Purpose: The gold standard for colorectal cancer metastases detection in the
peritoneum is histological evaluation of a removed tissue sample. For feedback
during interventions, real-time in-vivo imaging with confocal laser microscopy
has been proposed for differentiation of benign and malignant tissue by manual
expert evaluation. Automatic image classification could improve the surgical
workflow further by providing immediate feedback.
Methods: We analyze the feasibility of classifying tissue from confocal laser
microscopy in the colon and peritoneum. For this purpose, we adopt both
classical and state-of-the-art convolutional neural networks to directly learn
from the images. As the available dataset is small, we investigate several
transfer learning strategies including partial freezing variants and full
fine-tuning. We address the distinction of different tissue types, as well as
benign and malignant tissue.
Results: We present a thorough analysis of transfer learning strategies for
colorectal cancer with confocal laser microscopy. In the peritoneum, metastases
are classified with an AUC of 97.1 and in the colon, the primarius is
classified with an AUC of 73.1. In general, transfer learning substantially
improves performance over training from scratch. We find that the optimal
transfer learning strategy differs for models and classification tasks.
Conclusions: We demonstrate that convolutional neural networks and transfer
learning can be used to identify cancer tissue with confocal laser microscopy.
We show that there is no generally optimal transfer learning strategy and model
as well as task-specific engineering is required. Given the high performance
for the peritoneum, even with a small dataset, application for intraoperative
decision support could be feasible.Comment: Accepted for publication in the International Journal of Computer
Assisted Radiology and Surgery (IJCARS