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Brodsky V, Ullah E, Bychkov A, Song AH, Walk EE, Louis P, Rasool G, Singh RS, Mahmood F, Bui MM, Parwani AV. Generative Artificial Intelligence in Anatomic Pathology. Arch Pathol Lab Med 2025; 149:298-318. [PMID: 39836377 DOI: 10.5858/arpa.2024-0215-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2024] [Indexed: 01/22/2025]
Abstract
CONTEXT.— Generative artificial intelligence (AI) has emerged as a transformative force in various fields, including anatomic pathology, where it offers the potential to significantly enhance diagnostic accuracy, workflow efficiency, and research capabilities. OBJECTIVE.— To explore the applications, benefits, and challenges of generative AI in anatomic pathology, with a focus on its impact on diagnostic processes, workflow efficiency, education, and research. DATA SOURCES.— A comprehensive review of current literature and recent advancements in the application of generative AI within anatomic pathology, categorized into unimodal and multimodal applications, and evaluated for clinical utility, ethical considerations, and future potential. CONCLUSIONS.— Generative AI demonstrates significant promise in various domains of anatomic pathology, including diagnostic accuracy enhanced through AI-driven image analysis, virtual staining, and synthetic data generation; workflow efficiency, with potential for improvement by automating routine tasks, quality control, and reflex testing; education and research, facilitated by AI-generated educational content, synthetic histology images, and advanced data analysis methods; and clinical integration, with preliminary surveys indicating cautious optimism for nondiagnostic AI tasks and growing engagement in academic settings. Ethical and practical challenges require rigorous validation, prompt engineering, federated learning, and synthetic data generation to help ensure trustworthy, reliable, and unbiased AI applications. Generative AI can potentially revolutionize anatomic pathology, enhancing diagnostic accuracy, improving workflow efficiency, and advancing education and research. Successful integration into clinical practice will require continued interdisciplinary collaboration, careful validation, and adherence to ethical standards to ensure the benefits of AI are realized while maintaining the highest standards of patient care.
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Affiliation(s)
- Victor Brodsky
- From the Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri (Brodsky)
| | - Ehsan Ullah
- the Department of Surgery, Health New Zealand, Counties Manukau, New Zealand (Ullah)
| | - Andrey Bychkov
- the Department of Pathology, Kameda Medical Center, Kamogawa City, Chiba Prefecture, Japan (Bychkov)
- the Department of Pathology, Nagasaki University, Nagasaki, Japan (Bychkov)
| | - Andrew H Song
- the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Song, Mahmood)
| | - Eric E Walk
- Office of the Chief Medical Officer, PathAI, Boston, Massachusetts (Walk)
| | - Peter Louis
- the Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey (Louis)
| | - Ghulam Rasool
- the Department of Oncologic Sciences, Morsani College of Medicine and Department of Electrical Engineering, University of South Florida, Tampa (Rasool)
- the Department of Machine Learning, Moffitt Cancer Center and Research Institute, Tampa, Florida (Rasool)
- Department of Machine Learning, Neuro-Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida (Rasool)
| | - Rajendra S Singh
- Dermatopathology and Digital Pathology, Summit Health, Berkley Heights, New Jersey (Singh)
| | - Faisal Mahmood
- the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Song, Mahmood)
| | - Marilyn M Bui
- Department of Machine Learning, Pathology, Moffitt Cancer Center and Research Institute, Tampa, Florida (Bui)
| | - Anil V Parwani
- the Department of Pathology, The Ohio State University, Columbus (Parwani)
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Kotoulas SC, Spyratos D, Porpodis K, Domvri K, Boutou A, Kaimakamis E, Mouratidou C, Alevroudis I, Dourliou V, Tsakiri K, Sakkou A, Marneri A, Angeloudi E, Papagiouvanni I, Michailidou A, Malandris K, Mourelatos C, Tsantos A, Pataka A. A Thorough Review of the Clinical Applications of Artificial Intelligence in Lung Cancer. Cancers (Basel) 2025; 17:882. [PMID: 40075729 PMCID: PMC11898928 DOI: 10.3390/cancers17050882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 02/06/2025] [Accepted: 02/25/2025] [Indexed: 03/14/2025] Open
Abstract
According to data from the World Health Organization (WHO), lung cancer is becoming a global epidemic. It is particularly high in the list of the leading causes of death not only in developed countries, but also worldwide; furthermore, it holds the leading place in terms of cancer-related mortality. Nevertheless, many breakthroughs have been made the last two decades regarding its management, with one of the most prominent being the implementation of artificial intelligence (AI) in various aspects of disease management. We included 473 papers in this thorough review, most of which have been published during the last 5-10 years, in order to describe these breakthroughs. In screening programs, AI is capable of not only detecting suspicious lung nodules in different imaging modalities-such as chest X-rays, computed tomography (CT), and positron emission tomography (PET) scans-but also discriminating between benign and malignant nodules as well, with success rates comparable to or even better than those of experienced radiologists. Furthermore, AI seems to be able to recognize biomarkers that appear in patients who may develop lung cancer, even years before this event. Moreover, it can also assist pathologists and cytologists in recognizing the type of lung tumor, as well as specific histologic or genetic markers that play a key role in treating the disease. Finally, in the treatment field, AI can guide in the development of personalized options for lung cancer patients, possibly improving their prognosis.
