Publikationen

2024

• Prediction of tumor board procedural recommendations using large language models

  Aubreville, M. ., Ganz, J. ., Ammeling, J. ., Rosbach, E. ., Gehrke, T. ., Scherzad, A. ., … Goncalves, M. . (2024). Prediction of tumor board procedural recommendations using large language models. European Archives of Oto-Rhino-Laryngology. http://doi.org/10.1007/s00405-024-08947-9 (Original work published 2025)

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  Multidisciplinary tumor boards are meetings where a team of medical specialists, including medical oncologists, radiation oncologists, radiologists, surgeons, and pathologists, collaborate to determine the best treatment plan for cancer patients. While decision-making in this context is logistically and cost-intensive, it has a significant positive effect on overall cancer survival.

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    • Aubreville, Marc

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research

  • Profilbereich

    • Informatik und Gestaltung

  • Forschungsfeld

    • Digitalisierung im Gesundheitswesen
    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Marc Aubreville
    • Jonathan Ganz
    • Jonas Ammeling
    • Emely Rosbach
    • Thomas Gehrke
    • Agmal Scherzad
    • Stephan Hackenberg
    • Miguel Goncalves

• Re-identification from histopathology images

  Ganz, J. ., Ammeling, J. ., Jabari, S. ., Breininger, K. ., & Aubreville, M. . (2024). Re-identification from histopathology images. Medical Image Analysis, 103335. http://doi.org/10.1016/j.media.2024.103335 (Original work published 2025)

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    • Aubreville, Marc

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research

  • Forschungsfeld

    • Digitalisierung im Gesundheitswesen
    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Jonathan Ganz
    • Jonas Ammeling
    • Samir Jabari
    • Katharina Breininger
    • Marc Aubreville

• Breast cancer survival prediction using an automated mitosis detection pipeline

  Stathonikos, N. ., Aubreville, M. ., de Vries, S. ., Wilm, F. ., Bertram, C. A., Veta, M. ., & van Diest, P. J. (2024). Breast cancer survival prediction using an automated mitosis detection pipeline. The Journal of Pathology: Clinical Research, 10, e70008. http://doi.org/https://doi.org/10.1002/2056-4538.70008

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  Abstract Mitotic count (MC) is the most common measure to assess tumor proliferation in breast cancer patients and is highly predictive of patient outcomes. It is, however, subject to inter- and intraobserver variation and reproducibility challenges that may hamper its clinical utility. In past studies, artificial intelligence (AI)-supported MC has been shown to correlate well with traditional MC on glass slides. Considering the potential of AI to improve reproducibility of MC between pathologists, we undertook the next validation step by evaluating the prognostic value of a fully automatic method to detect and count mitoses on whole slide images using a deep learning model. The model was developed in the context of the Mitosis Domain Generalization Challenge 2021 (MIDOG21) grand challenge and was expanded by a novel automatic area selector method to find the optimal mitotic hotspot and calculate the MC per 2 mm2. We employed this method on a breast cancer cohort with long-term follow-up from the University Medical Centre Utrecht (N = 912) and compared predictive values for overall survival of AI-based MC and light-microscopic MC, previously assessed during routine diagnostics. The MIDOG21 model was prognostically comparable to the original MC from the pathology report in uni- and multivariate survival analysis. In conclusion, a fully automated MC AI algorithm was validated in a large cohort of breast cancer with regard to retained prognostic value compared with traditional light-microscopic MC.

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    • Aubreville, Marc

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research

  • Profilbereich

    • Informatik und Gestaltung

  • Forschungsfeld

    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Nikolas Stathonikos
    • Marc Aubreville
    • Sjoerd de Vries
    • Frauke Wilm
    • Christof Bertram
    • Mitko Veta
    • Paul van Diest
  • • artificial intelligence
    • machine learning
    • histopathology
    • prognosis
    • mitosis
    • outcome
    • deep learning

• Information mismatch in PHH3-assisted mitosis annotation leads to interpretation shifts in H&E slide analysis

  Ganz, J. ., Marzahl, C. ., Ammeling, J. ., Rosbach, E. ., Richter, B. ., Puget, C. ., … Aubreville, M. . (2024). Information mismatch in PHH3-assisted mitosis annotation leads to interpretation shifts in H&E slide analysis. Scientific Reports, 14, 26273. http://doi.org/10.1038/s41598-024-77244-6

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  Abstract The count of mitotic figures (MFs) observed in hematoxylin and eosin (H&E)-stained slides is an important prognostic marker, as it is a measure for tumor cell proliferation. However, the identification of MFs has a known low inter-rater agreement. In a computer-aided setting, deep learning algorithms can help to mitigate this, but they require large amounts of annotated data for training and validation. Furthermore, label noise introduced during the annotation process may impede the algorithms’ performance. Unlike H&E, where identification of MFs is based mainly on morphological features, the mitosis-specific antibody phospho-histone H3 (PHH3) specifically highlights MFs. Counting MFs on slides stained against PHH3 leads to higher agreement among raters and has therefore recently been used as a ground truth for the annotation of MFs in H&E. However, as PHH3 facilitates the recognition of cells indistinguishable from H&E staining alone, the use of this ground truth could potentially introduce an interpretation shift and even label noise into the H&E-related dataset, impacting model performance. This study analyzes the impact of PHH3-assisted MF annotation on inter-rater reliability and object level agreement through an extensive multi-rater experiment. Subsequently, MF detectors, including a novel dual-stain detector, were evaluated on the resulting datasets to investigate the influence of PHH3-assisted labeling on the models’ performance. We found that the annotators’ object-level agreement significantly increased when using PHH3-assisted labeling (F1: 0.53 to 0.74). However, this enhancement in label consistency did not translate to improved performance for H&E-based detectors, neither during the training phase nor the evaluation phase. Conversely, the dual-stain detector was able to benefit from the higher consistency. This reveals an information mismatch between the H&E and PHH3-stained images as the cause of this effect, which renders PHH3-assisted annotations not well-aligned for use with H&E-based detectors. Based on our findings, we propose an improved PHH3-assisted labeling procedure.

