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Evidential deep learning-based ALK-expression screening using H&E-stained histopathological images
Sai Chandra Kosaraju1, Sai Phani Parsa2, Dae Hyun Song3,4
1Computer Science Department, California Polytechnic State University, Pomona, CA, USA.
NPJ Digital Medicine
|October 14, 2025
Summary
Deep learning accurately predicts Anaplastic Lymphoma Kinase (ALK) gene rearrangements in non-small cell lung cancer from H&E images. This cost-effective AI tool achieves over 95% accuracy, aiding targeted therapy decisions.
Area of Science:
- Oncology
- Pathology
- Artificial Intelligence
Background:
- Accurate identification of genetic alterations in non-small cell lung cancer (NSCLC) is crucial for effective targeted therapies.
- Current methods for detecting genetic alterations like Anaplastic Lymphoma Kinase (ALK) rearrangement can be costly and time-consuming.
- Deep learning offers a potential solution for predicting genetic alterations directly from standard histopathological images.
Purpose of the Study:
- To develop and validate a deep learning algorithm for the pathological interpretation and prediction of ALK rearrangements in NSCLC.
- To assess the clinical applicability and accuracy of the AI model in screening ALK alterations.
- To reduce unnecessary medical costs associated with genetic testing and explore genotype-phenotype associations.
Main Methods:
- Development of a pathologically interpretable, evidence-based deep learning algorithm.
- Training and validation of the model using H&E-stained pathological images from NSCLC resection and biopsy specimens.
- Evaluation of the model's predictive accuracy and clinical utility.
Main Results:
- The deep learning model achieved over 95% accuracy in predicting ALK alterations on both resection and biopsy datasets.
- The developed algorithm demonstrates high potential for clinical application in NSCLC diagnostics.
- The study provides insights into the association between genetic alterations and pathological phenotypes.
Conclusions:
- Deep learning provides an accurate and efficient method for screening ALK alterations in NSCLC, potentially reducing healthcare costs.
- The AI-driven approach offers significant clinical utility for guiding targeted therapy selection.
- A publicly available, open-source Python software package facilitates the implementation of this technology.

