Human-level recognition of blast cells in acute myeloid leukaemia with convolutional neural networks

Reliable recognition of malignant white blood cells is a key step in the diagnosis of haematologic malignancies such as acute myeloid leukaemia. Microscopic morphological examination of blood cells is usually performed by trained human examiners, making the process tedious, time-consuming and hard to standardize. Here, we compile an annotated image dataset of over 18,000 white blood cells, use it to train a convolutional neural network for leukocyte classification and evaluate the network’s performance by comparing to inter- and intra-expert variability. The network classifies the most important cell types with high accuracy. It also allows us to decide two clinically relevant questions with human-level performance: (1) if a given cell has blast character and (2) if it belongs to the cell types normally present in non-pathological blood smears. Our approach holds the potential to be used as a classification aid for examining much larger numbers of cells in a smear than can usually be done by a human expert. This will allow clinicians to recognize malignant cell populations with lower prevalence at an earlier stage of the disease. Deep learning is currently transforming digital pathology, helping to make more reliable and faster clinical diagnoses. A promising application is in the recognition of malignant white blood cells—an essential step for detecting acute myeloid leukaemia that is challenging even for trained human examiners. An annotated image dataset of over 18,000 white blood cells is compiled and used to train a convolutional neural network for leukocyte classification. The network classifies the most important cell types with high accuracy and can answer clinically relevant binary questions with human-level performance.