Region-Based Segmentation of Lymph Node Metastases in Whole-Slide Images of Colorectal Cancer: A Pilot Clinical Study

Digital technologies and artificial intelligence (AI) are transforming medical diagnostics, particularly in pathology. This study presented a two-stage computer vision model designed to detect colorectal cancer metastases in whole slide images (WSIs) of lymph nodes.

We developed a classification-segmentation pipeline optimized for both accuracy and efficiency. The model was trained on 108 WSIs and evaluated on 554 WSIs collected from two institutions using Leica Aperio AT2 and Hamamatsu NanoZoomer S360 scanners.

The classification model achieved a recall of 1.0 and a specificity of 0.935, while the segmentation model reported a Dice coefficient of 0.818 ± 0.105. Pathologists appreciated the model's precision in distinguishing solitary cancer cells from histiocytosis, reducing the need for peer consultations. Feedback from the pilot study indicated that the AI tool served as a valuable second opinion, enhancing diagnostic confidence.

This study explored the practical applications of AI in clinical pathology, offering perspectives from both pathologists and data scientists. Our findings highlighted how AI can streamline workflows, improve diagnostic accuracy, and support personalized treatment planning. The integration of AI into pathology workflows has the potential to redefine diagnostic standards while maintaining the critical role of pathologists in decision-making.