Context-aware stacked convolutional neural networks for classification of breast carcinomas in whole-slide histopathology images

• Published in: Journal of medical imaging (Bellingham, Wash.) Vol. 4; no. 4; p. 044504
• Main Authors: Bejnordi, Babak Ehteshami, Zuidhof, Guido, Balkenhol, Maschenka, Hermsen, Meyke, Bult, Peter, van Ginneken, Bram, Karssemeijer, Nico, Litjens, Geert, van der Laak, Jeroen
• Format: Journal Article
• Language: English
• Published: United States Society of Photo-Optical Instrumentation Engineers 01-10-2017
• Subjects: Computer-Aided Diagnosis; histopathology; deep learning; breast cancer; convolutional neural networks; context-aware CNN
• ISSN: 2329-4302; 2329-4310
• DOI: 10.1117/1.JMI.4.4.044504

Currently, histopathological tissue examination by a pathologist represents the gold standard for breast lesion diagnostics. Automated classification of histopathological whole-slide images (WSIs) is challenging owing to the wide range of appearances of benign lesions and the visual similarity of ductal carcinoma in-situ (DCIS) to invasive lesions at the cellular level. Consequently, analysis of tissue at high resolutions with a large contextual area is necessary. We present context-aware stacked convolutional neural networks (CNN) for classification of breast WSIs into normal/benign, DCIS, and invasive ductal carcinoma (IDC). We first train a CNN using high pixel resolution to capture cellular level information. The feature responses generated by this model are then fed as input to a second CNN, stacked on top of the first. Training of this stacked architecture with large input patches enables learning of fine-grained (cellular) details and global tissue structures. Our system is trained and evaluated on a dataset containing 221 WSIs of hematoxylin and eosin stained breast tissue specimens. The system achieves an AUC of 0.962 for the binary classification of nonmalignant and malignant slides and obtains a three-class accuracy of 81.3% for classification of WSIs into normal/benign, DCIS, and IDC, demonstrating its potential for routine diagnostics.