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Automated Classification of Lymphoma Subtypes From Histopathological Images Using a U-Net Deep Learning Model: Comparative Evaluation Study.

BACKGROUND: Accurate classification and grading of lymphoma subtypes are essential for treatment planning. Traditional diagnostic methods face challenges of subjectivity and inefficiency, highlighting the need for automated solutions based on deep learning techniques. OBJECTIVE: This study aimed to investigate the application of deep learning technology, specifically the U-Net model, in classifying and grading lymphoma subtypes to enhance diagnostic precision and efficiency. METHODS: In this study, the U-Net model was used as the primary tool for image segmentation integrated with attention mechanisms and residual networks for feature extraction and classification. A total of 620 high-quality histopathological images representing 3 major lymphoma subtypes were collected from The Cancer Genome Atlas and the Cancer Imaging Archive. All images underwent standardized preprocessing, including Gaussian filtering for noise reduction, histogram equalization, and normalization. Data augmentation techniques such as rotation, flipping, and scaling were applied to improve the model's generalization capability. The dataset was divided into training (70%), validation (15%), and test (15%) subsets. Five-fold cross-validation was used to assess model robustness. Performance was benchmarked against mainstream convolutional neural network architectures, including fully convolutional network, SegNet, and DeepLabv3+. RESULTS: The U-Net model achieved high segmentation accuracy, effectively delineating lesion regions and improving the quality of input for classification and grading. The incorporation of attention mechanisms further improved the model's ability to extract key features, whereas the residual structure of the residual network enhanced classification accuracy for complex images. In the test set (N=1250), the proposed fusion model achieved an accuracy of 92% (1150/1250), a sensitivity of 91.04% (1138/1250), a specificity of 89.04% (1113/1250), and an F1-score of 90% (1125/1250) for the classification of the 3 lymphoma subtypes, with an area under the receiver operating characteristic curve of 0.95 (95% CI 0.93-0.97). The high sensitivity and specificity of the model indicate strong clinical applicability, particularly as an assistive diagnostic tool. CONCLUSIONS: Deep learning techniques based on the U-Net architecture offer considerable advantages in the automated classification and grading of lymphoma subtypes. The proposed model significantly improved diagnostic accuracy and accelerated pathological evaluation, providing efficient and precise support for clinical decision-making. Future work may focus on enhancing model robustness through integration with advanced algorithms and validating performance across multicenter clinical datasets. The model also holds promise for deployment in digital pathology platforms and artificial intelligence-assisted diagnostic workflows, improving screening efficiency and promoting consistency in pathological classification.

Humans↗

Characteristics of the software for computer applications in medicine.

The requirements of clinical medicine which have tended to make the design and implementation of software for hospital computer systems more difficult than that elsewhere, are discussed in this paper. Specific constraints on the software for selected computer-assisted activities in a hospital environment are examined in considerable depth. It is shown that since some of these activities have counterparts elsewhere, hospital computing can benefit from the accumulated experience in dealing with similiar problems in business and scientific environments. The argument is put forward that developing countries, with their characteristic problem of acute shortage of skilled manpower in both medicine and computing, should initially concentrate on applying computers to these activities alone. Furthermore, medical education in such countries should incorporate programmes relating to computer technology in general and the software aspects in particular.

Computers↗

Addressing challenges in nursing informatics instruction.

Objectives for the interactive experiences include exposure to a wide variety of computer applications; in-depth experience with at least one application; overcoming computer fear; appreciating the rigid, logical flow of computerized problem-solving; and appreciating the benefits and limitations of computer applications for a variety of purposes. Ultimately, a major purpose of transferring informatics content is related to stimulating students' imagination with respect to the computer's ability to aid their professional endeavors. Robinson (1984) describes the imagination factor: "I think the total potential of computers is only limited by our imagination. It's like giving an artist a palette that has an infinite number of colors, some of them invisible to the naked eye. . . It is a tool for the realization of ideas." Students who have been exposed to the benefits of major categories of computer applications can appreciate computer capabilities with respect to exploring scientific and nursing phenomena, and building databases to store and access information (Newbern, 1985). These students should have enough theoretical and experimental knowledge of computers to become actively involved in making creative, informed decisions about how computers will be applied to nursing in their professional setting. Hardin and Skiba (1982) noted a gap between the powerful information processing capabilities of the computer and its relatively limited use by nursing--a gap which still exists today. Students who have participated in an idea generation course on computer applications can help to bridge this gap, helping nursing to take full advantage of the computer-saturated environments of the future.

Computer User Training↗

Computer assisted instruction for preoperative and postoperative patient education in joint replacement surgery.

