Intraoperative cytological diagnosis of brain tumours: A preliminary study using a deep learning model

© 2022 John Wiley & Sons Ltd.Background: Intraoperative pathological diagnosis of central nervous system (CNS) tumours is essential to planning patient management in neuro-oncology. Frozen section slides and cytological preparations provide architectural and cellular information that is analysed by pathologists to reach an intraoperative diagnosis. Progress in the fields of artificial intelligence and machine learning means that AI systems have significant potential for the provision of highly accurate real-time diagnosis in cytopathology. Objective: To investigate the efficiency of machine-learning models in the intraoperative cytological diagnosis of CNS tumours. Materials and Methods: We trained a deep neural network to classify biopsy material for intraoperative tissue diagnosis of four major brain lesions. Overall, 205 medical images were obtained from squash smear slides of histologically correlated cases, with 18 high-grade and 11 low-grade gliomas, 17 metastatic carcinomas, and 9 non-neoplastic pathological brain tissue samples. The neural network model was trained and evaluated using 5-fold cross-validation. Results: The model achieved 95% and 97% diagnostic accuracy in the patch-level classification and patient-level classification tasks, respectively. Conclusions: We conclude that deep learning-based classification of cytological preparations may be a promising complementary method for the rapid and accurate intraoperative diagnosis of CNS tumours