Comparing Weak and Strong Annotation Strategies for Multiple Instance Learning in Digital Pathology

Sammanfattning: Prostate cancer is the second most diagnosed cancer worldwide and its diagnosis is done through visual inspection of biopsy tissue by a pathologist, who assigns a score used by doctors to decide on the treatment. However, the scoring system, the Gleason score, is affected by a high inter and intra-observer variability, lack of standardization, and overestimation. Therefore, there is a need for new solutions that can reduce these issues and provide a more accurate diagnosis. Nowadays, high-resolution digital images of biopsy tissues can be obtained and stored. The availability of such images, called Whole Slide Images (WSI) allows the implementation of Machine and Deep learning models to assist pathologists in diagnosing prostate cancer. Multiple-Instance Learning (MIL) has been shown to reach very promising results in digital pathology and binary classification of prostate cancer slides. However, such models require large datasets to ensure good performances. This project wants to investigate the use of small sets of strongly annotated images to create new large datasets to train a MIL model. To evaluate the performance of this approach, the standard dataset is used to obtain baselines for both binary and multiclass classification tasks. For multiclassification, the International Society of Urological Pathology (ISUP) score is used, which is derived from the Gleason score. The dataset used is the publicly available PANDA. In this project, only the slides from RadboudUniversity Medical Center are used, which consists of 5160 images. The MIL model chosen is the Clustering-constrained Attention Multiple instance learning (CLAM) model, which is publicly available. The standard approach reaches a Cohen’s kappa (κ) of 0.78 and 0.59 for binary and multiclass classification respectively. To evaluate the new approach, large datasets are created starting from different set sizes. Using 500 images, the model reaches a κ of 0.72 and 0.38 respectively. While for the binary the results of the two approaches are comparable, the new approach is not beneficial for multiclass classification tasks.