A study of criteria for grading follicular lymphoma using a cell type classifier from pathology images based on complementary-label learning

We propose a criterion for grading follicular lymphoma that is consistent with the intuitive evaluation, which is conducted by experienced pathologists. A criterion for grading follicular lymphoma is defined by the World Health Organization (WHO) based on the number of centroblasts and centrocytes within the field of view. However, the WHO criterion is not often used in clinical practice because it is impractical for pathologists to visually identify the cell type of each cell and count the number of centroblasts and centrocytes. Hence, based on the widespread use of digital pathology, we make it practical to identify and count the cell type by using image processing and then construct a criterion for grading based on the number of cells. Here, the problem is that labeling the cell type is not easy even for experienced pathologists. To alleviate this problem, we build a new dataset for cell type classification, which contains the pathologists’ confusion records during labeling, and we construct the cell type classifier using complementary-label learning from this dataset. Then we propose a criterion based on the composition ratio of cell types that is consistent with the pathologists’ grading. Our experiments demonstrate that the classifier can accurately identify cell types and the proposed criterion is more consistent with the pathologists’ grading than the current WHO criterion. [Display omitted] •Proposed follicular lymphoma grading reflecting pathologists’ intuition.•Highlighted impracticality of the current WHO criterion in clinical practice.•Identified and counted cell type based on computational pathology.•Created a new dataset with pathologists’ cell type labeling confusion.•Demonstrated higher alignment of proposed criterion with pathologists’ grading.