A Deep Learning Approach for Rapid Mutational Screening in Melanoma

Image-based analysis as a rapid method for mutation detection can be advantageous in research or clinical settings when tumor tissue is limited or unavailable for direct testing. Here, we applied a deep convolutional neural network (CNN) to whole slide images of melanomas from 256 patients and developed a fully automated model that first selects for tumor-rich areas (Area Under the Curve AUC=0.96) then predicts for the presence of mutated BRAF in our test set (AUC=0.72) Model performance was cross-validated on melanoma images from The Cancer Genome Atlas (AUC=0.75). We confirm that the mutated BRAF genotype is linked to phenotypic alterations at the level of the nucleus through saliency mapping and pathomics analysis, which reveal that cells with mutated BRAF exhibit larger and rounder nuclei. Not only do these findings provide additional insights on how BRAF mutations affects tumor structural characteristics, deep learning-based analysis of histopathology images have the potential to be integrated into higher order models for understanding tumor biology, developing biomarkers, and predicting clinical outcomes.

[1]  E. Neri,et al.  Imaging-Based Prediction of Molecular Therapy Targets in NSCLC by Radiogenomics and AI Approaches: A Systematic Review , 2020, Diagnostics.

[2]  G. Boland,et al.  Integration of Digital Pathologic and Transcriptomic Analyses Connects Tumor-Infiltrating Lymphocyte Spatial Density With Clinical Response to BRAF Inhibitors , 2020, Frontiers in Oncology.

[3]  Ying Xiao,et al.  Combining texture features of whole slide images improves prognostic prediction of recurrence-free survival for cutaneous melanoma patients , 2020, World Journal of Surgical Oncology.

[4]  Virtual biopsy using MRI radiomics for prediction of BRAF status in melanoma brain metastasis , 2020, Scientific Reports.

[5]  Hyunjin Park,et al.  Radiomics Study of Thyroid Ultrasound for Predicting BRAF Mutation in Papillary Thyroid Carcinoma: Preliminary Results , 2020, American Journal of Neuroradiology.

[6]  Kyunghwa Han,et al.  Radiomics in predicting mutation status for thyroid cancer: A preliminary study using radiomics features for predicting BRAFV600E mutations in papillary thyroid carcinoma , 2020, PloS one.

[7]  S. Tabbarah,et al.  Personalized Breast Cancer Treatments Using Artificial Intelligence in Radiomics and Pathomics. , 2019, Journal of medical imaging and radiation sciences.

[8]  Jakob Nikolas Kather,et al.  Pan-cancer image-based detection of clinically actionable genetic alterations , 2019, Nature Cancer.

[9]  Alexander W. Jung,et al.  Pan-cancer computational histopathology reveals mutations, tumor composition and prognosis , 2019, Nature Cancer.

[10]  Peiling Tsou,et al.  Mapping Driver Mutations to Histopathological Subtypes in Papillary Thyroid Carcinoma: Applying a Deep Convolutional Neural Network , 2019, Journal of clinical medicine.

[11]  A. Addeo,et al.  The Promise of Digital Biopsy for the Prediction of Tumor Molecular Features and Clinical Outcomes Associated With Immunotherapy , 2019, Front. Med..

[12]  D. Power,et al.  High concordance of BRAF mutational status in matched primary and metastatic melanoma , 2018, Journal of cutaneous pathology.

[13]  A. Spathis,et al.  BRAF Mutation Status in Primary, Recurrent, and Metastatic Malignant Melanoma and Its Relation to Histopathological Parameters , 2019, Dermatology practical & conceptual.

[14]  James X. Sun,et al.  Encorafenib/binimetinib for the treatment of BRAF-mutant advanced, unresectable, or metastatic melanoma: design, development, and potential place in therapy , 2018, OncoTargets and therapy.

[15]  N. Razavian,et al.  Classification and mutation prediction from non–small cell lung cancer histopathology images using deep learning , 2018, Nature Medicine.

[16]  Heather D. Couture,et al.  Image analysis with deep learning to predict breast cancer grade, ER status, histologic subtype, and intrinsic subtype , 2018, npj Breast Cancer.

[17]  H. Haenssle,et al.  Man against machine: diagnostic performance of a deep learning convolutional neural network for dermoscopic melanoma recognition in comparison to 58 dermatologists , 2018, Annals of oncology : official journal of the European Society for Medical Oncology.

[18]  Linda G. Shapiro,et al.  Detection and classification of cancer in whole slide breast histopathology images using deep convolutional networks , 2018, Pattern Recognit..

