Cancer pathology reflects disease progression (or regression) and associated molecular characteristics, and provides rich phenotypic information that is predictive of cancer grade and has potential implications in treatment planning and prognosis. According to the remarkable performance of computational approaches in the digital pathology domain, we hypothesized that machine learning can help to distinguish low-grade gliomas (LGG) from high-grade gliomas (HGG) by exploiting the rich phenotypic information that reflects the microvascular proliferation level, mitotic activity, presence of necrosis, and nuclear atypia present in digital pathology images. A set of 735 whole-slide digital pathology images of glioma patients (median age: 49.65 years, male: 427, female: 308, median survival: 761.26 days) were obtained from TCGA. Sub-images that contained a viable tumor area, showing sufficient histologic characteristics, and that did not have any staining artifact were extracted. Several clinical measures and imaging features, including conventional (intensity, morphology) and advanced textures features (gray-level co-occurrence matrix and gray-level run-length matrix), extracted from the sub-images were further used for training the support vector machine model with linear configuration. We sought to evaluate the combined effect of conventional imaging, clinical, and texture features by assessing the predictive value of each feature type and their combinations through a predictive classifier. The texture features were successfully validated on the glioma patients in 10-fold cross-validation (accuracy = 75.12%, AUC = 0.652). The addition of texture features to clinical and conventional imaging features improved grade prediction compared to the models trained on clinical and conventional imaging features alone (p = 0.045 and p = 0.032 for conventional imaging features and texture features, respectively). The integration of imaging, texture, and clinical features yielded a significant improvement in accuracy, supporting the synergistic value of these features in the predictive model. The findings suggest that the texture features, when combined with conventional imaging and clinical markers, may provide an objective, accurate, and integrated prediction of glioma grades. The proposed digital pathology imaging-based marker may help to (i) stratify patients into clinical trials, (ii) select patients for targeted therapies, and (iii) personalize treatment planning on an individual person basis.

Distinguishing benign from malignant disease is a primary challenge for colon histopathologists. Current clinical methods rely on qualitative visual analysis of features such as glandular architecture and size that exist on a continuum from benign to malignant. Consequently, discordance between histopathologists is common. To provide more reliable analysis of colon specimens, we propose an end-to-end computational pathology pipeline that encompasses gland segmentation, cancer detection, and then further breaking down the malignant samples into different cancer grades. We propose a multi-step gland segmentation method, which models tissue components as ellipsoids. For cancer detection/grading, we encode cellular morphology, spatial architectural patterns of glands, and texture by extracting multi-scale features: (i) Gland-based: extracted from individual glands, (ii) local-patch-based: computed from randomly-selected image patches, and (iii) image-based: extracted from images, and employ a hierarchical ensemble-classification method. Using two datasets (Rawalpindi Medical College (RMC), n = 174 and gland segmentation (GlaS), n = 165) with three cancer grades, our method reliably delineated gland regions (RMC = 87.5%, GlaS = 88.4%), detected the presence of malignancy (RMC = 97.6%, GlaS = 98.3%), and predicted tumor grade (RMC = 98.6%, GlaS = 98.6%). Training the model using one dataset and testing it on the other showed strong concordance in cancer detection (Train RMC – Test GlaS = 94.5%, Train GlaS – Test RMC = 93.7%) and grading (Train RMC – Test GlaS = 95%, Train GlaS – Test RMC = 95%) suggesting that the model will be applicable across institutions. With further prospective validation, the techniques demonstrated here may provide a reproducible and easily accessible method to standardize analysis of colon cancer specimens.

