Journal of Pathology Informatics

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 11  |  Issue : 1  |  Page : 32-

Comparing deep learning and immunohistochemistry in determining the site of origin for well-differentiated neuroendocrine tumors


Jordan Redemann, Fred A Schultz, Cathy Martinez, Michael Harrell, Douglas P Clark, David R Martin, Joshua A Hanson 
 Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA

Correspondence Address:
Dr. Joshua A Hanson
Department of Pathology, University of New Mexico Hospital, 2211 Lomas Blvd NE, Albuquerque, NM 87106
USA

Background: Determining the site of origin for metastatic well-differentiated neuroendocrine tumors (WDNETs) is challenging, and immunohistochemical (IHC) profiles do not always lead to a definitive diagnosis. We sought to determine if a deep-learning convolutional neural network (CNN) could improve upon established IHC profiles in predicting the site of origin in a cohort of WDNETs from the common primary sites. Materials and Methods: Hematoxylin and eosin (H&E)-stained tissue microarrays (TMAs) were created using 215 WDNETs arising from the known primary sites. A CNN trained and tested on 60% (n = 130) and 40% (n = 85) of these cases, respectively. One hundred and seventy-nine cases had TMA tissue remaining for the IHC analysis. These cases were stained with IHC markers pPAX8, CDX2, SATB2, and thyroid transcription factor-1 (markers of pancreas/duodenum, ileum/jejunum/duodenum, colorectum/appendix, and lung WDNET sites of origin, respectively). The CNN diagnosis was deemed correct if it designated a majority or plurality of the tumor area as the known site of origin. The IHC diagnosis was deemed correct if the most specific marker for a particular site of origin met an H-score threshold determined by two pathologists. Results: When all cases were considered, the CNN correctly identified the site of origin at a lower rate compared to IHC (72% vs. 82%, respectively). Of the 85 cases in the CNN test set, 66 had sufficient TMA material for IHC stains, thus 66 cases were available for a direct case-by-case comparison of IHC versus CNN. The CNN correctly identified 70% of these cases, while IHC correctly identified 76%, a finding that was not statistically significant (P = 0.56). Conclusion: A CNN can identify WDNET site of origin at an accuracy rate close to the current gold standard IHC methods.


How to cite this article:
Redemann J, Schultz FA, Martinez C, Harrell M, Clark DP, Martin DR, Hanson JA. Comparing deep learning and immunohistochemistry in determining the site of origin for well-differentiated neuroendocrine tumors.J Pathol Inform 2020;11:32-32


How to cite this URL:
Redemann J, Schultz FA, Martinez C, Harrell M, Clark DP, Martin DR, Hanson JA. Comparing deep learning and immunohistochemistry in determining the site of origin for well-differentiated neuroendocrine tumors. J Pathol Inform [serial online] 2020 [cited 2020 Oct 26 ];11:32-32
Available from: https://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2020;volume=11;issue=1;spage=32;epage=32;aulast=Redemann;type=0