Frei, Ana Leni; Oberson, Raphaël; Baumann, Elias; Perren, Aurel; Grobholz, Rainer; Lugli, Alessandro; Dawson, Heather; Abbet, Christian; Lertxundi, Ibai; Reinhard, Stefan; Mookhoek, Aart; Feichtinger, Johann; Sarro, Rossella; Gadient, Gallus; Dommann-Scherrer, Corina; Barizzi, Jessica; Berezowska, Sabina; Glatz, Katharina; Dertinger, Susanne; Banz, Yara; ... (2023). Pathologist computer-aided diagnostic scoring of tumor cell fraction: A Swiss national study. Modern pathology, 36(12), p. 100335. Springer Nature 10.1016/j.modpat.2023.100335
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Tumor cell fraction (TCF) estimation is a common clinical task with well-established large inter-observer variability. It thus provides an ideal testbed to evaluate potential impacts of employing a computer-aided diagnostic (TCFCAD) tool to support pathologists' evaluation. During a National Slide Seminar event, pathologists (n=69) were asked to visually estimate TCF in 10 regions of interest (ROI) from hematoxylin and eosin (H&E) colorectal cancer images intentionally curated for diverse tissue compositions, cellularity, and stain intensities. Next, they re-evaluated the same ROIs while being provided a TCFCAD created overlay highlighting predicted tumor versus non-tumor cells, together with the corresponding TCF percentage. Participants also reported confidence levels in their assessments using a 5-tiers scale, indicating no confidence to high confidence, respectively. The TCF ground truth (GT) was defined by manual cell-counting by experts. When assisted, inter-observer variability significantly decreased, showing estimates converging to the GT. This improvement remained even when TCFCAD predictions deviated slightly from the GT. The standard-deviation of estimated TCF to the GT across ROIs was 9.9% vs 5.8% with TCFCAD, p < 0.0001. The intraclass correlation coefficient increased from 0.8 to 0.93 (CI95% [0.65, 0.93] vs [0.86, 0.98]) and pathologists stated feeling more confident when aided (3.67 ± 0.81 vs. 4.17 ± 0.82 with CAD). TCFCAD estimation support demonstrated improved scoring accuracy, inter-pathologist agreement and scoring confidence. Interestingly, pathologists also expressed more willingness to use such a CAD tool at the end of the survey, highlighting the importance of training/education to increase adoption of CAD systems.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology 04 Faculty of Medicine > Service Sector > Institute of Pathology |
UniBE Contributor: |
Frei, Ana Leni, Oberson, Raphaël Denis, Baumann, Elias, Perren, Aurel, Lugli, Alessandro, Dawson, Heather, Reinhard, Stefan, Mookhoek, Aart, Banz Wälti, Yara Sarah, Zlobec, Inti |
Subjects: |
500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health |
ISSN: |
1530-0285 |
Publisher: |
Springer Nature |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Sep 2023 11:10 |
Last Modified: |
23 Sep 2024 00:25 |
Publisher DOI: |
10.1016/j.modpat.2023.100335 |
PubMed ID: |
37742926 |
BORIS DOI: |
10.48350/186554 |
URI: |
https://boris.unibe.ch/id/eprint/186554 |
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