A Pathologist-Informed Workflow for Classification of Prostate Glands in Histopathology
This addresses the time-consuming and error-prone process of manual Gleason grading by pathologists, offering an automated solution for prostate cancer diagnosis.
The paper tackles the problem of automating prostate cancer diagnosis and grading from histopathology images by proposing a workflow that isolates and classifies individual glands, achieving results comparable to other machine-learning methods.
Pathologists diagnose and grade prostate cancer by examining tissue from needle biopsies on glass slides. The cancer's severity and risk of metastasis are determined by the Gleason grade, a score based on the organization and morphology of prostate cancer glands. For diagnostic work-up, pathologists first locate glands in the whole biopsy core, and -- if they detect cancer -- they assign a Gleason grade. This time-consuming process is subject to errors and significant inter-observer variability, despite strict diagnostic criteria. This paper proposes an automated workflow that follows pathologists' \textit{modus operandi}, isolating and classifying multi-scale patches of individual glands in whole slide images (WSI) of biopsy tissues using distinct steps: (1) two fully convolutional networks segment epithelium versus stroma and gland boundaries, respectively; (2) a classifier network separates benign from cancer glands at high magnification; and (3) an additional classifier predicts the grade of each cancer gland at low magnification. Altogether, this process provides a gland-specific approach for prostate cancer grading that we compare against other machine-learning-based grading methods.