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Jiao F, Shang Z, Lu H, Chen P, Chen S, Xiao J, Zhang F, Zhang D, Lv C, Han Y. A weakly supervised deep learning framework for automated PD-L1 expression analysis in lung cancer. Front Immunol 2025; 16:1540087. [PMID: 40230846 PMCID: PMC11994606 DOI: 10.3389/fimmu.2025.1540087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Accepted: 03/12/2025] [Indexed: 04/16/2025] Open
Abstract
The growing application of immune checkpoint inhibitors (ICIs) in cancer immunotherapy has underscored the critical need for reliable methods to identify patient populations likely to respond to ICI treatments, particularly in lung cancer treatment. Currently, the tumor proportion score (TPS), a crucial biomarker for patient selection, relies on manual interpretation by pathologists, which often shows substantial variability and inconsistency. To address these challenges, we innovatively developed multi-instance learning for TPS (MiLT), an innovative artificial intelligence (AI)-powered tool that predicts TPS from whole slide images. Our approach leverages multiple instance learning (MIL), which significantly reduces the need for labor-intensive cell-level annotations while maintaining high accuracy. In comprehensive validation studies, MiLT demonstrated remarkable consistency with pathologist assessments (intraclass correlation coefficient = 0.960, 95% confidence interval = 0.950-0.971) and robust performance across both internal and external cohorts. This tool not only standardizes TPS evaluation but also adapts to various clinical standards and provides time-efficient predictions, potentially transforming routine pathological practice. By offering a reliable, AI-assisted solution, MiLT could significantly improve patient selection for immunotherapy and reduce inter-observer variability among pathologists. These promising results warrant further exploration in prospective clinical trials and suggest new possibilities for integrating advanced AI in pathological diagnostics. MiLT represents a significant step toward more precise and efficient cancer immunotherapy decision-making.
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Affiliation(s)
- Feng Jiao
- Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhanxian Shang
- Department of Pathology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hongmin Lu
- Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peilin Chen
- Department of Clinical and Translational Medicine, 3D Medicines Inc., Shanghai, China
| | - Shiting Chen
- Department of Clinical and Translational Medicine, 3D Medicines Inc., Shanghai, China
| | - Jiayi Xiao
- School of Life Science and Technology, Tongji University, Shanghai, China
| | - Fuchuang Zhang
- Department of Clinical and Translational Medicine, 3D Medicines Inc., Shanghai, China
| | - Dadong Zhang
- Department of Clinical and Translational Medicine, 3D Medicines Inc., Shanghai, China
| | - Chunxin Lv
- Department of Oncology, Shanghai Punan Hospital of Pudong New District, Shanghai, China
| | - Yuchen Han
- Department of Pathology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Solovev IA. [Artificial intelligence in pathological anatomy]. Arkh Patol 2024; 86:65-71. [PMID: 38591909 DOI: 10.17116/patol20248602165] [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] [Indexed: 04/10/2024]
Abstract
The review presents key concepts and global developments in the field of artificial intelligence used in pathological anatomy. The work examines two types of artificial intelligence (AI): weak and strong ones. A review of experimental algorithms using both deep machine learning and computer vision technologies to work with WSI images of preparations, diagnose and make a prognosis for various malignant neoplasms is carried out. It has been established that weak artificial intelligence at this stage of development of computer (digital) pathological anatomy shows significantly better results in speeding up and refining diagnostic procedures than strong artificial intelligence having signs of general intelligence. The article also discusses three options for the further development of AI assistants for pathologists based on the technologies of large language models (strong AI) ChatGPT (PathAsst), Flan-PaLM2 and LIMA. As a result of the analysis of the literature, key problems in the field were identified: the equipment of pathology institutions, the lack of experts in training neural networks, the lack of strict criteria for the clinical viability of AI diagnostic technologies.
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Affiliation(s)
- I A Solovev
- Pitirim Sorokin Syktyvkar State University, Syktyvkar, Russia
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