The management of prostate cancer (PCa) is dependent on biomarkers of biological aggression. This includes an invasive biopsy to facilitate a histopathological assessment of the tumor’s grade. This review explores the technical processes of applying magnetic resonance imaging based radiomic models to the evaluation of PCa. By exploring how a deep radiomics approach further optimizes the prediction of a PCa’s grade group, it will be clear how this integration of artificial intelligence mitigates existing major technological challenges faced by a traditional radiomic model: image acquisition, small data sets, image processing, labeling/segmentation, informative features, predicting molecular features and incorporating predictive models. Other potential impacts of artificial intelligence on the personalized treatment of PCa will also be discussed. The role of deep radiomics analysis-a deep texture analysis, which extracts features from convolutional neural networks layers, will be highlighted. Existing clinical work and upcoming clinical trials will be reviewed, directing investigators to pertinent future directions in the field. For future progress to result in clinical translation, the field will likely require multi-institutional collaboration in producing prospectively populated and expertly labeled imaging libraries.

We seek the development and evaluation of a fast, accurate, and consistent method for general-purpose segmentation, based on interactive machine learning (IML). To validate our method, we identified retrospective cohorts of 20 brain, 50 breast, and 50 lung cancer patients, as well as 20 spleen scans, with corresponding ground truth annotations. Utilizing very brief user training annotations and the adaptive geodesic distance transform, an ensemble of SVMs is trained, providing a patient-specific model applied to the whole image. Two experts segmented each cohort twice with our method and twice manually. The IML method was faster than manual annotation by 53.1% on average. We found significant (p < 0.001) overlap difference for spleen (Dice_IML/Dice_Manual = 0.91/0.87), breast tumors (Dice_IML/Dice_Manual = 0.84/0.82), and lung nodules (Dice_IML/Dice_Manual = 0.78/0.83). For intra-rater consistency, a significant (p = 0.003) difference was found for spleen (Dice_IML/Dice_Manual = 0.91/0.89). For inter-rater consistency, significant (p < 0.045) differences were found for spleen (Dice_IML/Dice_Manual = 0.91/0.87), breast (Dice_IML/Dice_Manual = 0.86/0.81), lung (Dice_IML/Dice_Manual = 0.85/0.89), the non-enhancing (Dice_IML/Dice_Manual = 0.79/0.67) and the enhancing (Dice_IML/Dice_Manual = 0.79/0.84) brain tumor sub-regions, which, in aggregation, favored our method. Quantitative evaluation for speed, spatial overlap, and consistency, reveals the benefits of our proposed method when compared with manual annotation, for several clinically relevant problems. We publicly release our implementation through CaPTk (Cancer Imaging Phenomics Toolkit) and as an MITK plugin.

White matter lesions (WML) are common in a variety of brain pathologies, including ischemia affecting blood vessels deeper inside the brain’s white matter, and show an abnormal signal in T1-weighted and FLAIR images. The emergence of personalized medicine requires quantification and analysis of differential characteristics of WML across different brain regions. Manual segmentation and analysis of WMLs is laborious and time-consuming; therefore, automated methods providing robust, reproducible, and fast WML segmentation and analysis are highly desirable. In this study, we tackled the segmentation problem as a voxel-based classification problem. We developed an ensemble of different classification models, including six models of support vector machine, trained on handcrafted and transfer learning features, and five models of Residual neural network, trained on varying window sizes. The output of these models was combined through majority-voting. A series of image processing operations was applied to remove false positives in a post-processing step. Moreover, images were mapped to a standard atlas template to quantify the spatial distribution of WMLs, and a radiomic analysis of all the lesions across different brain regions was carried out. The performance of the method on multi-institutional WML Segmentation Challenge dataset (n = 150) comprising T1-weighted and FLAIR images was >90% within data of each institution, multi-institutional data pooled together, and across-institution training–testing. Forty-five percent of lesions were found in the temporal lobe of the brain, and these lesions were easier to segment (95.67%) compared to lesions in other brain regions. Lesions in different brain regions were characterized by their differential characteristics of signal strength, size/shape, heterogeneity, and texture (p < 0.001). The proposed multimodal ensemble-based segmentation of WML showed effective performance across all scanners. Further, the radiomic characteristics of WMLs of different brain regions provide an in vivo portrait of phenotypic heterogeneity in WMLs, which points to the need for precision diagnostics and personalized treatment.