[19]  R. Botella-Estrada,et al.  The association between dermoscopic features and BRAF mutational status in cutaneous melanoma: Significance of the blue‐white veil , 2018, Journal of the American Academy of Dermatology.

[20]  Toby C. Cornish,et al.  US Food and Drug Administration Approval of Whole Slide Imaging for Primary Diagnosis: A Key Milestone Is Reached and New Questions Are Raised. , 2018, Archives of pathology & laboratory medicine.

[21]  Kenneth A. Iczkowski,et al.  Radio-pathomic Maps of Epithelium and Lumen Density Predict the Location of High-Grade Prostate Cancer , 2018, International journal of radiation oncology, biology, physics.

[22]  Rajarsi R. Gupta,et al.  Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images. , 2018, Cell reports.

[23]  Anant Madabhushi,et al.  RaPtomics: integrating radiomic and pathomic features for predicting recurrence in early stage lung cancer , 2018, Medical Imaging.

[24]  I. Stanganelli,et al.  Dermoscopy and confocal microscopy for metachronous multiple melanomas: morphological, clinical, and molecular correlations , 2018, European Journal of Dermatology.

[25]  K. Sloth,et al.  Concordance in BRAF V600E status over time in malignant melanoma and corresponding metastases , 2018, Histopathology.

[26]  P. Marcorelles,et al.  Evaluation of a Rapid, Fully Automated Platform for Detection of BRAF and NRAS Mutations in Melanoma. , 2018, Acta dermato-venereologica.

[27]  Mathilde Jalving,et al.  Rapid BRAF mutation tests in patients with advanced melanoma: comparison of immunohistochemistry, Droplet Digital PCR, and the Idylla Mutation Platform , 2017, Melanoma research.

[28]  Liang Cheng,et al.  Molecular testing for BRAF mutations to inform melanoma treatment decisions: a move toward precision medicine , 2017, Modern Pathology.

[29]  D. Brat,et al.  Predicting cancer outcomes from histology and genomics using convolutional networks , 2017, Proceedings of the National Academy of Sciences.

[30]  G. Pellacani,et al.  BRAF, NRAS and C-KIT Advanced Melanoma: Clinico-pathological Features, Targeted-Therapy Strategies and Survival. , 2017, Anticancer research.

[31]  Ehsan Kazemi,et al.  Deep Convolutional Neural Networks Enable Discrimination of Heterogeneous Digital Pathology Images , 2017, bioRxiv.

[32]  C. Berking,et al.  Prognostic significance of BRAF and NRAS mutations in melanoma: a German study from routine care , 2017, BMC Cancer.

[33]  Yi Gao,et al.  Towards Generation, Management, and Exploration of Combined Radiomics and Pathomics Datasets for Cancer Research , 2017, AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science.

[34]  Martin Wattenberg,et al.  SmoothGrad: removing noise by adding noise , 2017, ArXiv.

[35]  K. Flaherty,et al.  Targeted agents and immunotherapies: optimizing outcomes in melanoma , 2017, Nature Reviews Clinical Oncology.

[36]  Sebastian Thrun,et al.  Dermatologist-level classification of skin cancer with deep neural networks , 2017, Nature.

[37]  A. Ballestrero,et al.  Heterogeneity and frequency of BRAF mutations in primary melanoma: Comparison between molecular methods and immunohistochemistry , 2016, Oncotarget.

[38]  Ce Zhang,et al.  Predicting non-small cell lung cancer prognosis by fully automated microscopic pathology image features , 2016, Nature Communications.

[39]  Joel H. Saltz,et al.  Automatic histopathology image analysis with CNNs , 2016, 2016 New York Scientific Data Summit (NYSDS).

[40]  P. Brousset,et al.  Highly Concordant Results Between Immunohistochemistry and Molecular Testing of Mutated V600E BRAF in Primary and Metastatic Melanoma. , 2016, Acta dermato-venereologica.

[41]  M. Mahalingam,et al.  BRAF and epithelial-mesenchymal transition in primary cutaneous melanoma: a role for Snail and E-cadherin? , 2016, Human pathology.

[42]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[43]  Jean Claude Zenklusen,et al.  A Practical Guide to The Cancer Genome Atlas (TCGA) , 2016, Statistical Genomics.

[44]  P. Laurent-Puig,et al.  Why and how immunohistochemistry should now be used to screen for the BRAFV600E status in metastatic melanoma? The experience of a single institution (LCEP, Nice, France) , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[45]  C. Férec,et al.  Dual NRASQ61R and BRAFV600E mutation-specific immunohistochemistry completes molecular screening in melanoma samples in a routine practice. , 2015, Human pathology.

