arXiv:2510.04861cs.LG2025-10

CRISP模型通过超10万张冰冻切片训练,实现术中病理精准辅助诊断。

A Clinical-grade Universal Foundation Model for Intraoperative Pathology

  • 基于多中心数据训练的通用病理模型,支持跨机构、跨癌种泛化。
  • 在2000例前瞻性病例中准确率高,92.6%案例直接指导手术决策。
  • 人机协作可减少35%工作量,提升微转移检出率至87.5%。

术中病理对精准手术至关重要,但受限于诊断复杂性和高质量冰冻切片数据稀缺。尽管计算病理学取得进展,缺乏大规模前瞻性验证阻碍了其在手术流程中的常规应用。本文提出CRISP(Clinical-grade Robust Intraoperative Support for Pathology),基于来自八家医学中心超过10万张冰冻切片训练而成。在近100项回顾性诊断任务中评估了超过1.5万张术中幻灯片,涵盖良恶性判别、关键术中决策及泛癌检测等。模型展现出跨机构、跨肿瘤类型和解剖部位的强泛化能力,包括此前未见的部位与罕见癌症。在超过2000例前瞻性队列中,CRISP在真实临床条件下保持高准确率,直接指导手术决策达92.6%。人机协作进一步降低35%诊断工作量,避免105项附加检测,并以87.5%准确率提升微转移检出。这些结果表明,CRISP是推动人工智能在术中病理中临床落地的可靠范式。

原文摘要 · Abstract (English)

Intraoperative pathology is pivotal to precision surgery, yet its clinical impact is constrained by diagnostic complexity and the limited availability of high-quality frozen-section data. While computational pathology has made significant strides, the lack of large-scale, prospective validation has impeded its routine adoption in surgical workflows. Here, we introduce CRISP, a clinical-grade foundation model developed on over 100,000 frozen sections from eight medical centers, specifically designed to provide Clinical-grade Robust Intraoperative Support for Pathology (CRISP). CRISP was comprehensively evaluated on more than 15,000 intraoperative slides across nearly 100 retrospective diagnostic tasks, including benign-malignant discrimination, key intraoperative decision-making, and pan-cancer detection, etc. The model demonstrated robust generalization across diverse institutions, tumor types, and anatomical sites-including previously unseen sites and rare cancers. In a prospective cohort of over 2,000 patients, CRISP sustained high diagnostic accuracy under real-world conditions, directly informing surgical decisions in 92.6% of cases. Human-AI collaboration further reduced diagnostic workload by 35%, avoided 105 ancillary tests and enhanced detection of micrometastases with 87.5% accuracy. Together, these findings position CRISP as a clinical-grade paradigm for AI-driven intraoperative pathology, bridging computational advances with surgical precision and accelerating the translation of artificial intelligence into routine clinical practice.

术中病理AI医疗通用模型精准外科

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