1. CAMELYON17: Moving the challenge to patient level
Oscar Geessink Radboud University Medical Center
Nijmegen, The Netherlands

2. Aim
To evaluate algorithms for automated assessment of H&E-stained lymph node slides
Detection
Lesion-level + Slide-level

3. Aim
To evaluate algorithms for automated assessment of H&E-stained lymph node slides
Detection
Lesion-level + Slide-level
Detection + Classification
Patient-level

4. Motivation for CAMELYON17
In clinical practice:
There are multiple lymph node slides per patient
It’s irrelevant to detect all lesions in a single slide
Pathologist have to report on isolated tumor cells as well

5. TNM-staging system Tumor – lymph Node – Metastasis
Classify the extent of cancer spread
Indication of patient prognosis
Guide treatment
pN-stage is an essential part of TNM
Therapeutic implications for breast cancer patients

6. Task Determine a pN-stage per patient
Two categories of lymph node metastasis:
Macro: > 2.0 mm
Micro: > 0.2 mm ( or > 200 cells), but < 2.0 mm
Isolated tumor cells, are not counted as metastases:
ITC: < 0.2 mm (or < 200 cells)

7. Task Simplified pN-stage: pN0: No tumor cells pN0(i+): Only ITCs
pN1mi: Only micro-metastases
pN1: Metastases in 1–3 nodes, at least 1 macro
pN2: Metastases in 4–9 nodes, at least 1 macro

8. Patients Slides from 5 centers Forged artificial “patients”
1 patient = 5 slides
Every patient labeled with a pN-stage
1 slide = 1 lymph node
Every slide labeled:
Macro
Micro
ITC
Negative

9. Patients Training_Patient_024 pN-stage: pN1 Slides from 5 centers
Slide 1: Micro
Slide 2: Macro
Slide 3: Micro
Slide 4: ITC
Slide 5: Negative
Slides from 5 centers
Forged artificial “patients”
1 patient = 5 slides
Every patient labeled with a pN-stage
1 slide = 1 lymph node
Every slide labeled:
Macro
Micro
ITC
Negative

10. Training data
400 slides
Lesion-level annotations

11. Training data 400 slides Lesion-level annotations
500 slides (100 patients)
Slide-level labels
Patient-level labels
50 Lesion-level annotations

12. Training data Training_Patient_024 pN-stage: pN1 400 slides
Slide 1: Micro
Slide 2: Macro
Slide 3: Micro
Slide 4: ITC
Slide 5: Negative
400 slides
Lesion-level annotations
500 slides (100 patients)
Slide-level labels
Patient-level labels
50 Lesion-level annotations

13. Testing data
500 slides (100 patients)
No labels/annotations

14. Testing data Test_Patient_151 pN-stage: ? 500 slides (100 patients)
No labels/annotations

15. Questions?