RESUMO
The pathologic diagnosis of nasopharyngeal carcinoma (NPC) by different pathologists is often inefficient and inconsistent. We have therefore introduced a deep learning algorithm into this process and compared the performance of the model with that of three pathologists with different levels of experience to demonstrate its clinical value. In this retrospective study, a total of 1970 whole slide images of 731 cases were collected and divided into training, validation, and testing sets. Inception-v3, which is a state-of-the-art convolutional neural network, was trained to classify images into three categories: chronic nasopharyngeal inflammation, lymphoid hyperplasia, and NPC. The mean area under the curve (AUC) of the deep learning model is 0.936 based on the testing set, and its AUCs for the three image categories are 0.905, 0.972, and 0.930, respectively. In the comparison with the three pathologists, the model outperforms the junior and intermediate pathologists, and has only a slightly lower performance than the senior pathologist when considered in terms of accuracy, specificity, sensitivity, AUC, and consistency. To our knowledge, this is the first study about the application of deep learning to NPC pathologic diagnosis. In clinical practice, the deep learning model can potentially assist pathologists by providing a second opinion on their NPC diagnoses.
Assuntos
Aprendizado Profundo , Diagnóstico por Computador , Carcinoma Nasofaríngeo/diagnóstico , Neoplasias Nasofaríngeas/diagnóstico , Bases de Dados Factuais , Humanos , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/patologia , Redes Neurais de Computação , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND AND PURPOSE: Geometric information such as distance information is essential for dose calculations in radiotherapy. However, state-of-the-art dose prediction methods use only binary masks without distance information. This study aims to develop a dose prediction deep learning method for nasopharyngeal carcinoma radiotherapy by taking advantage of the distance information as well as the mask information. MATERIALS AND METHODS: A novel transformation method based on boundary distance was proposed to facilitate the prediction of dose distributions. Radiotherapy datasets of 161 nasopharyngeal carcinoma patients were retrospectively collected, including binary masks of organs-at-risk (OARs) and targets, planning CT, and clinical plans. The patients were randomly divided into 130, 11 and 20 cases for training, validating, and testing the models, respectively. Furthermore, 40 patients from an external cohort were used to test the generalizability of the models. RESULTS: The proposed method shows superior performance. The predicted dose error and dose-volume histogram (DVH) error of our method were 7.51% and 11.6% lower than the mask-based method, respectively. For the inverse planning, compared with mask-based methods, our method provided similar performances on the GTVnx and OARs and outperformed on the GTVnd and the CTV, the pass rates of which increased from 89.490% and 90.016% to 96.694% and 91.189%, respectively. CONCLUSION: The preliminary results on nasopharyngeal carcinoma radiotherapy cases showed that our proposed distance-guided method for dose prediction achieved better performance than mask-based methods. Further studies with more patients and on other cancer sites are warranted to fully validate the proposed method.