A narrative review of digital pathology and artificial intelligence: focusing on lung cancer

Abstract

The emergence of whole slide imaging technology allows for pathology diagnosis on a computer screen. The applications of digital pathology are expanding, from supporting remote institutes suffering from a shortage of pathologists to routine use in daily diagnosis including that of lung cancer. Through practice and research large archival databases of digital pathology images have been developed that will facilitate the development of artificial intelligence (AI) methods for image analysis. Currently, several AI applications have been reported in the field of lung cancer; these include the segmentation of carcinoma foci, detection of lymph node metastasis, counting of tumor cells, and prediction of gene mutations. Although the integration of AI algorithms into clinical practice remains a significant challenge, we have implemented tumor cell count for genetic analysis, a helpful application for routine use. Our experience suggests that pathologists often overestimate the contents of tumor cells, and the use of AI-based analysis increases the accuracy and makes the tasks less tedious. However, there are several difficulties encountered in the practical use of AI in clinical diagnosis. These include the lack of sufficient annotated data for the development and validation of AI systems, the explainability of black box AI models, such as those based on deep learning that offer the most promising performance, and the difficulty in defining the ground truth data for training and validation owing to inherent ambiguity in most applications. All of these together present significant challenges in the development and clinical translation of AI methods in the practice of pathology. Additional research on these problems will help in resolving the barriers to the clinical use of AI. Helping pathologists in developing knowledge of the working and limitations of AI will benefit the use of AI in both diagnostics and research.

Artificial Intelligence in Digital Pathology: What Is the Future? Part 1: From the Digital Slide Onwards

“…( digital pathology [Title]) AND ( artificial intelligence [Title]) currently reports 17 works [ 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Requirement of artificial intelligence technology awareness for thoracic surgeons

“…By researching the large archival databases of digital pathology images and detailed image analysis facilitate accurate diagnosis. It can also provide support from remote institutes for an expert second opinion [ 12 ].…”

Artificial intelligence-based analysis for immunohistochemistry staining of immune checkpoints to predict resected non-small cell lung cancer survival and relapse

“…However, due to the excessive workload of manually labeling tumor cells (TCs) and TILs in each whole slide, spatial analysis is still challenging to achieve in single-plex chromogenic IHCs. With the advance of medical artificial intelligence (20)(21)(22)(23), making full use of single-plex chromogenic IHC techniques for spatial analysis between cells is critical to breaking through these economic and technical limitations.…”