PD-L1 expression assessment in Angiosarcoma improves with artificial intelligence support
Tumoral PD-L1 expression is assessed to weigh immunotherapy options in the treatment of various types of cancer. To determine PD-L1 expression, each tumor cell needs to be assessed to calculate the percentage of PD-L1 positive tumor cells, called tumor proportion score (TPS). Pathologists cannot evaluate each cell individually due to time constraints and thus need to approximate TPS, which has been shown to result in low concordance rates. Decision quality could be improved by an AI-based TPS prediction tool which serves as a "second opinion". Establishing such a tool requires a certain amount of training data, which manifests a bottleneck for rare cancer types such as Angiosarcoma. To address this challenge, we developed and open sourced a pipeline that leverages pre-trained and generalist models to achieve strong TPS prediction performance on limited data. Pathologists were asked to reassess patients for which their TPS strongly disagreed with the AI's prediction. In many of these cases, pathologists updated their TPS score, improving their assessment, thus demonstrating the technical feasibility and practical value of AI-based TPS scoring assistance for rare cancers.
Authors
- Christine Sers (ORCID: https://orcid.org/0000-0002-6219-1514)
- Philip Bischoff (ORCID: https://orcid.org/0000-0002-4442-7116)
- Armin Jarosch (ORCID: https://orcid.org/0000-0002-6040-394X)
- Franziska Brandes
- Fabian Reith (ORCID: https://orcid.org/0000-0003-4013-4882)
- Frederik Maximilian Schäfer
- Siyer Roohani (ORCID: https://orcid.org/0000-0002-8232-4994)
- Anne Flörcken
- Robert Öllinger (ORCID: https://orcid.org/0000-0002-4499-1673)
- Sven Märdian (ORCID: https://orcid.org/0000-0003-4220-2797)
- Jan Philipp Albrecht (ORCID: https://orcid.org/0000-0002-3792-9695)
- Alexander Dörr
- Norbert Frühauf
- D.J. Van der Horst
- Dagmar Kainmüller
- K Tielking
- F Ghoreschi
Institutions
- University of Bern (CH)
- University of Potsdam (DE)
- German Cancer Research Center (DE)
- Max Delbrück Center (DE)
- Heidelberg University (DE)
- Helmholtz-Zentrum Berlin für Materialien und Energie (DE)
- University Hospital of Bern (CH)
- Humboldt-Universität zu Berlin (DE)
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
Publication Details
- Journal
- Journal of Pathology Informatics
- Published
- 2025-05-09
- DOI
- https://doi.org/10.1016/j.jpi.2025.100447
- Primary Topic
- Vascular Tumors and Angiosarcomas
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Deutsche Forschungsgemeinschaft
- Humboldt-Universität zu Berlin
- Berlin Institute of Health