Deep learning-based image analysis predicts PD-L1 status from H&E-stained histopathology images in breast cancer

Gil Shamai (), Amir Livne, António Polónia, Edmond Sabo, Alexandra Cretu, Gil Bar-Sela and Ron Kimmel
Additional contact information
Gil Shamai: Technion
Amir Livne: Technion
António Polónia: Ipatimup
Edmond Sabo: Carmel Medical Center
Alexandra Cretu: Carmel Medical Center
Gil Bar-Sela: Haemek Medical Center
Ron Kimmel: Technion

Nature Communications, 2022, vol. 13, issue 1, 1-13

Abstract: Abstract Programmed death ligand-1 (PD-L1) has been recently adopted for breast cancer as a predictive biomarker for immunotherapies. The cost, time, and variability of PD-L1 quantification by immunohistochemistry (IHC) are a challenge. In contrast, hematoxylin and eosin (H&E) is a robust staining used routinely for cancer diagnosis. Here, we show that PD-L1 expression can be predicted from H&E-stained images by employing state-of-the-art deep learning techniques. With the help of two expert pathologists and a designed annotation software, we construct a dataset to assess the feasibility of PD-L1 prediction from H&E in breast cancer. In a cohort of 3,376 patients, our system predicts the PD-L1 status in a high area under the curve (AUC) of 0.91 – 0.93. Our system is validated on two external datasets, including an independent clinical trial cohort, showing consistent prediction performance. Furthermore, the proposed system predicts which cases are prone to pathologists miss-interpretation, showing it can serve as a decision support and quality assurance system in clinical practice.

Date: 2022
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DOI: 10.1038/s41467-022-34275-9

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