A Deep-Learning Algorithm for Thyroid Malignancy Prediction From Whole Slide Cytopathology Images

Abstract

We consider thyroid-malignancy prediction from ultra-high-resolution whole-slide cytopathology images. We propose a deep-learning-based algorithm that is inspired by the way a cytopathologist diagnoses the slides. The algorithm identifies diagnostically relevant image regions and assigns them local malignancy scores, that in turn are incorporated into a global malignancy prediction. We discuss the relation of our deep-learning-based approach to multiple-instance learning (MIL) and describe how it deviates from classical MIL methods by the use of a supervised procedure to extract relevant regions from the whole-slide. The analysis of our algorithm further reveals a close relation to hypothesis testing, which, along with unique characteristics of thyroid cytopathology, allows us to devise an improved training strategy. We further propose an ordinal regression framework for the simultaneous prediction of thyroid malignancy and an ordered diagnostic score acting as a regularizer, which further improves the predictions of the network. Experimental results demonstrate that the proposed algorithm outperforms several competing methods, achieving performance comparable to human experts.

Department

Description

Provenance

Citation

Scholars@Duke

Dov David

Adjunct Associate in the Department of Pathology
Pendse

Avani Anil Pendse

Associate Professor of Pathology
Henao

Ricardo Henao

Associate Professor in Biostatistics & Bioinformatics
Carin

Lawrence Carin

Professor of Electrical and Computer Engineering

Lawrence Carin earned the BS, MS, and PhD degrees in electrical engineering at the University of Maryland, College Park, in 1985, 1986, and 1989, respectively. In 1989 he joined the Electrical Engineering Department at Brooklyn Polytechnic Institute (now part of NYU) as an Assistant Professor, and became an Associate Professor there in 1994. In September 1995 he joined the Electrical and Computer Engineering (ECE) Department at Duke University, where he is now a Professor. He was ECE Department Chair from 2011-2014, and Vice Provost and Vice President for Research from 2014-2020. He was the Provost at King Abdullah University of Science & Technology (KAUST) from 2020-2023, returning to Duke in 2023. From 2003-2014 he held the William H. Younger Distinguished Professorship, and since 2018 he has held the James L. Meriam Distinguished Professorship. Dr. Carin's research focuses on machine learning (ML) and artificial intelligence (AI). He publishes widely in the main ML/AI forums, and has addressed many applications of AI, including in  medicine and security. He was co-founder of the small business Signal Innovations Group, which was acquired by BAE Systems in 2014, and in 2017 he co-founded the company Infinia ML, which was acquired by Aspirion in 2023. He is an IEEE Fellow.


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