Deep learning approach to predict sentinel lymph node status directly from routine histology of primary melanoma tumours
European Journal of Cancer, vol. 154, pp. 227–234
Abstract
AIM: Sentinel lymph node status is a central prognostic factor for melanomas. However, the surgical excision involves some risks for affected patients. In this study, we therefore aimed to develop a digital biomarker that can predict lymph node metastasis non-invasively from digitised H&E slides of primary melanoma tumours. METHODS: A total of 415 H&E slides from primary melanoma tumours with known sentinel node (SN) status from three German university hospitals and one private pathological practice were digitised (150 SN positive/265 SN negative). Two hundred ninety-one slides were used to train artificial neural networks (ANNs). The remaining 124 slides were used to test the ability of the ANNs to predict sentinel status. ANNs were trained and/or tested on data sets that were matched or not matched between SN-positive and SN-negative cases for patient age, ulceration, and tumour thickness, factors that are known to correlate with lymph node status. RESULTS: The best accuracy was achieved by an ANN that was trained and tested on unmatched cases (61.8% ± 0.2%) area under the receiver operating characteristic (AUROC). In contrast, ANNs that were trained and/or tested on matched cases achieved (55.0% ± 3.5%) AUROC or less. CONCLUSION: Our results indicate that the image classifier can predict lymph node status to some, albeit so far not clinically relevant, extent. It may do so by mostly detecting equivalents of factors on histological slides that are already known to correlate with lymph node status. Our results provide a basis for future research with larger data cohorts.
Authors 24
-
Titus Josef Brinker corresponding
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany. Electronic address: titus.brinker@dkfz.de
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
Affiliation as printed
Private Laboratory of Dermatohistopathology, Mönchhofstraße 52, 69120, Heidelberg, Germany
-
Dermatopathologie Friedrichshafen
Affiliation as printed
Dermatopathology Laboratory, Friedrichshafen, Germany
-
University Hospital Heidelberg
Affiliation as printed
Department of Dermatology, University Hospital Heidelberg, Heidelberg. Germany
-
University Hospital Regensburg
Affiliation as printed
Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
-
Affiliation as printed
Department of Dermatology, University Hospital Essen, Essen, Germany
-
Affiliation as printed
Department of Dermatology, University Hospital Essen, Essen, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Translational Medical Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases · Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Translational Medical Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany; Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany
Translational Medical Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
-
German Cancer Research Center · National Center for Tumor Diseases
Affiliation as printed
Digital Biomarkers for Oncology Group, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
-
Berlin Institute of Health at Charité - Universitätsmedizin Berlin · Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Clinical-Translational Sciences, Charité University Medicine and Berlin Institute of Health (BIH), Berlin, Germany
-
Affiliation as printed
Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
-
Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
-
Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
-
Institut für Hämatopathologie Hamburg
Affiliation as printed
Institute for Hematopathology Hamburg, Hamburg, Germany
-
Affiliation as printed
Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
-
Affiliation as printed
Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
-
Affiliation as printed
Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
-
Heidelberg University · University Hospital Schleswig-Holstein · University Medical Centre Mannheim
Affiliation as printed
Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; Department of Dermatology, University Hospital (UKSH), Kiel, Germany
Department of Dermatology, University Hospital (UKSH), Kiel, Germany
Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
Cited by 66 stored of 66
No patents citing this paper on Lens.org (checked 2026-10-06).