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Affiliation(s)
- Serafeim-Chrysovalantis Kotoulas
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Dionysios Spyratos
- Pulmonary Department, Unit of thoracic Malignancies Research, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, Leoforos Papanikolaou Municipality of Chortiatis, 57010 Thessaloniki, Greece; (D.S.); (K.P.); (K.D.)
| | - Konstantinos Porpodis
- Pulmonary Department, Unit of thoracic Malignancies Research, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, Leoforos Papanikolaou Municipality of Chortiatis, 57010 Thessaloniki, Greece; (D.S.); (K.P.); (K.D.)
| | - Kalliopi Domvri
- Pulmonary Department, Unit of thoracic Malignancies Research, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, Leoforos Papanikolaou Municipality of Chortiatis, 57010 Thessaloniki, Greece; (D.S.); (K.P.); (K.D.)
| | - Afroditi Boutou
- Pulmonary Department General, Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (A.B.); (A.T.)
| | - Evangelos Kaimakamis
- 1st ICU, Medical Informatics Laboratory, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, Leoforos Papanikolaou Municipality of Chortiatis, 57010 Thessaloniki, Greece;
| | - Christina Mouratidou
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Ioannis Alevroudis
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Vasiliki Dourliou
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Kalliopi Tsakiri
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Agni Sakkou
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Alexandra Marneri
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Elena Angeloudi
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (V.D.); (K.T.); (A.S.); (A.M.); (E.A.)
| | - Ioanna Papagiouvanni
- 4th Internal Medicine Department, General Hospital of Thessaloniki “Ippokrateio”, Aristotle’s University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece;
| | - Anastasia Michailidou
- 2nd Propaedeutic Internal Medicine Department, General Hospital of Thessaloniki “Ippokrateio”, Aristotle’s University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece;
| | - Konstantinos Malandris
- 2nd Internal Medicine Department, General Hospital of Thessaloniki “Ippokrateio”, Aristotle’s University of Thessaloniki, Konstantinoupoleos 49, 54642 Thessaloniki, Greece;
| | - Constantinos Mourelatos
- Biology and Genetics Laboratory, Aristotle’s University of Thessaloniki, 54624 Thessaloniki, Greece;
| | - Alexandros Tsantos
- Pulmonary Department General, Hospital of Thessaloniki “Ippokrateio”, Konstantinoupoleos 49, 54642 Thessaloniki, Greece; (A.B.); (A.T.)
