Whole slide imaging-based deep learning to predict the treatment response of patients with non-small cell lung cancer

Background: This study developed and validated a deep learning (DL) model based on whole slide imaging (WSI) for predicting the treatment response to chemotherapy and radiotherapy (CRT) among patients with non-small cell lung cancer (NSCLC). Methods: We collected the WSI of 120 nonsurgical patients with NSCLC treated with CRT from three hospitals in China. Based on the processed WSI, two DL models were established: a tissue classification model which was used to select tumor-tiles, and another model which predicted the treatment response of the patients based on the tumor-tiles (predicting the treatment response of each tile). A voting method was employed, by which the label of tiles with the greatest quantity from 1 patient would be used as the label of the patient. Results: The tissue classification model had a great performance (accuracy in the training set/internal validation set =0.966/0.956). Based on 181,875 tumor-tiles selected by the tissue classification model, the model for predicting the treatment response demonstrated strong predictive ability (accuracy of patient-level prediction in the internal validation set/external validation set 1/external validation set 2 =0.786/0.742/0.737). Conclusions: A DL model was constructed based on WSI to predict the treatment response of patients with NSCLC. This model can help doctors to formulate personalized CRT plans and improve treatment outcomes.