Combining Artificial Intelligence and Simplified Image Processing for the Automatic Detection of Mycobacterium tuberculosis in Acid-fast Stain : A Cross-institute Training and Validation Study

Am J Surg Pathol. 2024 Jul 1;48(7):866-873. doi: 10.1097/PAS.0000000000002223. Epub 2024 Apr 9.

Abstract

Tuberculosis (TB) poses a significant health threat in Taiwan, necessitating efficient detection methods. Traditional screening for acid-fast positive bacilli in acid-fast stain is time-consuming and prone to human error due to staining artifacts. To address this, we present an automated TB detection platform leveraging deep learning and image processing. Whole slide images from 2 hospitals were collected and processed on a high-performance system. The system utilizes an image processing technique to highlight red, rod-like regions and a modified EfficientNet model for binary classification of TB-positive regions. Our approach achieves a 97% accuracy in tile-based TB image classification, with minimal loss during the image processing step. By setting a 0.99 threshold, false positives are significantly reduced, resulting in a 94% detection rate when assisting pathologists, compared with 68% without artificial intelligence assistance. Notably, our system efficiently identifies artifacts and contaminants, addressing challenges in digital slide interpretation. Cross-hospital validation demonstrates the system's adaptability. The proposed artificial intelligence-assisted pipeline improves both detection rates and time efficiency, making it a promising tool for routine pathology work in TB detection.

Publication types

  • Validation Study
  • Multicenter Study

MeSH terms

  • Artificial Intelligence
  • Automation, Laboratory
  • Bacteriological Techniques
  • Deep Learning*
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Mycobacterium tuberculosis* / isolation & purification
  • Predictive Value of Tests
  • Reproducibility of Results
  • Staining and Labeling / methods
  • Taiwan
  • Tuberculosis* / diagnosis
  • Tuberculosis* / microbiology