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The significant progress made in the field of cancer prognosis using whole slide images (WSIs) is encouraging, indicating a promising future for cancer diagnosis and management. The ability to accurately predict survival rates and recurrence risk using deep learning methods has significant implications for clinical practice and patient care. As more sophisticated models and techniques are developed, the potential to revolutionize the field of oncology is immense.
In the domain of cancer prognosis, significant strides have been made through the application of deep learning methodologies to WSIs. This approach has enabled researchers to develop predictive models for a wide range of cancer types. It is imperative to note that the interpretation of this rich and complex data has necessitated a myriad of sophisticated techniques, many of which have been adeptly crafted to fit the peculiarities of specific cancer types (Table 1).
Ref. | Deep Learning Methods | Expected Strengths | Expected Limitations |
---|---|---|---|
[25] | Multihead Attention (Attention Mechanisms) | Comprehensive WSI analysis outperforms existing approaches and contributes to prognosis prediction. | Not specified |
[26] | General Deep Learning (including MLP) | Potential biomarkers discovered provide enhanced prognostic performance. | Interpretability and generalizability limitations may hinder clinical acceptance. |
[27] | ResNet | Cost-effective tumor mutation burden measurement and prognostic biomarkers outperform original TMB signature. | Not specified |
[28] | Deep Multimagnification Network | Highly correlated necrosis ratio estimation and outcome prediction. | Dependence on manual review of necrosis ratio from multiple slides. |
[29] | Federated Learning | Privacy-preserving multicentric studies with interpretable ML model. | Biases from small-scale study and time-consuming expert annotations. |
[30] | CNN | Potential for multimodal data use in clinical applications with high diagnostic accuracy. | Not specified |
[31] | ResNet, Attention Mechanisms | Risk stratification facilitated in ovarian cancer through deep learning framework. | Moderate mean value of C-index; uneven prediction strength across subgroups. |
[32] | Multiple-Instance Learning (MIL), GAT, Attention Mechanisms | Novel MIL fusion model enables accurate prognostic risk prediction. | Not specified, potential challenges with image segmentation and representation. |
[33] | ResNet-50 | MPIS integration with clinicopathological variables improves LUAD prognostic stratification. | Transferability of MPIS to all cancer types uncertain. |
[34] | Weakly Supervised Deep Learning | Accurate bladder cancer diagnosis and personalized treatment decisions. | Not specified |
[35] | General Deep Learning (including MLP) | The proposed model improves survival prediction in bladder cancer by assessing TILs. | Not specified |
[36] | CNN, Attention Mechanisms | High-performance prognosis prediction in Epithelial ovarian cancer using AI mechanisms. | Not specified |
[37] | General Deep Learning (including MLP) | High-accuracy colorectal cancer prognosis using a weakly supervised deep learning network. | Not specified |
[38] | General Deep Learning (including MLP) | Deep learning-based immune index correlates strongly with colorectal cancer survival rates. | Not specified |
[39] | General Deep Learning (including MLP) | Multimodality prognostic model provides high-performance survival prediction in hepatocellular carcinoma. | Not specified |
[40] | General Deep Learning (including MLP) | Depiction of tumor microenvironment immunophenotypes offers insights into biological pathways in bladder cancer. | Not specified |
[41] | Sparse Representation Learning | The proposed model improves risk stratification in breast cancer with integrated biomarkers. | Effectiveness tied to biomarker extraction quality; untested outside of breast cancer. |
[42] | CNN with Autoencoder | Deep learning-based pathological risk score predicts cervical cancer prognosis. | Prediction performance tied to dataset quality; clinical application untested. |
[43] | Autoencoder with Regularization | CMS discovery allows personalized diagnosis in lower-grade gliomas. | Limitations with validating subtypes for other cancer types and accounting for inter-tumor heterogeneity. |
[44] | ResNet | The proposed model identifies morphological features associated with metastasis in cSCC. | Performance tied to data quality and diversity; untested outside of cSCC. |
[45] | Deep Learning with Multiresolution | Deep learning method for breast cancer survival integrates image data, improving model performance. | Needs more validation; performance varies with data quality. |
[46] | Variational Autoencoder (VAE), Generative Adversarial Network (GAN) | Improved prognostic signature for stratifying outcomes in stage III CRC. | Limited generalizability to other cancer types or stages. |
[47] | Spatial Pyramid Network | Automated CRC risk stratification approach related to gland formation. | Model may require further refinement despite better discrimination. |
[48] | ResNet-34 | TIL infiltrates assessment in breast cancer WSIs acts as significant biomarkers. | Dependence on TIL infiltrates; performance in TIL absence unclear. |
[49] | General Deep Learning (including MLP) | Prognostic utility for CRC PFS prediction based on automatic TIL quantification. | Performance tied to TIL quantification; unclear performance in TIL absence. |
[50] | General Deep Learning (including MLP) | End-to-end multimodal fusion improves survival outcome prediction. | Performance tied to availability of paired WSI, genotype, and transcriptome data. |
