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Proceedings Paper

Toward automatic segmentation and quantification of tumor and stroma in whole-slide images of H and E stained rectal carcinomas
Author(s): Oscar G. F. Geessink; Alexi Baidoshvili; Gerard Freling; Joost M. Klaase; Cornelis H. Slump; Ferdinand van der Heijden
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Paper Abstract

Visual estimation of tumor and stroma proportions in microscopy images yields a strong, Tumor-(lymph)Node- Metastasis (TNM) classification-independent predictor for patient survival in colorectal cancer. Therefore, it is also a potent (contra)indicator for adjuvant chemotherapy. However, quantification of tumor and stroma through visual estimation is highly subject to intra- and inter-observer variability. The aim of this study is to develop and clinically validate a method for objective quantification of tumor and stroma in standard hematoxylin and eosin (H and E) stained microscopy slides of rectal carcinomas. A tissue segmentation algorithm, based on supervised machine learning and pixel classification, was developed, trained and validated using histological slides that were prepared from surgically excised rectal carcinomas in patients who had not received neoadjuvant chemotherapy and/or radiotherapy. Whole-slide scanning was performed at 20× magnification. A total of 40 images (4 million pixels each) were extracted from 20 whole-slide images at sites showing various relative proportions of tumor and stroma. Experienced pathologists provided detailed annotations for every extracted image. The performance of the algorithm was evaluated using cross-validation by testing on 1 image at a time while using the other 39 images for training. The total classification error of the algorithm was 9.4% (SD = 3.2%). Compared to visual estimation by pathologists, the algorithm was 7.3 times (P = 0.033) more accurate in quantifying tissues, also showing 60% less variability. Automatic tissue quantification was shown to be both reliable and practicable. We ultimately intend to facilitate refined prognostic stratification of (colo)rectal cancer patients and enable better personalized treatment.

Paper Details

Date Published: 17 March 2015
PDF: 7 pages
Proc. SPIE 9420, Medical Imaging 2015: Digital Pathology, 94200F (17 March 2015); doi: 10.1117/12.2081665
Show Author Affiliations
Oscar G. F. Geessink, Lab. of Pathology East Netherlands (Netherlands)
Medisch Spectrum Twente (Netherlands)
Univ. Twente (Netherlands)
Alexi Baidoshvili, Lab. of Pathology East Netherlands (Netherlands)
Gerard Freling, Lab. of Pathology East Netherlands (Netherlands)
Joost M. Klaase, Medisch Spectrum Twente (Netherlands)
Cornelis H. Slump, Univ. Twente (Netherlands)
Ferdinand van der Heijden, Univ. Twente (Netherlands)

Published in SPIE Proceedings Vol. 9420:
Medical Imaging 2015: Digital Pathology
Metin N. Gurcan; Anant Madabhushi, Editor(s)

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