用深度学习分析胎盘切片图像,自动识别产妇炎症状态。
Machine learning identification of maternal inflammatory response and histologic choroamnionitis from placental membrane whole slide images
- 采用多实例学习框架,结合病理基础模型提取特征。
- 炎症阶段分类准确率达88.5%,Kappa值0.772,表现优于通用模型。
- 可辅助临床早期发现炎症,适合病理与医学AI研究者参考。
胎盘在妊娠、分娩过程中构成关键抗感染屏障。胎盘内的炎症过程对后代健康有短期和长期影响。数字病理学与机器学习在理解胎盘炎症方面具有重要意义,但针对产妇炎症反应(MIR)的预测方法仍鲜有研究。本文旨在利用全切片图像(WSI)探索机器学习识别MIR的潜力,并建立早期基准。我们采用多实例学习(MIL)框架,结合三种特征提取器:基于ImageNet的EfficientNet-v2s,以及两个病理学基础模型UNI和Phikon,研究从组织病理学WSI中预测MIR阶段的能力。同时,通过模型学习到的注意力图解释预测结果。此外,也使用MIL框架预测白细胞计数(WBC)和最高体温(Tmax)。基于注意力机制的MIL模型在分类MIR时达到最高88.5%的平衡准确率和0.772的Cohen's Kappa值。我们发现,病理基础模型(UNI和Phikon)在平衡准确率和Kappa值上均优于ImageNet预训练模型(EfficientNet-v2s)。对于WBC和Tmax的预测,实际值与预测值间存在轻微相关性。通过分析模型失败案例,发现其多为易受观察者差异影响的边缘情况、病理科医生过度解读或标注错误所致。
原文摘要 · Abstract (English)
The placenta forms a critical barrier to infection through pregnancy, labor and, delivery. Inflammatory processes in the placenta have short-term, and long-term consequences for offspring health. Digital pathology and machine learning can play an important role in understanding placental inflammation, and there have been very few investigations into methods for predicting and understanding Maternal Inflammatory Response (MIR). This work intends to investigate the potential of using machine learning to understand MIR based on whole slide images (WSI), and establish early benchmarks. To that end, we use Multiple Instance Learning framework with 3 feature extractors: ImageNet-based EfficientNet-v2s, and 2 histopathology foundation models, UNI and Phikon to investigate predictability of MIR stage from histopathology WSIs. We also interpret predictions from these models using the learned attention maps from these models. We also use the MIL framework for predicting white blood cells count (WBC) and maximum fever temperature ($T_{max}$). Attention-based MIL models are able to classify MIR with a balanced accuracy of up to 88.5% with a Cohen's Kappa ($κ$) of up to 0.772. Furthermore, we found that the pathology foundation models (UNI and Phikon) are both able to achieve higher performance with balanced accuracy and $κ$, compared to ImageNet-based feature extractor (EfficientNet-v2s). For WBC and $T_{max}$ prediction, we found mild correlation between actual values and those predicted from histopathology WSIs. We used MIL framework for predicting MIR stage from WSIs, and compared effectiveness of foundation models as feature extractors, with that of an ImageNet-based model. We further investigated model failure cases and found them to be either edge cases prone to interobserver variability, examples of pathologist's overreach, or mislabeled due to processing errors.
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