This article describes a comprehensive system for preoperative and postoperative patient education. The system offers a cost-effective method of instruction which encourages patient interaction and practice with decision making. The system was designed for patients undergoing total joint replacement surgery and includes two preoperative lessons, and a third lesson presented postoperatively at the bedside. The computer lessons were developed using data collected by a patient assessment instrument, and collaboratively with input from a nurse clinical specialist, orthopedic surgeon, physical therapist, and computer programmer. In this project, several advantages for using computer assisted instruction for preoperative and postoperative patient education were identified.

Computer-Assisted Instruction↗

Ranking radiotherapy treatment plans using decision-analytic and heuristic techniques.

Radiotherapy treatment optimization is done by generating a set of tentative treatment plans, evaluating them and selecting the plan closest to achieving a set of conflicting treatment objectives. The evaluation of potential plans involves making tradeoffs among competing possible outcomes. Multiattribute decision theory provides a framework for specifying such tradeoffs and using them to select optimal actions. Using these concepts, we have developed a plan-ranking model which ranks a set of tentative treatment plans from best to worst. Heuristics are used to refine this model so that it reflects the clinical condition of the patient being treated and the practice preferences of the physician prescribing the treatment. A figure of merit is computed for each tentative plan, and is used to rank the plans. The approach described is very general and can be used for other medical domains having similar characteristics. The figure of merit can also be used as an objective function by computer programs that attempt to automatically generate an optimal treatment plan.

Artificial Intelligence↗

Evaluation of a Computerized Clinical Information System (Micromedex).

This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database.

Computer Systems↗

AI/Consult: a prototype directed history system based upon the AI/Rheum knowledge base.

An expert system is designed which uses the AI/Rheum knowledge base as the basis for a directed workup system for rheumatological disorders. A Turbo Pascal prototype is demonstrated which, unlike AI/Rheum, permits entry by the clinician of a patient's chief complaint(s) and subsequently develops a dynamic differential diagnosis for this limited set of findings. The system restricts its line of questioning to those pertinent in order to rule in or rule out items on this dynamic differential diagnosis, and, unlike AI/Rheum, it provides immediate notification to the user when a critical mass of information has been entered in order to meet a diagnosis at one of the AI/Rheum criteria table's three levels of diagnosis (possible, probable, definite). Thus the system allows for a more rapid, focused decision making approach than does AI/Consult, while it follows the trend established by QMR in that it abandons the Greek Oracle problem solving approach and instead adopts a physician-assisted hypothesis investigation approach. The system is currently a prototype, without AI/Rheum's page oriented and mouse driven interface, and thus the total user interaction time may be longer than with AI/Rheum even though fewer user interactions (responses) are required. Plans for future development include optimization of the knowledge base to allow for more efficient, problem oriented questioning and modification of the knowledge base compiler in order to dynamically rule out diseases through the addition of three new levels of diagnosis in the knowledge base criteria tables.

Diagnosis, Computer-Assisted↗

Patient management in the ICU: the PDB System.

The Intensive Care Unit is the area in patient care where the amount of patient data from a variety of sources is particularly large. The problem for clinicians lies in the ability to gather, and use these data in the decision making process. A well designed computer based patient data management system, incorporating a variety of data analysis tools, would have a dramatic impact in patient care in an environment such as this. The PDB System has been in continuous use at the Montreal General Hospital's Surgical and Trauma Intensive Care Unit since Jan. 88. Its initial implementation in two beds in our SICU has allowed the complete replacement of the conventional patient paper record. It is used by all ICU staff, including nurses, physicians, and ward clerks for the recording/viewing of all patient vital data, laboratory data, medications, and optionally chart notes. In addition, medical staff has the option to use the entered data to perform a variety of data analysis procedures.

Critical Care↗

Bayesian diagnostic probabilities without assuming independence of symptoms.

The paper describes an application of Bayes' Theorem to the problem of estimating from past data the probabilities that patients have certain diseases, given their symptoms. The data consist of hospital records of patients who suffered acute abdominal pain. For each patient the records showed a large number of symptoms and the final diagnosis to one of nine diseases or diagnostic groups. Most current methods of computer diagnosis use the "Simple Bayes" model in which the symptoms are assumed to be independent, but the present paper does not make this assumption. Those symptoms (or lack of symptoms) which are most relevant to the diagnosis of each disease are identified by a sequence of chi-squared tests. The computer diagnoses obtained as a result of the implementation of this approach are compared with those given by the "Simple Bayes" method, by the method of classification trees (CART), and also with the preliminary and final diagnoses made by physicians.

Abdominal Pain↗

[Computers in emergency medicine].

Computer's applications in emergency medicine are reviewed. In the Emergency Health Care computer science provides support to the solution of medical problems (with diagnostic and medical decision making softwares) and to the management of emergency departments. Computer interfaced to instrumental equipments allows the monitoring of biomedical signals and their transmission at distance. Finally, the possibilities of computer-aided instruction are presented. Teaching methods such as the tutor-system and the simulation are discussed.

Computer-Assisted Instruction↗

[Computer and acid-base disorders].

