RT Journal Article
SR Electronic
T1 Deep Learning Global Glomerulosclerosis in Transplant Kidney Frozen Sections
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 292789
DO 10.1101/292789
A1 Jon N. Marsh
A1 Matthew K. Matlock
A1 Satoru Kudose
A1 Ta-Chiang Liu
A1 Thaddeus S. Stappenbeck
A1 Joseph P. Gaut
A1 S. Joshua Swamidass
YR 2018
UL http://biorxiv.org/content/early/2018/04/06/292789.abstract
AB Transplantable kidneys are in very limited supply. Accurate viability assessment prior to transplantation could minimize organ discard. Rapid and accurate evaluation of intra-operative donor kidney biopsies is essential for determining which kidneys are eligible for transplantation. The criteria for accepting or rejecting donor kidneys relies heavily on pathologist determination of the percent of glomeruli (determined from a frozen section) that are normal and sclerotic. This percentage is a critical measurement that correlates with transplant outcome. Inter- and intra-observer variability in donor biopsy evaluation is, however, significant. An automated method for determination of percent global glomerulosclerosis could prove useful in decreasing evaluation variability, increasing throughput, and easing the burden on pathologists. Here, we describe the development of a deep learning model that identifies and classifies non-sclerosed and sclerosed glomeruli in whole-slide images of donor kidney frozen section biopsies. This model extends a convolutional neural network (CNN) pre-trained on a large database of digital images. The extended model, when trained on just 48 whole slide images, exhibits slide-level evaluation performance on par with expert renal pathologists. The model substantially outperforms a model trained on image patches of isolated glomeruli. Encouragingly, the model’s performance is robust to slide preparation artifacts associated with frozen section preparation. As the first model reported that identifies and classifies normal and sclerotic glomeruli in frozen kidney sections, and thus the first model reported in the literature relevant to kidney transplantation, it may become an essential part of donor kidney biopsy evaluation in the clinical setting.