Deep Learning Models Capture Histological Disease Activity in Crohn’s Disease and Ulcerative Colitis with High Fidelity

Abstract Background and Aims Histological disease activity in inflammatory bowel disease [IBD] is associated with clinical outcomes and is an important endpoint in drug development. We developed deep learning models for automating histological assessments in IBD. Methods Histology images of intestin...

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Bibliographic Details
Published in:	Journal of Crohn's and colitis Vol. 18; no. 4; pp. 604 - 614
Main Authors:	Rymarczyk, Dawid, Schultz, Weiwei, Borowa, Adriana, Friedman, Joshua R, Danel, Tomasz, Branigan, Patrick, Chałupczak, Michał, Bracha, Anna, Krawiec, Tomasz, Warchoł, Michał, Li, Katherine, De Hertogh, Gert, Zieliński, Bartosz, Ghanem, Louis R, Stojmirovic, Aleksandar
Format:	Journal Article
Language:	English
Published:	UK Oxford University Press 23-04-2024
Subjects:	Colitis, Ulcerative - pathology Colon - pathology Crohn Disease - pathology Deep Learning Humans Intestinal Mucosa - pathology Original Severity of Illness Index histology Artificial intelligence inflammatory bowel disease
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Summary:	Abstract Background and Aims Histological disease activity in inflammatory bowel disease [IBD] is associated with clinical outcomes and is an important endpoint in drug development. We developed deep learning models for automating histological assessments in IBD. Methods Histology images of intestinal mucosa from phase 2 and phase 3 clinical trials in Crohn’s disease [CD] and ulcerative colitis [UC] were used to train artificial intelligence [AI] models to predict the Global Histology Activity Score [GHAS] for CD and Geboes histopathology score for UC. Three AI methods were compared. AI models were evaluated on held-back testing sets, and model predictions were compared against an expert central reader and five independent pathologists. Results The model based on multiple instance learning and the attention mechanism [SA-AbMILP] demonstrated the best performance among competing models. AI-modelled GHAS and Geboes subgrades matched central readings with moderate to substantial agreement, with accuracies ranging from 65% to 89%. Furthermore, the model was able to distinguish the presence and absence of pathology across four selected histological features, with accuracies for colon in both CD and UC ranging from 87% to 94% and for CD ileum ranging from 76% to 83%. For both CD and UC and across anatomical compartments [ileum and colon] in CD, comparable accuracies against central readings were found between the model-assigned scores and scores by an independent set of pathologists. Conclusions Deep learning models based upon GHAS and Geboes scoring systems were effective at distinguishing between the presence and absence of IBD microscopic disease activity.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Dawid Rymarczyk, Weiwei Schultz and Adriana Borowa Denotes equal first co-authorship. Bartosz Zieliński, Louis R. Ghanem and Aleksandar Stojmirovic Denotes equal senior co-authorship.
ISSN:	1873-9946 1876-4479
DOI:	10.1093/ecco-jcc/jjad171