferring the capabilities of a giga-scale model to a large-scale model, using just 1K pathology slides of a target cancer (e.g., breast, prostate, etc.). The resulting distilled model not only outperformed state-of-the-art models of the same size (i.e., large-scale) across several benchmarks but also, interestingly, surpassed the giga-scale teacher and huge-scale models in some benchmarks. In addition, the distilled model exhibited a higher robustness index, indicating improved resilience to image variations originating from multiple institutions. These findings suggest that the proposed distillation approach for a large-scale model is a data- and parameter-efficient way to achieve giga-scale-level performance for cancer-specific applications without prohibitive computational burden.

Geongyu Lee, Joonho Lee, Tae-Yeong Kwak et al.

Accurate prediction of the likelihood of recurrence is important in the selection of postoperative treatment for patients with early-stage breast cancer. In this study, we investigated whether deep learning algorithms can predict patients' risk of recurrence by analyzing the pathology images of their cancer histology.We analyzed 125 hematoxylin and eosin-stained whole slide images (WSIs) from 125 patients across two institutions (National Cancer Center and Korea University Medical Center Guro Hospital) to predict breast cancer recurrence risk using deep learning. Sensitivity reached 0.857, 0.746, and 0.529 for low, intermediate, and high-risk categories, respectively, with specificity of 0.816, 0.803, and 0.972, and a Pearson correlation of 0.61 with histological grade. Class activation maps highlighted features like tubule formation and mitotic rate, suggesting a cost-effective approach to risk stratification, pending broader validation. These findings suggest that deep learning models trained exclusively on hematoxylin and eosin stained whole slide images can approximate genomic assay results, offering a cost-effective and scalable tool for breast cancer recurrence risk assessment. However, further validation using larger and more balanced datasets is needed to confirm the clinical applicability of our approach.