[46]  Steven J. M. Jones,et al.  Genomic Classification of Cutaneous Melanoma , 2015, Cell.

[47]  J. Chipuk,et al.  Immune biomarkers are more accurate in prediction of survival in ulcerated than in non-ulcerated primary melanomas , 2015, Cancer Immunology, Immunotherapy.

[48]  S. Rosso,et al.  Association Between NRAS and BRAF Mutational Status and Melanoma-Specific Survival Among Patients With Higher-Risk Primary Melanoma. , 2015, JAMA oncology.

[49]  M. Mihm,et al.  BAP1 and BRAFV600E expression in benign and malignant melanocytic proliferations. , 2015, Human pathology.

[50]  Andrew Zisserman,et al.  Very Deep Convolutional Networks for Large-Scale Image Recognition , 2014, ICLR.

[51]  Michael S. Bernstein,et al.  ImageNet Large Scale Visual Recognition Challenge , 2014, International Journal of Computer Vision.

[52]  Thomas Error in Text. Association Between NRAS and BRAF Mutational Status and Melanoma-Specific Survival Among Patients With Higher-Risk Primary Melanoma. , 2015, JAMA oncology.

[53]  C. Cohen,et al.  Accurate detection of BRAF p.V600E mutations in challenging melanoma specimens requires stringent immunohistochemistry scoring criteria or sensitive molecular assays. , 2014, Human pathology.

[54]  J. Wilmott,et al.  Intrapatient Homogeneity of BRAFV600E Expression in Melanoma , 2014, The American journal of surgical pathology.

[55]  D. Cappellen,et al.  Tumor Homogeneity between Primary and Metastatic Sites for BRAF Status in Metastatic Melanoma Determined by Immunohistochemical and Molecular Testing , 2013, PloS one.

[56]  A. von Deimling,et al.  Detection of BRAF p.V600E mutations in melanomas: comparison of four methods argues for sequential use of immunohistochemistry and pyrosequencing. , 2013, The Journal of molecular diagnostics : JMD.

[57]  R. Ádány,et al.  Marked genetic differences between BRAF and NRAS mutated primary melanomas as revealed by array comparative genomic hybridization , 2012, Melanoma research.

[58]  Alessandro Testori,et al.  The role of BRAF V600 mutation in melanoma , 2012, Journal of Translational Medicine.

[59]  N. Bhatia Frequencies of BRAF and NRAS mutations are different in histological types and sites of origin of cutaneous melanoma: a meta-analysis , 2012 .

[60]  K. Flaherty,et al.  Prevalence of BRAF V600E mutation in Chinese melanoma patients: large scale analysis of BRAF and NRAS mutations in a 432-case cohort. , 2012, European journal of cancer.

[61]  C. Tzen,et al.  Clinical outcome and pathological features associated with NRAS mutation in cutaneous melanoma , 2011, Pigment cell & melanoma research.

[62]  H. Zentgraf,et al.  Assessment of BRAF V600E mutation status by immunohistochemistry with a mutation-specific monoclonal antibody , 2011, Acta Neuropathologica.

[63]  J. Choi,et al.  Frequencies of BRAF and NRAS mutations are different in histological types and sites of origin of cutaneous melanoma: a meta‐analysis , 2011, The British journal of dermatology.

[64]  D. Schadendorf,et al.  Genetic and morphologic features for melanoma classification , 2010, Pigment cell & melanoma research.

[65]  Li-E. Wang,et al.  Clinical Correlates of NRAS and BRAF Mutations in Primary Human Melanoma , 2010, Clinical Cancer Research.

[66]  H. Ostrer,et al.  Developing a multidisciplinary prospective melanoma biospecimen repository to advance translational research. , 2009, American journal of translational research.

[67]  Jane Fridlyand,et al.  Improving Melanoma Classification by Integrating Genetic and Morphologic Features , 2008, PLoS medicine.

[68]  F. Schmidt Meta-Analysis , 2008 .

[69]  M. Trivett,et al.  Distinct clinical and pathological features are associated with the BRAF(T1799A(V600E)) mutation in primary melanoma. , 2007, The Journal of investigative dermatology.

[70]  Anne E Carpenter,et al.  CellProfiler: image analysis software for identifying and quantifying cell phenotypes , 2006, Genome Biology.

[71]  M. Wood,et al.  Analysis and interpretation of data. , 1978, The Journal of family practice.