Deep pathomics: A new image-based tool for predicting response to treatment in stage III non-small cell lung cancer

PLoS One. 2023 Nov 28;18(11):e0294259. doi: 10.1371/journal.pone.0294259. eCollection 2023.

Abstract

Despite the advantages offered by personalized treatments, there is presently no way to predict response to chemoradiotherapy in patients with non-small cell lung cancer (NSCLC). In this exploratory study, we investigated the application of deep learning techniques to histological tissue slides (deep pathomics), with the aim of predicting the response to therapy in stage III NSCLC. We evaluated 35 digitalized tissue slides (biopsies or surgical specimens) obtained from patients with stage IIIA or IIIB NSCLC. Patients were classified as responders (12/35, 34.7%) or non-responders (23/35, 65.7%) based on the target volume reduction shown on weekly CT scans performed during chemoradiation treatment. Digital tissue slides were tested by five pre-trained convolutional neural networks (CNNs)-AlexNet, VGG, MobileNet, GoogLeNet, and ResNet-using a leave-two patient-out cross validation approach, and we evaluated the networks' performances. GoogLeNet was globally found to be the best CNN, correctly classifying 8/12 responders and 10/11 non-responders. Moreover, Deep-Pathomics was found to be highly specific (TNr: 90.1) and quite sensitive (TPr: 0.75). Our data showed that AI could surpass the capabilities of all presently available diagnostic systems, supplying additional information beyond that currently obtainable in clinical practice. The ability to predict a patient's response to treatment could guide the development of new and more effective therapeutic AI-based approaches and could therefore be considered an effective and innovative step forward in personalised medicine.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Carcinoma, Non-Small-Cell Lung* / therapy
  • Chemoradiotherapy
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / therapy
  • Neural Networks, Computer
  • Tomography, X-Ray Computed / methods

Grants and funding

This work was supported by Università Campus Bio-Medico di Roma under the programme “University Strategic Projects 2018 call” within the project “a CoLlAborative multi-sources Radiopathomics approach for personalised Oncology in non- small cell lung cancer (CLARO)”. It is also supported by: i) Fondazione CRUI within the project “GO fot IT”, ii) FONDO PER LA CRESCITA SOSTENIBILE (F.C.S.), bando Accordo Innovazione DM 24/5/2017 (Ministero delle Imprese e del Made in Italy), CUP B89J23000580005, iii) project n. F/130096/01-05/X38 - Fondo per la Crescita Sostenibile - ACCORDI PER L'INNOVAZIONE DI CUI AL D.M. 24 MAGGIO 2017 - Ministero dello Sviluppo Economico (Italy), iii) Programma Operativo Nazionale (PON) “Ricerca e Innovazione” 2014-2020 CCI2014IT16M2OP005 Azione IV.4, iv) Regione Lazio PO FSE 2014-2020, Obiettivo specifico 10.5 Azione Cardine 21. the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.