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  4. Pathologist Computer-Aided Diagnostic Scoring of Tumor Cell Fraction: A Swiss National Study
 
research article

Pathologist Computer-Aided Diagnostic Scoring of Tumor Cell Fraction: A Swiss National Study

Frei, Ana Leni
•
Oberson, Raphael
•
Baumann, Elias
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October 19, 2023
Modern Pathology

Tumor cell fraction (TCF) estimation is a common clinical task with well-established large interobserver variability. It thus provides an ideal test bed to evaluate potential impacts of employing a tumor cell fraction 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 (ROIs) from hematoxylin and eosin 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 vs nontumor cells, together with the corresponding TCF percentage. Participants also reported confidence levels in their assessments using a 5-tier scale, indicating no confidence to high confidence, respectively. The TCF ground truth (GT) was defined by manual cell-counting by experts. When assisted, interobserver variability significantly decreased, showing estimates converging to the GT. This improvement remained even when TCFCAD predictions deviated slightly from the GT. The standard deviation (SD) of the estimated TCF to the GT across ROIs was 9.9% vs 5.8% with TCFCAD (P < .0001). The intraclass correlation coefficient increased from 0.8 to 0.93 (95% CI, 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 the computer-aided diagnostic [CAD] tool). TCFCAD estimation support demonstrated improved scoring accuracy, interpathologist 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.

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Type
research article
DOI
10.1016/j.modpat.2023.100335
Web of Science ID

WOS:001107299600001

Author(s)
Frei, Ana Leni
Oberson, Raphael
Baumann, Elias
Perren, Aurel
Grobholz, Rainer
Lugli, Alessandro
Dawson, Heather
Abbet, Christian Robert  
Lertxundi, Ibai
Reinhard, Stefan
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Date Issued

2023-10-19

Publisher

Elsevier Science Inc

Published in
Modern Pathology
Volume

36

Issue

12

Article Number

100335

Subjects

Life Sciences & Biomedicine

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Computer-Aided Diagnostic Tool

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Digital Pathology

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Interobserver Variability

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Tumor Cell Fraction

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Artificial Intelligence

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Pathology

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LTS5  
FunderGrant Number

Swiss National Science Founda-tion

CRSII5 193832

Available on Infoscience
February 19, 2024
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/204318
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