# Slideflow: deep learning for digital histopathology with real-time whole-slide visualization

**Authors:** James M. Dolezal, Sara Kochanny, Emma Dyer, Siddhi Ramesh, Andrew Srisuwananukorn, Matteo Sacco, Frederick M. Howard, Anran Li, Prajval Mohan, Alexander T. Pearson

PMC · DOI: 10.1186/s12859-024-05758-x · 2024-03-27

## TL;DR

Slideflow is a deep learning library for digital histopathology that offers a flexible and interactive interface for analyzing whole-slide images.

## Contribution

Slideflow introduces a framework-agnostic deep learning library with real-time whole-slide visualization and efficient data processing tools.

## Key findings

- Slideflow enables whole-slide tile extraction at 40x magnification in 2.5 seconds per slide.
- The library supports rapid experimentation with deep learning methods using either Tensorflow or PyTorch.
- It includes tools for stain normalization, weakly-supervised classification, and real-time visualization on various hardware.

## Abstract

Deep learning methods have emerged as powerful tools for analyzing histopathological images, but current methods are often specialized for specific domains and software environments, and few open-source options exist for deploying models in an interactive interface. Experimenting with different deep learning approaches typically requires switching software libraries and reprocessing data, reducing the feasibility and practicality of experimenting with new architectures. We developed a flexible deep learning library for histopathology called Slideflow, a package which supports a broad array of deep learning methods for digital pathology and includes a fast whole-slide interface for deploying trained models. Slideflow includes unique tools for whole-slide image data processing, efficient stain normalization and augmentation, weakly-supervised whole-slide classification, uncertainty quantification, feature generation, feature space analysis, and explainability. Whole-slide image processing is highly optimized, enabling whole-slide tile extraction at 40x magnification in 2.5 s per slide. The framework-agnostic data processing pipeline enables rapid experimentation with new methods built with either Tensorflow or PyTorch, and the graphical user interface supports real-time visualization of slides, predictions, heatmaps, and feature space characteristics on a variety of hardware devices, including ARM-based devices such as the Raspberry Pi.

The online version contains supplementary material available at 10.1186/s12859-024-05758-x.

## Full-text entities

- **Genes:** BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673] {aka B-RAF1, B-raf, BRAF-1, BRAF1, NS7, RAFB1}, ESR1 (estrogen receptor 1) [NCBI Gene 2099] {aka ER, ESR, ESRA, ESTRR, Era, NR3A1}
- **Diseases:** adenocarcinoma (MESH:D000230), CLAM (MESH:D007859), lung cancer (MESH:D008175), thyroid cancer (MESH:D013964), squamous cell carcinoma (MESH:D002294), breast cancer (MESH:D001943), head and neck squamous cell carcinoma (MESH:D000077195), WSI (MESH:C564543), inflammation (MESH:D007249), head and neck cancer (MESH:D006258), Cancer (MESH:D009369)
- **Chemicals:** hematoxylin (MESH:D006416), Slideflow (-), ATP (MESH:D000255), H&amp;E (MESH:D006371), VIPS (MESH:C056638)
- **Species:** Homo sapiens (human, species) [taxon 9606], Human papillomavirus (species) [taxon 10566]

## Figures

15 figures with captions in the complete paper: https://tomesphere.com/paper/PMC10967068/full.md

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Source: https://tomesphere.com/paper/PMC10967068