Deep learning–based objective and reproducible osteosarcoma chemotherapy response assessment and outcome prediction Journal Article


Authors: Ho, D. J.; Agaram, N. P.; Jean, M. H.; Suser, S. D.; Chu, C.; Vanderbilt, C. M.; Meyers, P. A.; Wexler, L. H.; Healey, J. H.; Fuchs, T. J.; Hameed, M. R.
Article Title: Deep learning–based objective and reproducible osteosarcoma chemotherapy response assessment and outcome prediction
Abstract: Osteosarcoma is the most common primary bone cancer, whose standard treatment includes pre-operative chemotherapy followed by resection. Chemotherapy response is used for prognosis and management of patients. Necrosis is routinely assessed after chemotherapy from histology slides on resection specimens, where necrosis ratio is defined as the ratio of necrotic tumor/overall tumor. Patients with necrosis ratio ≥90% are known to have a better outcome. Manual microscopic review of necrosis ratio from multiple glass slides is semiquantitative and can have intraobserver and interobserver variability. In this study, an objective and reproducible deep learning–based approach was proposed to estimate necrosis ratio with outcome prediction from scanned hematoxylin and eosin whole slide images (WSIs). To conduct the study, 103 osteosarcoma cases with 3134 WSIs were collected. Deep Multi-Magnification Network was trained to segment multiple tissue subtypes, including viable tumor and necrotic tumor at a pixel level and to calculate case-level necrosis ratio from multiple WSIs. Necrosis ratio estimated by the segmentation model highly correlates with necrosis ratio from pathology reports manually assessed by experts. Furthermore, patients were successfully stratified to predict overall survival with P = 2.4 × 10–6 and progression-free survival with P = 0.016. This study indicates that deep learning can support pathologists as an objective tool to analyze osteosarcoma from histology for assessing treatment response and predicting patient outcome. © 2023 American Society for Investigative Pathology
Keywords: osteosarcoma; bone neoplasms; bone tumor; pathology; necrosis; humans; prognosis; human; deep learning
Journal Title: American Journal of Pathology
Volume: 193
Issue: 3
ISSN: 0002-9440
Publisher: Elsevier Science, Inc.  
Date Published: 2023-03-01
Start Page: 341
End Page: 349
Language: English
DOI: 10.1016/j.ajpath.2022.12.004
PUBMED: 36563747
PROVIDER: scopus
PMCID: PMC10013034
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF --Corresponding author is MSK author: Meera R. Hameed -- Source: Scopus
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MSK Authors
  1. Meera Hameed
    281 Hameed
  2. Leonard H Wexler
    191 Wexler
  3. Narasimhan P Agaram
    190 Agaram
  4. Paul Meyers
    311 Meyers
  5. John H Healey
    547 Healey
  6. Stephanie Dana Suser
    19 Suser
  7. David Joon Ho
    12 Ho
  8. Marc-Henri Jean
    10 Jean
  9. Cynthia Chu
    5 Chu