Microsatellite instability-high (MSI-H) is a tumor agnostic biomarker for immune checkpoint inhibitor therapy. However, MSI status is not routinely tested in prostate cancer, in part due to low prevalence and assay cost. As such, prediction of MSI status from hematoxylin and eosin (H&E) stained whole-slide images (WSIs) could identify prostate cancer patients most likely to benefit from confirmatory testing and becoming eligible for immunotherapy. Prostate biopsies and surgical resections from de-identified records of consecutive prostate cancer patients referred to our institution were analyzed. Their MSI status was determined by next generation sequencing. Patients before a cutoff date were split into an algorithm development set (n=4015, MSI-H 1.8%) and a paired validation set (n=173, MSI-H 19.7%) that consisted of two serial sections from each sample, one stained and scanned internally and the other at an external site. Patients after the cutoff date formed the temporal validation set (n=1350, MSI-H 2.3%). Attention-based multiple instance learning models were trained to predict MSI-H from H&E WSIs. The MSI-H predictor achieved area under the receiver operating characteristic curve values of 0.78 (95% CI [0.69-0.86]), 0.72 (95% CI [0.63-0.81]), and 0.72 (95% CI [0.62-0.82]) on the internally prepared, externally prepared, and temporal validation sets, respectively. While MSI-H status is significantly correlated with Gleason score, the model remained predictive within each Gleason score subgroup. In summary, we developed and validated an AI-based MSI-H diagnostic model on a large real-world cohort of routine H&E slides, which effectively generalized to externally stained and scanned samples and a temporally independent validation cohort. This algorithm has the potential to direct prostate cancer patients toward immunotherapy and to identify MSI-H cases secondary to Lynch syndrome.

Multiparametric magnetic resonance imaging (mp-MRI) has shown excellent results in the detection of prostate cancer (PCa). However, characterizing prostate lesions aggressiveness in mp-MRI sequences is impossible in clinical practice, and biopsy remains the reference to determine the Gleason score (GS). In this work, we propose a novel end-to-end multi-class network that jointly segments the prostate gland and cancer lesions with GS group grading. After encoding the information on a latent space, the network is separated in two branches: 1) the first branch performs prostate segmentation 2) the second branch uses this zonal prior as an attention gate for the detection and grading of prostate lesions. The model was trained and validated with a 5-fold cross-validation on an heterogeneous series of 219 MRI exams acquired on three different scanners prior prostatectomy. In the free-response receiver operating characteristics (FROC) analysis for clinically significant lesions (defined as GS > 6) detection, our model achieves 69.0% $\pm$14.5% sensitivity at 2.9 false positive per patient on the whole prostate and 70.8% $\pm$14.4% sensitivity at 1.5 false positive when considering the peripheral zone (PZ) only. Regarding the automatic GS group

Basics: What is a Gleason Score? One important component of staging your cancer is the grade of the cancer. While the stage of your cancer looks at where the cancer is present in your body -- how it is behaving at the macro level -- the grade describes what the actual cancer cells look like under a microscope -- how they are behaving on a micro level. Traditionally, prostate cancer grades were described according to the Gleason Score, a system named for the pathologist who developed it in the 1960s. Dr. Donald Gleason realized that cancerous cells fall into 5 distinct patterns as they change from normal cells to tumor cells.

Researchers from the RIKEN Center for Advanced Intelligence Project (AIP) in Japan have shown that a deep-learning algorithm can be used to extract interpretable features from annotation-free histopathology images from prostate cancer patients. Their framework outperformed the prediction of biochemical recurrence using conventional, Gleason Score-based methods (Nature Commun. Prostate cancer is the second most common cancer affecting men worldwide, with an incidence rate of 13.5%, according to the World Health Organization. The extracted samples of tissue are examined under a microscope and, if cancerous cells are found, divided into risk groups assigned through the Gleason Score. This grading system is considered the gold standard in cancer medicine, as it determines the aggressiveness of prostate cancer and helps doctors establish the right course of treatment.

