The artificial intelligence-based model ANORAK improves histopathological grading of lung adenocarcinoma.

Pan X., AbdulJabbar K., Coelho-Lima J., Grapa A-I., Zhang H., Cheung AHK., Baena J., Karasaki T., Wilson CR., Sereno M., Veeriah S., Aitken SJ., Hackshaw A., Nicholson AG., Jamal-Hanjani M., TRACERx Consortium None., Swanton C., Yuan Y., Le Quesne J., Moore DA.

The introduction of the International Association for the Study of Lung Cancer grading system has furthered interest in histopathological grading for risk stratification in lung adenocarcinoma. Complex morphology and high intratumoral heterogeneity present challenges to pathologists, prompting the development of artificial intelligence (AI) methods. Here we developed ANORAK (pyrAmid pooliNg crOss stReam Attention networK), encoding multiresolution inputs with an attention mechanism, to delineate growth patterns from hematoxylin and eosin-stained slides. In 1,372 lung adenocarcinomas across four independent cohorts, AI-based grading was prognostic of disease-free survival, and further assisted pathologists by consistently improving prognostication in stage I tumors. Tumors with discrepant patterns between AI and pathologists had notably higher intratumoral heterogeneity. Furthermore, ANORAK facilitates the morphological and spatial assessment of the acinar pattern, capturing acinus variations with pattern transition. Collectively, our AI method enabled the precision quantification and morphology investigation of growth patterns, reflecting intratumoral histological transitions in lung adenocarcinoma.

DOI

10.1038/s43018-023-00694-w

Type

Journal article

Journal

Nature cancer

Publication Date

02/2024

Volume

5

Pages

347 - 363

Addresses

Centre for Evolution and Cancer, The Institute of Cancer Research, London, UK.

Keywords

TRACERx Consortium, Humans, Adenocarcinoma, Lung Neoplasms, Neoplasm Staging, Artificial Intelligence, Adenocarcinoma of Lung

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