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Capar A, Ekinci DA, Ertano M, Niazi MKK, Balaban EB, Aloglu I, Dogan M, Su Z, Aker FV, Gurcan MN. An interpretable framework for inter-observer agreement measurements in TILs scoring on histopathological breast images: A proof-of-principle study. PLoS One 2024; 19:e0314450. [PMID: 39636880 PMCID: PMC11620390 DOI: 10.1371/journal.pone.0314450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 11/11/2024] [Indexed: 12/07/2024] Open
Abstract
Breast cancer, a widespread and life-threatening disease, necessitates precise diagnostic tools for improved patient outcomes. Tumor-Infiltrating Lymphocytes (TILs), reflective of the immune response against cancer cells, are pivotal in understanding breast cancer behavior. However, inter-observer variability in TILs scoring methods poses challenges to reliable assessments. This study introduces a novel and interpretable proof-of-principle framework comprising two innovative inter-observer agreement measures. The first method, Boundary-Weighted Fleiss' Kappa (BWFK), addresses tissue segmentation predictions, focusing on mitigating disagreements along tissue boundaries. BWFK enhances the accuracy of stromal segmentation, providing a nuanced assessment of inter-observer agreement. The second proposed method, the Distance Based Cell Agreement Algorithm (DBCAA), eliminates the need for ground truth annotations in cell detection predictions. This innovative approach offers versatility across histopathological analyses, overcoming data availability challenges. Both methods were applied to assess inter-observer agreement using a clinical image dataset consisting of 25 images of invasive ductal breast carcinoma tissue, each annotated by four pathologists, serving as a proof-of-principle. Experimental investigations demonstrated that the BWFK method yielded gains of up to 32% compared to the standard Fleiss' Kappa model. Furthermore, a procedure for conducting clinical validations of artificial intelligence (AI) based cell detection methods was elucidated. Thoroughly validated on a clinical dataset, the framework contributes to standardized, reliable, and interpretable inter-observer agreement assessments. This study is the first examination of inter-observer agreements in stromal segmentation and lymphocyte detection for the TILs scoring problem. The study emphasizes the potential impact of these measures in advancing histopathological image analysis, fostering consensus in TILs scoring, and ultimately improving breast cancer diagnostics and treatment planning. The source code and implementation guide for this study are accessible on our GitHub page, and the full clinical dataset is available for academic and research purposes on Kaggle.
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Affiliation(s)
- Abdulkerim Capar
- Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Informatics Institute, Istanbul Technical University, Istanbul, Turkiye
| | - Dursun Ali Ekinci
- Informatics Institute, Istanbul Technical University, Istanbul, Turkiye
| | - Mucahit Ertano
- Informatics Institute, Istanbul Technical University, Istanbul, Turkiye
| | - M. Khalid Khan Niazi
- Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Erva Bengu Balaban
- Department of Pathology, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkiye
| | - Ibrahim Aloglu
- Department of Pathology, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkiye
| | - Meryem Dogan
- Department of Pathology, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkiye
| | - Ziyu Su
- Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Fugen Vardar Aker
- Department of Pathology, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkiye
| | - Metin Nafi Gurcan
- Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
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Green RM, Lo Vercio LD, Dauter A, Barretto EC, Devine J, Vidal-García M, Marchini M, Robertson S, Zhao X, Mahika A, Shakir MB, Guo S, Boughner JC, Dean W, Lander AD, Marcucio RS, Forkert ND, Hallgrímsson B. Quantifying the relationship between cell proliferation and morphology during development of the face. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.12.540515. [PMID: 37214859 PMCID: PMC10197725 DOI: 10.1101/2023.05.12.540515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Morphogenesis requires highly coordinated, complex interactions between cellular processes: proliferation, migration, and apoptosis, along with physical tissue interactions. How these cellular and tissue dynamics drive morphogenesis remains elusive. Three dimensional (3D) microscopic imaging poses great promise, and generates elegant images. However, generating even moderate through-put quantified images is challenging for many reasons. As a result, the association between morphogenesis and cellular processes in 3D developing tissues has not been fully explored. To address this critical gap, we have developed an imaging and image analysis pipeline to enable 3D quantification of cellular dynamics along with 3D morphology for the same individual embryo. Specifically, we focus on how 3D distribution of proliferation relates to morphogenesis during mouse facial development. Our method involves imaging with light-sheet microscopy, automated segmentation of cells and tissues using machine learning-based tools, and quantification of external morphology via geometric morphometrics. Applying this framework, we show that changes in proliferation are tightly correlated to changes in morphology over the course of facial morphogenesis. These analyses illustrate the potential of this pipeline to investigate mechanistic relationships between cellular dynamics and morphogenesis during embryonic development.
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Affiliation(s)
- Rebecca M Green
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lucas D Lo Vercio
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Andreas Dauter
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Elizabeth C Barretto
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Jay Devine
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Marta Vidal-García
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | | | - Samuel Robertson
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Xiang Zhao
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Anandita Mahika
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - M Bilal Shakir
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Sienna Guo
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
| | - Julia C Boughner
- Department of Anatomy, Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Wendy Dean
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Arthur D Lander
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, United States
| | - Ralph S Marcucio
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, United States
| | - Nils D Forkert
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Benedikt Hallgrímsson
- Department of Cell Biology & Anatomy, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- McCaig Bone and Joint Institute, University of Calgary, Calgary, AB, Canada
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