Deep neural networks for automated classification of colorectal polyps on histopathology slides: A multi-institutional evaluation

Histological classification of colorectal polyps plays a critical role in both screening for colorectal cancer and care of affected patients. In this study, we developed a deep neural network for classification of four major colorectal polyp types on digitized histopathology slides and compared its performance to local pathologists' diagnoses at the point-of-care retrieved from corresponding pathology labs. We evaluated the deep neural network on an internal dataset of 157 histopathology slides from the Dartmouth-Hitchcock Medical Center (DHMC) in New Hampshire, as well as an external dataset of 513 histopathology slides from 24 different institutions spanning 13 states in the United States. For the internal evaluation, the deep neural network had a mean accuracy of 93.5% (95% CI 89.6%-97.4%), compared with local pathologists' accuracy of 91.4% (95% CI 87.0%-95.8%). On the external test set, the deep neural network achieved an accuracy of 85.7% (95% CI 82.7%-88.7%), significantly outperforming the accuracy of local pathologists at 80.9% (95% CI 77.5%-84.3%, p<0.05) at the point-of-care. If confirmed in clinical settings, our model could assist pathologists by improving the diagnostic efficiency, reproducibility, and accuracy of colorectal cancer screenings.