Adjudication reduces the errors in DR grading. A small set of adjudicated DR grades allows substantial improvements in algorithm performance. The resulting algorithm's performance was on par with that of individual U.S. Board-Certified ophthalmologists and retinal specialists.

For prostate cancer patients, the Gleason score is one of the most important prognostic factors, potentially determining treatment independent of the stage. However, Gleason scoring is based on subjective microscopic examination of tumor morphology and suffers from poor reproducibility. Here we present a deep learning system (DLS) for Gleason scoring whole-slide images of prostatectomies. Our system was developed using 112 million pathologist-annotated image patches from 1226 slides, and evaluated on an independent validation dataset of 331 slides. Compared to a reference standard provided by genitourinary pathology experts, the mean accuracy among 29 general pathologists was 0.61 on the validation set. The DLS achieved a significantly higher diagnostic accuracy of 0.70 ( p = 0.002) and trended towards better patient risk stratification in correlations to clinical follow-up data. Our approach could improve the accuracy of Gleason scoring and subsequent therapy decisions, particularly where specialist expertise is unavailable. The DLS also goes beyond the current Gleason system to more finely characterize and quantitate tumor morphology, providing opportunities for refinement of the Gleason system itself.

Deriving interpretable prognostic features from deep-learning-based prognostic histopathology models remains a challenge. In this study, we developed a deep learning system (DLS) for predicting disease-specific survival for stage II and III colorectal cancer using 3652 cases (27,300 slides). When evaluated on two validation datasets containing 1239 cases (9340 slides) and 738 cases (7140 slides), respectively, the DLS achieved a 5-year disease-specific survival AUC of 0.70 (95% CI: 0.66–0.73) and 0.69 (95% CI: 0.64–0.72), and added significant predictive value to a set of nine clinicopathologic features. To interpret the DLS, we explored the ability of different human-interpretable features to explain the variance in DLS scores. We observed that clinicopathologic features such as T-category, N-category, and grade explained a small fraction of the variance in DLS scores (R2 = 18% in both validation sets). Next, we generated human-interpretable histologic features by clustering embeddings from a deep-learning-based image-similarity model and showed that they explained the majority of the variance (R2 of 73–80%). Furthermore, the clustering-derived feature most strongly associated with high DLS scores was also highly prognostic in isolation. With a distinct visual appearance (poorly differentiated tumor cell clusters adjacent to adipose tissue), this feature was identified by annotators with 87.0–95.5% accuracy. Our approach can be used to explain predictions from a prognostic deep learning model and uncover potentially-novel prognostic features that can be reliably identified by people for future validation studies.

The memory capacity, computational power, communication bandwidth, energy consumption, and physical size of the brain all tend to scale with the number of synapses, which outnumber neurons by a factor of 10,000. Although progress in cortical simulations using modern digital computers has been rapid, the essential disparity between the classical von Neumann computer architecture and the computational fabric of the nervous system makes large-scale simulations expensive, power hungry, and time consuming. Over the last three decades, CMOS-based neuromorphic implementations of “electronic cortex” have emerged as an energy efficient alternative for modeling neuronal behavior. However, the key ingredient for electronic implementation of any self-learning system—programmable, plastic Hebbian synapses scalable to biological densities—has remained elusive. We demonstrate the viability of implementing such electronic synapses using nanoscale phase change devices. We introduce novel programming schemes for modulation of device conductance to closely mimic the phenomenon of Spike Timing Dependent Plasticity (STDP) observed biologically, and verify through simulations that such plastic phase change devices should support simple correlative learning in networks of spiking neurons. Our devices, when arranged in a crossbar array architecture, could enable the development of synaptronic systems that approach the density (∼10 11 synapses per sq cm) and energy efficiency (consuming ∼1pJ per synaptic programming event) of the human brain.

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