| | - Athanasia Pataka
- Respiratory Failure Clinic and Sleep Laboratory, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, Leoforos Papanikolaou Municipality of Chortiatis, 57010 Thessaloniki, Greece;
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Yang F, He Q, Wang Y, Zeng S, Xu Y, Ye J, He Y, Guan T, Wang Z, Li J. Unsupervised stain augmentation enhanced glomerular instance segmentation on pathology images. Int J Comput Assist Radiol Surg 2025; 20:225-236. [PMID: 38848032 DOI: 10.1007/s11548-024-03154-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/16/2024] [Indexed: 02/11/2025]
Abstract
PURPOSE In pathology images, different stains highlight different glomerular structures, so a supervised deep learning-based glomerular instance segmentation model trained on individual stains performs poorly on other stains. However, it is difficult to obtain a training set with multiple stains because the labeling of pathology images is very time-consuming and tedious. Therefore, in this paper, we proposed an unsupervised stain augmentation-based method for segmentation of glomerular instances. METHODS In this study, we successfully realized the conversion between different staining methods such as PAS, MT and PASM by contrastive unpaired translation (CUT), thus improving the staining diversity of the training set. Moreover, we replaced the backbone of mask R-CNN with swin transformer to further improve the efficiency of feature extraction and thus achieve better performance in instance segmentation task. RESULTS To validate the method presented in this paper, we constructed a dataset from 216 WSIs of the three stains in this study. After conducting in-depth experiments, we verified that the instance segmentation method based on stain augmentation outperforms existing methods across all metrics for PAS, PASM, and MT stains. Furthermore, ablation experiments are performed in this paper to further demonstrate the effectiveness of the proposed module. CONCLUSION This study successfully demonstrated the potential of unsupervised stain augmentation to improve glomerular segmentation in pathology analysis. Future research could extend this approach to other complex segmentation tasks in the pathology image domain to further explore the potential of applying stain augmentation techniques in different domains of pathology image analysis.
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Affiliation(s)
- Fan Yang
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Qiming He
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Yanxia Wang
- Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Siqi Zeng
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
- Research Institute of Tsinghua, Pearl River Delta, Guangzhou, China
| | - Yingming Xu
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Jing Ye
- Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Yonghong He
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Tian Guan
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Shenzhen, China.
| | - Zhe Wang
- Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China.
| | - Jing Li
- Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China.
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Wang R, Yang S, Li Q, Zhong D. CytoGAN: Unpaired staining transfer by structure preservation for cytopathology image analysis. Comput Biol Med 2024; 180:108942. [PMID: 39096614 DOI: 10.1016/j.compbiomed.2024.108942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/05/2024]
Abstract
With the development of digital pathology, deep learning is increasingly being applied to endometrial cell morphology analysis for cancer screening. And cytology images with different staining may degrade the performance of these analysis algorithms. To address the impact of staining patterns, many strategies have been proposed and hematoxylin and eosin (H&E) images have been transferred to other staining styles. However, none of the existing methods are able to generate realistic cytological images with preserved cellular layout, and many important clinical structural information is lost. To address the above issues, we propose a different staining transformation model, CytoGAN, which can quickly and realistically generate images with different staining styles. It includes a novel structure preservation module that preserves the cell structure well, even if the resolution or cell size between the source and target domains do not match. Meanwhile, a stain adaptive module is designed to help the model generate realistic and high-quality endometrial cytology images. We compared our model with ten state-of-the-art stain transformation models and evaluated by two pathologists. Furthermore, in the downstream endometrial cancer classification task, our algorithm improves the robustness of the classification model on multimodal datasets, with more than 20 % improvement in accuracy. We found that generating specified specific stains from existing H&E images improves the diagnosis of endometrial cancer. Our code will be available on github.
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Affiliation(s)
- Ruijie Wang
- School of Automation Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, PR China.
| | - Sicheng Yang
- School of Computer Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, PR China.
| | - Qiling Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, PR China.
| | - Dexing Zhong
- School of Automation Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, PR China; Pazhou Laboratory, Guangzhou, 510335, PR China; Research Institute of Xi'an Jiaotong University, Zhejiang, 311215, PR China.
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Deep learning for computational cytology: A survey. Med Image Anal 2023; 84:102691. [PMID: 36455333 DOI: 10.1016/j.media.2022.102691] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/22/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
Computational cytology is a critical, rapid-developing, yet challenging topic in medical image computing concerned with analyzing digitized cytology images by computer-aided technologies for cancer screening. Recently, an increasing number of deep learning (DL) approaches have made significant achievements in medical image analysis, leading to boosting publications of cytological studies. In this article, we survey more than 120 publications of DL-based cytology image analysis to investigate the advanced methods and comprehensive applications. We first introduce various deep learning schemes, including fully supervised, weakly supervised, unsupervised, and transfer learning. Then, we systematically summarize public datasets, evaluation metrics, versatile cytology image analysis applications including cell classification, slide-level cancer screening, nuclei or cell detection and segmentation. Finally, we discuss current challenges and potential research directions of computational cytology.
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