Automated histologic diagnosis of CNS tumors with machine learning

A new mass discovered in the CNS is a common reason for referral to a neurosurgeon. CNS masses are typically discovered on MRI or computed tomography (CT) scans after a patient presents with new neurologic symptoms. Presenting symptoms depend on the location of the tumor and can include headaches, seizures, difficulty expressing or comprehending language, weakness affecting extremities, sensory changes, bowel or bladder dysfunction, gait and balance changes, vision changes, hearing loss and endocrine dysfunction. A mass in the CNS has a broad differential diagnosis, including tumor, infection, inflammatory or demyelinating process, infarct, hemorrhage, vascular malformation and radiation treatment effect. The most likely diagnoses can be narrowed based on patient demographics, medical history, imaging characteristics and adjunctive laboratory studies. However, accurate histopathologic interpretation of tissue obtained at the time of surgery is frequently required to make a diagnosis and guide intraoperative decision making. Over half of CNS tumors in adults are metastases from systemic cancer originating elsewhere in the body [1]. An estimated 9.6% of adults with lung cancer, melanoma, breast cancer, renal cell carcinoma and colorectal cancer have brain metastases [2].