[51] | CNN | The proposed model for CLR and TIL quantification improves survival prediction in CRC. | Needs further validation on larger cohorts for generalizability and clinical deployment. |
[52] | ResNet-34 | The proposed model achieves high accuracy for prognosis in OCCC. | Single-institution data may limit model generalizability. |
[53] | General Deep Learning (including MLP) | The proposed model reduces interoperator variation in survival prediction from WSIs. | Efficiency compromised by WSI size and pattern heterogeneity. |
[54] | CNN | Stroma-immune score using deep learning improves survival prediction in CRC. | Larger validation cohorts needed for reliable assessment of model’s prognostic value. |
[55] | ResNet-18 | Improved prognosis and IDH mutation status prediction in lower-grade gliomas. | Small sample size may limit robustness and generalizability. |
[56] | CNN | The proposed model utilizes multiscale pathology images for prognosis prediction in lung adenocarcinoma. | Not specified |
[57] | EfficientUnet, ResNet | Efficient analysis of immune checkpoints and prognosis of NSCLC. | Not specified |
[58] | CNN | Accurate RCC subtype diagnosis and prediction of survival outcomes. | Interrater variability and limitations in capturing all biological signals. |
[59] | Weakly Supervised Deep Learning | Prognostic indicators from HCC pathological images improve risk stratification. | Efficiency and labor-saving limitations; needs further validation for patient treatment. |
[60] | Ensemble Learning | Prediction of MIBC prognosis significantly higher than TNM staging system. | Further validation and clinical deployment needed. |
[61] | CNN | Efficient assessment of TILs in triple negative breast cancer provides valuable prognostic information. | Optimal prognostic information yielding method unclear; lack of objective TIL assessment methods. |
[62] | CNN | High accuracy in predicting metastasis risk in pancreatic neuroendocrine tumors. | Not specified |
[63] | General Deep Learning (including MLP) | Accurate mucus proportion quantification in colorectal cancer suitable for clinical application. | Not specified |
[64] | General Deep Learning (including MLP) | Integrative analysis of histopathological images and genomic data improves understanding of disease progression. | Might not identify all potential regulatory regions in the human genome. |
[65] | General Deep Learning (including MLP) | Two deep learning algorithms aid risk stratification for hepatocellular carcinoma patients. | Not specified |
[66] | Convolutional Neural Networks (CNN) | Prognostic model predicts treatment failure in nasopharyngeal carcinoma better than existing clinical models. | Not specified |
[67] | General Deep Learning (including MLP) | The models developed can spatially characterize tumor heterogeneity. Showed a significant statistical link between heterogeneity and survival. | Lack of automated methods for characterizing tumor heterogeneity. |
[68] | CNN, Transfer Learning | Automated deep learning method for TSR quantification in colorectal cancer reduces pathologist workload. | Not specified |
[69] | CNN | CNN-based system distinguishes tissue types with high accuracy in gastric diseases. | Not specified |
[70] | Transfer Learning | Deep transfer learning quantifies histopathological patterns across a range of cancer types. | Not specified |
[71] | CNN | High-resolution TIL map generation on WSIs strongly associates with immune response pathways and genes. | Not specified |
[72] | CNN | Exceptional accuracy in brain cancer survival rate classification based on histopathological images. | Challenges in generalizability on unseen samples and practical clinical application. |
[73] | General Deep Learning (including MLP) | Deep learning classifier identifies breast cancer molecular subtypes and heterogeneity. | Potential inaccuracies due to intratumoral heterogeneity. |
[74] | General Deep Learning (including MLP) | Two-step deep learning approach accurately detects lung cancer metastases. | Presence of false positives in model predictions. |
[75] | General Deep Learning (including MLP) | TILAb score predicts disease-free survival in OSCC patients better than manual TIL score. | Accuracy tied to quality and clarity of WSIs. |
[76] | Convolutional Neural Networks (CNN) | High accuracy distinguishing renal cell carcinoma subtypes and predicting patient survival. | Class imbalance issues in medical datasets. |
[77] | Multimodal Neural Network | Model combining clinical, mRNA, microRNA data, and WSIs predicts survival for 20 cancer types. | Not specified; potential complexity in interpreting multiple data modalities. |
[78] | General Deep Learning (including MLP) | Automated approach determines TSR as an independent prognosticator in rectal cancer. | Applicable only in user-provided stroma hot-spots; performance tied to input image quality. |
[79] | General Deep Learning (including MLP) | Deep learning algorithm for cell identification in colon cancer images improves performance. | Patch selection for analysis may impact results. |
[80] | CNN | Quantification of tumor buds in bladder cancer adds prognostic value to traditional TNM staging. | Not specified |
[81] | CNN | Recurrence-related histological score allows for clinical decision making in HCC recurrence prediction. | Prediction accuracy varies; potential bias towards trained data and diseases. |
[82] | CNN | Automatic evaluation of the tumor microenvironment in WSIs aids in predicting disease progression. | Varied strength of predictors; potential bias towards specific cancer types. |