Accurate prediction of the treatment outcome is important for cancer treatment planning. We present an approach to predict prostate cancer (PCa) recurrence after radical prostatectomy using tissue images. We used a cohort whose case vs. control (recurrent vs. non-recurrent) status had been determined using post-treatment follow up. Further, to aid the development of novel biomarkers of PCa recurrence, cases and controls were paired based on matching of other predictive clinical variables such as Gleason grade, stage, age, and race. For this cohort, tissue resection microarray with up to four cores per patient was available. The proposed approach is based on deep learning, and its novelty lies in the use of two separate convolutional neural networks (CNNs)
– one to detect individual nuclei even in the crowded areas, and the other to classify them. To detect nuclear centers in an image, the first CNN predicts distance transform of the underlying (but unknown) multi-nuclear map from the input HE image. The second CNN classifies the patches centered at nuclear centers into those belonging to cases or controls. Voting across patches extracted from image(s) of a patient yields the probability of recurrence for the patient. The proposed approach gave 0.81 AUC for a sample of 30 recurrent cases and 30 non-recurrent controls, after being trained on an independent set of 80 case-controls pairs. If validated further, such an approach might help in choosing between a combination of treatment options such as active surveillance, radical prostatectomy, radiation, and hormone therapy. It can also generalize to the prediction of treatment outcomes in other cancers.