Deep Interactive Learning: An Efficient Labeling Approach for Deep Learning-Based Osteosarcoma Treatment Response Assessment
David Joon Ho, Narasimhan P. Agaram, Peter J. Schueffler, Chad M., Vanderbilt, Marc-Henri Jean, Meera R. Hameed, Thomas J. Fuchs

TL;DR
This paper introduces Deep Interactive Learning (DIaL), a method that significantly reduces annotation time for training CNNs to assess osteosarcoma treatment response, achieving accurate necrosis ratio estimation with minimal labeling effort.
Contribution
The paper presents DIaL, an efficient interactive annotation approach that minimizes manual labeling time for training CNNs in medical image segmentation tasks.
Findings
CNN trained with 7 hours of annotation achieves expert-level necrosis ratio estimation.
DIaL reduces annotation effort compared to traditional supervised learning methods.
Model predictions fall within inter-observer variability for pathology assessments.
Abstract
Osteosarcoma is the most common malignant primary bone tumor. Standard treatment includes pre-operative chemotherapy followed by surgical resection. The response to treatment as measured by ratio of necrotic tumor area to overall tumor area is a known prognostic factor for overall survival. This assessment is currently done manually by pathologists by looking at glass slides under the microscope which may not be reproducible due to its subjective nature. Convolutional neural networks (CNNs) can be used for automated segmentation of viable and necrotic tumor on osteosarcoma whole slide images. One bottleneck for supervised learning is that large amounts of accurate annotations are required for training which is a time-consuming and expensive process. In this paper, we describe Deep Interactive Learning (DIaL) as an efficient labeling approach for training CNNs. After an initial labeling…
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