One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of p...One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.展开更多
The Gleason grading system for prostate adenocarcinoma has evolved from its original scheme established in the 1960s-1970s, to a significantly modified system after two major consensus meetings conducted by the Intern...The Gleason grading system for prostate adenocarcinoma has evolved from its original scheme established in the 1960s-1970s, to a significantly modified system after two major consensus meetings conducted by the International Society of Urologic Pathology （ISUP） in 2005 and 2014, respectively. The Gleason grading system has been incorporated into the WHO classification of prostate cancer, the AJCC/ UICC staging system, and the NCCN guidelines as one of the key factors in treatment decision. Both pathologists and clinicians need to fully understand the principles and practice of this grading system. We here briefly review the historical aspects of the original scheme and the recent developments of Gleason grading system, focusing on major changes over the years that resulted in the modern Gleason grading system, which has led to a new ＂Grade Group＂ system proposed by the 2014 ISUP consensus, and adopted by the 2016 WHO classification of tumours of the prostate.展开更多
The Gleason grade group(GG)is an important basis for assessing the malignancy of prostate can-cer,but it requires invasive biopsy to obtain pathology.To noninvasively evaluate GG,an automatic prediction method is prop...The Gleason grade group(GG)is an important basis for assessing the malignancy of prostate can-cer,but it requires invasive biopsy to obtain pathology.To noninvasively evaluate GG,an automatic prediction method is proposed based on multi-scale convolutional neural network of the ensemble attention module trained with curriculum learning.First,a lesion-attention map based on the image of the region of interest is proposed in combination with the bottleneck attention module to make the network more focus on the lesion area.Second,the feature pyramid network is combined to make the network better learn the multi-scale information of the lesion area.Finally,in the network training,a curriculum based on the consistency gap between the visual evaluation and the pathological grade is proposed,which further improves the prediction performance of the network.Ex-perimental results show that the proposed method is better than the traditional network model in predicting GG performance.The quadratic weighted Kappa is 0.4711 and the positive predictive value for predicting clinically significant cancer is 0.9369.展开更多
基金supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R104),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.
基金supported by grants from the Natural Science Foundation of China (NSFC 81272848, 81272820, 81302225, 81572540)
文摘The Gleason grading system for prostate adenocarcinoma has evolved from its original scheme established in the 1960s-1970s, to a significantly modified system after two major consensus meetings conducted by the International Society of Urologic Pathology （ISUP） in 2005 and 2014, respectively. The Gleason grading system has been incorporated into the WHO classification of prostate cancer, the AJCC/ UICC staging system, and the NCCN guidelines as one of the key factors in treatment decision. Both pathologists and clinicians need to fully understand the principles and practice of this grading system. We here briefly review the historical aspects of the original scheme and the recent developments of Gleason grading system, focusing on major changes over the years that resulted in the modern Gleason grading system, which has led to a new ＂Grade Group＂ system proposed by the 2014 ISUP consensus, and adopted by the 2016 WHO classification of tumours of the prostate.
基金Foundation item:the Suzhou Municipal Health and Family Planning Commission's Key Diseases Diagnosis and Treatment Program(No.LCzX202001)the Science and Technology Development Project ofSuzhou(Nos.SS2019012andSKY2021031)+1 种基金the Youth Innovation Promotion Association CAS(No.2021324)the Medical Research Project of Jiangsu Provincial Health and Family Planning Commission(No.M2020068)。
文摘The Gleason grade group(GG)is an important basis for assessing the malignancy of prostate can-cer,but it requires invasive biopsy to obtain pathology.To noninvasively evaluate GG,an automatic prediction method is proposed based on multi-scale convolutional neural network of the ensemble attention module trained with curriculum learning.First,a lesion-attention map based on the image of the region of interest is proposed in combination with the bottleneck attention module to make the network more focus on the lesion area.Second,the feature pyramid network is combined to make the network better learn the multi-scale information of the lesion area.Finally,in the network training,a curriculum based on the consistency gap between the visual evaluation and the pathological grade is proposed,which further improves the prediction performance of the network.Ex-perimental results show that the proposed method is better than the traditional network model in predicting GG performance.The quadratic weighted Kappa is 0.4711 and the positive predictive value for predicting clinically significant cancer is 0.9369.