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    • Aubreville, Marc

  • Forschungsprojekt

    • Robust and Accurate Multi-Tumor, Multi-Species, Multi-Laboratory and Multi-Scanner Mitosis Detection with Large-Scale Datasets and Artificial Intelligence

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research
    • CIVU – Center for Interaction, Visualization and Usability

  • Profilbereich

    • Informatik und Gestaltung

  • Forschungsfeld

    • Human-Computer-Interaction
    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Jonathan Ganz
    • Christian Marzahl
    • Jonas Ammeling
    • Emely Rosbach
    • Barbara Richter
    • Chloé Puget
    • Daniela Denk
    • Elena Demeter
    • Flaviu Tăbăran
    • Gabriel Wasinger
    • Karoline Lipnik
    • Marco Tecilla
    • Matthew Valentine
    • Michael Dark
    • Niklas Abele
    • Pompei Bolfa
    • Ramona Erber
    • Robert Klopfleisch
    • Sophie Merz
    • Taryn Donovan
    • Samir Jabari
    • Christof Bertram
    • Katharina Breininger
    • Marc Aubreville

• Nuclear pleomorphism in canine cutaneous mast cell tumors: Comparison of reproducibility and prognostic relevance between estimates, manual morphometry, and algorithmic morphometry

  Haghofer, A. ., Parlak, E. ., Bartel, A. ., Donovan, T. ., Assenmacher, C.-A. ., Bolfa, P. ., … Bertram, C. . (2024). Nuclear pleomorphism in canine cutaneous mast cell tumors: Comparison of reproducibility and prognostic relevance between estimates, manual morphometry, and algorithmic morphometry. Veterinary Pathology, 03009858241295399. http://doi.org/10.1177/03009858241295399

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  Variation in nuclear size and shape is an important criterion of malignancy for many tumor types; however, categorical estimates by pathologists have poor reproducibility. Measurements of nuclear characteristics can improve reproducibility, but current manual methods are time-consuming. The aim of this study was to explore the limitations of estimates and develop alternative morphometric solutions for canine cutaneous mast cell tumors (ccMCTs). We assessed the following nuclear evaluation methods for accuracy, reproducibility, and prognostic utility: (1) anisokaryosis estimates by 11 pathologists; (2) gold standard manual morphometry of at least 100 nuclei; (3) practicable manual morphometry with stratified sampling of 12 nuclei by 9 pathologists; and (4) automated morphometry using deep learning–based segmentation. The study included 96 ccMCTs with available outcome information. Inter-rater reproducibility of anisokaryosis estimates was low (k = 0.226), whereas it was good (intraclass correlation = 0.654) for practicable morphometry of the standard deviation (SD) of nuclear size. As compared with gold standard manual morphometry (area under the ROC curve [AUC] = 0.839, 95% confidence interval [CI] = 0.701–0.977), the prognostic value (tumor-specific survival) of SDs of nuclear area for practicable manual morphometry and automated morphometry were high with an AUC of 0.868 (95% CI = 0.737–0.991) and 0.943 (95% CI = 0.889–0.996), respectively. This study supports the use of manual morphometry with stratified sampling of 12 nuclei and algorithmic morphometry to overcome the poor reproducibility of estimates. Further studies are needed to validate our findings, determine inter-algorithmic reproducibility and algorithmic robustness, and explore tumor heterogeneity of nuclear features in entire tumor sections.

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    • Aubreville, Marc

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research

  • Profilbereich

    • Informatik und Gestaltung

  • Forschungsfeld

    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Andreas Haghofer
    • Eda Parlak
    • Alexander Bartel
    • Taryn Donovan
    • Charles-Antoine Assenmacher
    • Pompei Bolfa
    • Michael Dark
    • Andrea Fuchs-Baumgartinger
    • Andrea Klang
    • Kathrin Jäger
    • Robert Klopfleisch
    • Sophie Merz
    • Barbara Richter
    • Yvonne Schulman
    • Hannah Janout
    • Jonathan Ganz
    • Josef Scharinger
    • Marc Aubreville
    • Stephan Winkler
    • Matti Kiupel
    • Christof Bertram

• An Interdisciplinary Perspective on AI-Supported Decision Making in Medicine

  Ammeling, J. ., Aubreville, M. ., Fritz, A. ., Kießig, A. ., Krügel, S. ., & Uhl, M. . (2024). An Interdisciplinary Perspective on AI-Supported Decision Making in Medicine. Technology in Society, 102791.

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  • Personenseiten

    • Aubreville, Marc

  • Forschungsprojekt

    • Robust and Accurate Multi-Tumor, Multi-Species, Multi-Laboratory and Multi-Scanner Mitosis Detection with Large-Scale Datasets and Artificial Intelligence

  • Abteilung/Einrichtung

    • FLAIR - Flensburg Artificial Intelligence Research
    • CIVU – Center for Interaction, Visualization and Usability

  • Profilbereich

    • Informatik und Gestaltung

  • Forschungsfeld

    • Data Science und Künstliche Intelligenz

  • Fachbereich

    • Fachbereich 3: Information und Kommunikation

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  • 2024
  • Journal Article
  • • Jonas Ammeling
    • Marc Aubreville
    • Alexis Fritz
    • Angelika Kießig
    • Sebastian Krügel
    • Matthias Uhl