Artificial intelligence (AI) technology developed by the RIKEN Center for Advanced Intelligence Project (AIP) in Japan has successfully found features in pathology images from human cancer patients, without annotation, that could be understood by human doctors. Further, the AI identified features relevant to cancer prognosis that were not previously noted by pathologists, leading to a higher accuracy of prostate cancer recurrence compared to pathologist-based diagnosis. Combining the predictions made by the AI with predictions by human pathologists led to an even greater accuracy. According to Yoichiro Yamamoto, the first author of the study published in Nature Communications, "This technology could contribute to personalized medicine by making highly accurate prediction of cancer recurrence possible by acquiring new knowledge from images. It could also contribute to understanding how AI can be used safely in medicine by helping to resolve the issue of AI being seen as a'black box.'"

Artificial intelligence (AI) technology developed by the RIKEN Center for Advanced Intelligence Project (AIP) in Japan has successfully found features in pathology images from human cancer patients, without annotation, that could be understood by human doctors. Further, the AI identified features relevant to cancer prognosis that were not previously noted by pathologists, leading to a higher accuracy of prostate cancer recurrence compared to pathologist-based diagnosis. Combining the predictions made by the AI with predictions by human pathologists led to an even greater accuracy. According to Yoichiro Yamamoto, M.D., Ph.D., the first author of the study published in Nature Communications, "This technology could contribute to personalized medicine by making highly accurate prediction of cancer recurrence possible by acquiring new knowledge from images. It could also contribute to understanding how AI can be used safely in medicine by helping to resolve the issue of AI being seen as a'black box.'"

Artificial intelligence (AI) technology developed by the RIKEN Center for Advanced Intelligence Project (AIP) in Japan has successfully found features in pathology images from human cancer patients, without annotation, that could be understood by human doctors. Further, the AI identified features relevant to cancer prognosis that were not previously noted by pathologists, leading to a higher accuracy of prostate cancer recurrence compared to pathologist-based diagnosis. Combining the predictions made by the AI with predictions by human pathologists led to an even greater accuracy. According to Yoichiro Yamamoto, the first author of the study published in Nature Communications, "This technology could contribute to personalized medicine by making highly accurate prediction of cancer recurrence possible by acquiring new knowledge from images. It could also contribute to understanding how AI can be used safely in medicine by helping to resolve the issue of AI being seen as a'black box.'"

Artificial intelligence (AI) technology developed by the RIKEN Center for Advanced Intelligence Project (AIP) in Japan has successfully found features in pathology images from human cancer patients, without annotation, that could be understood by human doctors. Further, the AI identified features relevant to cancer prognosis that were not previously noted by pathologists, leading to higher accuracy of prostate cancer recurrence compared to pathologist-based diagnosis. Combining the predictions made by the AI with predictions by human pathologists led to an even greater accuracy. According to Yoichiro Yamamoto, the first author of the study published in Nature Communications, "This technology could contribute to personalized medicine by making highly accurate prediction of cancer recurrence possible by acquiring new knowledge from images. It could also contribute to understanding how AI can be used safely in medicine by helping to resolve the issue of AI being seen as a'black box.'"

Generative Adversarial Networks (GANs) have shown considerable promise for mitigating the challenge of data scarcity when building machine learning-driven analysis algorithms. Specifically, a number of studies have shown that GAN-based image synthesis for data augmentation can aid in improving classification accuracy in a number of medical image analysis tasks, such as brain and liver image analysis. However, the efficacy of leveraging GANs for tackling prostate cancer analysis has not been previously explored. Motivated by this, in this study we introduce ProstateGAN, a GAN-based model for synthesizing realistic prostate diffusion imaging data. More specifically, in order to generate new diffusion imaging data corresponding to a particular cancer grade (Gleason score), we propose a conditional deep convolutional GAN architecture that takes Gleason scores into consideration during the training process. Experimental results show that high-quality synthetic prostate diffusion imaging data can be generated using the proposed ProstateGAN for specified Gleason scores.