The diagnosis of acid-base disorders has been subject to computerised analysis for many years. Expert systems, an application of artificial intelligence, have been validated. They are of help to clinical decision making, enabling the different diagnostic possibilities of given acid-base and hydro-electrolytic situations to be evaluated and appropriate therapy to be instituted. Computer networks improve the transmission of laboratory results to the intensive care units and the integration of data facilitates the monitoring of biochemical tendencies. Computers can also be used for teaching acid-base physiology and pathology.

Acid-Base Imbalance↗

Computer applications in orthopaedics.

With the rapid developments in microprocessors, the widespread availability of computers has brought about broad applications in the field of orthopaedics. The present technology enables large quantities of data to be logically processed in a very short span of time. This has led to the development of information management database systems where relevant medical information may be retrieved very quickly and effectively. The analytical power of the computer has also been utilised in expert systems to assist in clinical-decision making process. Computer graphics have revolutionised the visualisation of physical features of internal and external body parts, providing new and improved modalities of diagnosis. In some centres, surgical planning and rehearsals are already being carried out at the computer terminal with the use of animation and computer graphics. Computer technology has also played an active role in the field of prosthetics and rehabilitation. Intelligent robotic systems and microprocessor with functional neuromuscular stimulation have been applied to benefit, and in some cases restore some motor functions to the physically disabled. With more collaboration between engineers, scientists and the medical community, several prototypes of computer-controlled prostheses and prosthesis designed and manufactured by Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology are available today to assist the amputees in their daily living and ambulatory activities.

Computer Graphics↗

[Development and clinical application of an expert system for supporting diagnosis of 201Tl stress myocardial SPECT].

A consultation expert system which supports our computer aided reporting system was developed. The system was used for the evaluation of the two dimensional polar (bull's eye) display of 201Tl myocardial SPECT. The system consists of patients management (PM) and consultation expert systems (ES). The former is connected to image processors coupled with scinticameras. The bull's eye display of myocardial SPECT is transferred from image processor to the data base of PM. When inference request is made, the feature extraction program extracts information on localization, extent and severity of focal defects comparing count-rates pixel by pixel with the reference obtained from seven normal controls. The inference engine is activated to determine presence of focal defects utilizing diagnostic rules in the knowledge base. The results are sent back to PM and reported with the probability of assurance. Fifty eight patients with old myocardial infarction (OMI), angina pectoris (AP) and other diseases as well as normal controls were included in the study. The decision for presence or absence of focal defects by ES agreed with that by nuclear physicians (NP) in 301 segments among 330 (91%) in stress images. The presence of redistribution in delayed images agreed in 43 segments among 67 (64%). Image interpretation by ES agreed well with that of NP in patients with OMI (19/20) and AP (9/11). Seven were interpreted as normal by both ES and NP. The system is useful, as it provides NP with complementary and supportive information applicable to decision making and reporting. Further clinical experiences can improve knowledge base for better ES function.

Computer Systems↗

Construction of the diagnostic encyclopedia workstation. Computerizing pathology for the pathologist.

The combination of a personal computer and a laser-vision disc player is an adroit tool for storing and retrieving textual information in combination with pictorial information. This paper describes such a system (a "diagnostic encyclopedia workstation"), which provides information to the pathologist engaged in daily diagnostic practice. The system contains a considerable amount of descriptive textual information that might be useful in making diagnoses in histopathology, along with many illustrations; the text is presented in a natural language (English). The descriptive information is divided into 18 categories, including such topics as histology, macroscopy, immunopathology and clinical data; each topic has a separate display in the system. Also present are two types of "decision rules" for making diagnoses (confirmative criteria for a diagnosis under consideration and exclusive criteria for many other diagnoses) and a classifying structure. The present version of this system contains information on about 100 diagnoses in ovarian pathology, illustrated with about 3,000 color slides from about 140 cases. The information and pictures are immediately available. Further characteristics of this system are its flexibility, accessibility and user friendliness; it has been structured so that components of artificial intelligence may be added later.

Artificial Intelligence↗

Iliad: moving medical decision-making into new frontiers.

If the essence of clinical practice is a process of sequential problem-solving, whereby a physician works with a patient to formulate a series of decisions about diagnostic treatment, then it would naturally follow that the essence of medical education should evolve around the training of would-be clinicians in the difficult art of diagnostic decision-making. Yet this is not often the case.

Clinical Clerkship↗

[An aid in decision-making in hematology: characteristics and performances of the program. 200 cases of anemia].

An aid to decision programme has been applied to 200 cases of anaemia. Evaluation by the bayesian method rested on clinical data (age, sex, race) and laboratory data (blood count and differential, erythrocyte morphology). An accurate diagnosis was made initially in 107 cases, and for the first 5 diseases in 173 cases. The programme proved more effective than two clinicians recently trained in haematology. Devised for micro-computers, it can be used in routine practice and for teaching purposes.

Anemia↗