Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer

Abstract Pathology provides the definitive diagnosis, and Artificial Intelligence (AI) tools are poised to improve accuracy, inter-rater agreement, and turn-around time (TAT) of pathologists, leading to improved quality of care. A high value clinical application is the grading of Lymph Node Metastas...

Full description

Saved in:
Bibliographic Details
Main Authors: Yiannis Varnava, Kiran Jakate, Richard Garnett, Dimitrios Androutsos, Pascal N. Tyrrell, April Khademi
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-80495-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841544843758665728
author Yiannis Varnava
Kiran Jakate
Richard Garnett
Dimitrios Androutsos
Pascal N. Tyrrell
April Khademi
author_facet Yiannis Varnava
Kiran Jakate
Richard Garnett
Dimitrios Androutsos
Pascal N. Tyrrell
April Khademi
author_sort Yiannis Varnava
collection DOAJ
description Abstract Pathology provides the definitive diagnosis, and Artificial Intelligence (AI) tools are poised to improve accuracy, inter-rater agreement, and turn-around time (TAT) of pathologists, leading to improved quality of care. A high value clinical application is the grading of Lymph Node Metastasis (LNM) which is used for breast cancer staging and guides treatment decisions. A challenge of implementing AI tools widely for LNM classification is domain shift, where Out-of-Distribution (OOD) data has a different distribution than the In-Distribution (ID) data used to train the model, resulting in a drop in performance in OOD data. This work proposes a novel clustering and sampling method to automatically curate training datasets in an unsupervised manner with the aim of improving model generalization abilities. To evaluate the generalization performance of the proposed models, we applied a novel use of the Two One-sided Tests (TOST) method. This method examines whether the performance on ID and OOD data is equivalent, serving as a proxy for generalization. We provide the first evidence for computing equivalence margins that are data-dependent, which reduces subjectivity. The proposed framework shows the ensembled models constructed from models that generalized across both tumor and normal patches enhanced performance, achieving an F1 score of 0.81 for LNM classification on unseen ID and OOD samples. Interactive viewing of slide-level segmentations can be accessed on PathcoreFlow™ through https://web.pathcore.com/folder/18555?s=QTJVHJuhrfe5 . Segmentation models are available at https://github.com/IAMLAB-Ryerson/OOD-Generalization-LNM .
format Article
id doaj-art-c04e1d54c78c4ee98e91356c63bf2fc9
institution Kabale University
issn 2045-2322
language English
publishDate 2025-01-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-c04e1d54c78c4ee98e91356c63bf2fc92025-01-12T12:15:16ZengNature PortfolioScientific Reports2045-23222025-01-0115111610.1038/s41598-024-80495-yOut-of-distribution generalization for segmentation of lymph node metastasis in breast cancerYiannis Varnava0Kiran Jakate1Richard Garnett2Dimitrios Androutsos3Pascal N. Tyrrell4April Khademi5Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan UniversityDepartment of Pathology, Unity Health TorontoDepartment of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan UniversityDepartment of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan UniversityDepartment of Medical Imaging, University of TorontoDepartment of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan UniversityAbstract Pathology provides the definitive diagnosis, and Artificial Intelligence (AI) tools are poised to improve accuracy, inter-rater agreement, and turn-around time (TAT) of pathologists, leading to improved quality of care. A high value clinical application is the grading of Lymph Node Metastasis (LNM) which is used for breast cancer staging and guides treatment decisions. A challenge of implementing AI tools widely for LNM classification is domain shift, where Out-of-Distribution (OOD) data has a different distribution than the In-Distribution (ID) data used to train the model, resulting in a drop in performance in OOD data. This work proposes a novel clustering and sampling method to automatically curate training datasets in an unsupervised manner with the aim of improving model generalization abilities. To evaluate the generalization performance of the proposed models, we applied a novel use of the Two One-sided Tests (TOST) method. This method examines whether the performance on ID and OOD data is equivalent, serving as a proxy for generalization. We provide the first evidence for computing equivalence margins that are data-dependent, which reduces subjectivity. The proposed framework shows the ensembled models constructed from models that generalized across both tumor and normal patches enhanced performance, achieving an F1 score of 0.81 for LNM classification on unseen ID and OOD samples. Interactive viewing of slide-level segmentations can be accessed on PathcoreFlow™ through https://web.pathcore.com/folder/18555?s=QTJVHJuhrfe5 . Segmentation models are available at https://github.com/IAMLAB-Ryerson/OOD-Generalization-LNM .https://doi.org/10.1038/s41598-024-80495-yHistopathologyLymph nodeBreast cancerDeep learningSegmentationGeneralization
spellingShingle Yiannis Varnava
Kiran Jakate
Richard Garnett
Dimitrios Androutsos
Pascal N. Tyrrell
April Khademi
Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
Scientific Reports
Histopathology
Lymph node
Breast cancer
Deep learning
Segmentation
Generalization
title Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
title_full Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
title_fullStr Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
title_full_unstemmed Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
title_short Out-of-distribution generalization for segmentation of lymph node metastasis in breast cancer
title_sort out of distribution generalization for segmentation of lymph node metastasis in breast cancer
topic Histopathology
Lymph node
Breast cancer
Deep learning
Segmentation
Generalization
url https://doi.org/10.1038/s41598-024-80495-y
work_keys_str_mv AT yiannisvarnava outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer
AT kiranjakate outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer
AT richardgarnett outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer
AT dimitriosandroutsos outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer
AT pascalntyrrell outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer
AT aprilkhademi outofdistributiongeneralizationforsegmentationoflymphnodemetastasisinbreastcancer