title: Pathological Diagnosis of Gastric Cancers with a Novel Computerized Analysis System.
abstract: BACKGROUND
  Recent studies of molecular biology have provided great advances for diagnostic molecular pathology. Automated diagnostic systems with computerized scanning for sampled cells in fluids or smears are now widely utilized. Automated analysis of tissue sections is, however, very difficult because they exhibit a complex mixture of overlapping malignant tumor cells, benign host-derived cells, and extracellular materials. Thus, traditional histological diagnosis is still the most powerful method for diagnosis of diseases.
  
  
  METHODS
  We have developed a novel computer-assisted pathology system for rapid, automated histological analysis of hematoxylin and eosin (H and E)-stained sections. It is a multistage recognition system patterned after methods that human pathologists use for diagnosis but harnessing machine learning and image analysis. The system first analyzes an entire H and E-stained section (tissue) at low resolution to search suspicious areas for cancer and then the selected areas are analyzed at high resolution to confirm the initial suspicion.
  
  
  RESULTS
  After training the pathology system with gastric tissues samples, we examined its performance using other 1905 gastric tissues. The system's accuracy in detecting malignancies was shown to be almost equal to that of conventional diagnosis by expert pathologists.
  
  
  CONCLUSIONS
  Our novel computerized analysis system provides a support for histological diagnosis, which is useful for screening and quality control. We consider that it could be extended to be applicable to many other carcinomas after learning normal and malignant forms of various tissues. Furthermore, we expect it to contribute to the development of more objective grading systems, immunohistochemical staining systems, and fluorescent-stained image analysis systems.
authors.affiliation: Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; Department of Pathology, Wakayama Medical University, Wakayama, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Oikawa
authors.affiliation: Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
authors.affiliation: Medical Solution Division, NEC Corporation, Tokyo, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Kiyuna
authors.affiliation: Department of Machine Learning, NEC Laboratories America, Princeton, NJ, USA.
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Graf
authors.affiliation: Department of Machine Learning, NEC Laboratories America, Princeton, NJ, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Cosatto
authors.affiliation: Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuroda
keywords: Computerized analysis system; gastric cancer; pathological diagnosis; tissue section