Colorectal tumor identification by transferring knowledge from pan-cytokeratin to H&E

Tumor budding is a recently recognized, independent prognostic factor in colorectal cancer, but lacks a standardized assessment methodology. Although staining with pan-cytokeratin has been shown to mitigate the issue of lack of reproducible, intra-observer agreement, usage of this antibody remains expensive and is limited in clinical practice. We propose an automated image analysis framework to take advantage of the visual superiority of pan-cytokeratin and the routine use of H&E to detect and quantify tumor budding. Our framework has demonstrated promising ability to identify tumor regions of colorectal slides – 92.0% accuracy, 94.5% sensitivity, and 85% specificity – across four independent datasets.