arXiv:2607.03253cs.CVcs.AI2026-07

用语义分割实现肝癌病理图像的整图诊断,准确率超95%。

Semantic Segmentation-Driven Image-Level Diagnosis of Liver Cancers in Hematoxylin and Eosin Histopathology Images

  • 基于分割结果取主导类别进行整图分类,符合临床诊断逻辑。
  • 三类肝癌诊断平衡准确率最高达100%,显著优于小块切片模型。
  • 可辅助病理医生选免疫组化标记物,降低诊断成本与时间。

苏木精-伊红(H&E)染色是常规病理诊断的主要入口,从全切片H&E图像中实现计算机辅助诊断具有重要临床价值。然而,组织制备、染色流程和扫描条件的差异,以及专家像素级标注的不确定性,使自动化分析面临挑战。本研究提出一种基于语义分割的整图诊断框架,假设每张病理图像对应单一癌症类型,通过分割结果中占比最大的像素标签决定图像类别。采用nnU-Net架构,在本研究收集的公开数据集上训练,包含三种肝癌类型的像素级标注:肝细胞癌(HCC,30例患者共55幅图)、胆管细胞癌(CCA,29例患者共55幅图)、结直肠转移性腺癌(CMA,30例患者共60幅图),标注由四位病理医生独立完成。我们假设染色归一化与语义分割结合可缓解域偏移并降低对标注噪声的敏感性。五折交叉验证显示,三类癌症的平衡准确率分别为0.975(HCC)、0.950(CCA)和1.000(CMA),与免疫组化结果相当,且优于多个基于小块图像标注的深度学习模型。该框架有望帮助病理医生优先选择免疫组化标记物,减少诊断成本与周转时间,并与免疫组化结果融合提升整体诊断可靠性。

原文摘要 · Abstract (English)

As hematoxylin & eosin (H&E) staining constitutes the primary entry point in routine diagnostic workflows, computer-aided diagnosis from whole-slide H&E images is of particular clinical relevance. However, substantial variability in specimen preparation, staining protocols, and scanning conditions, together with inherent uncertainty in expert pixel-level annotations, makes automated analysis of H&E-stained images challenging. In this study, we propose a semantic segmentation-based framework for image-level diagnosis, grounded in the clinically motivated assumption that each histopathological image corresponds to a single cancer type. Image-level predictions are obtained by assigning the class of the dominant pixel-level label in the segmentation output. To ensure clinical relevance, we adopt the nnU-Net architecture and train it on a publicly available dataset collected in our study with pixel-level annotations for three liver cancer types: hepatocellular cacrcinoma (HCC; 55 images from 30 patients), cholangiocellular carcinoma (CCA; 55 images from 29 patients), and colorectal metastatic adenocarcinoma (CMA; 60 images from 30 patients). Annotations were independently provided by four pathologist. We hypothesize that the combination of stain normalization and semantic segmentation mitigates domain shift and reduces sensitivity to annotation noise. Five-fold cross-validation yielded balanced accuracy of 0.975 (HCC), 0.950 (CCA), and 1.000 (CMA), comparable to results obtained with immunohosthochemical staining and superior to several deep learning models trained on patch-level annotations. The proposed framework has the potential to support pathologists in prioritizing immunohistochemical marker selection, thereby reducing diagnostic costs and turnaround time. Integration with immunohistochemical findings improve overall diagnostic reliability.

病理诊断语义分割肝癌AI辅助

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