The Role of Artificial Intelligence in the Evaluation of Prostate Pathology

ABSTRACT Artificial intelligence (AI) is an emerging tool in diagnostic pathology, including prostate pathology. This review summarizes the possibilities offered by AI and also discusses the challenges and risks. AI has the potential to assist in the diagnosis and grading of prostate cancer. Diagnostic safety can be enhanced by avoiding the accidental underdiagnosis of small lesions. Another possible benefit is a greater degree of standardization of grading. AI for clinical use needs to be trained on large, high‐quality data sets that have been assessed by experienced pathologists. A problem with the use of AI in prostate pathology is the plethora of benign mimics of prostate cancer and morphological variants of cancer that are too unusual to allow sufficient training of AI. AI systems need to be able to account for variations in local routines for cutting, staining, and scanning of slides. We also need to be aware of the risk that users will rely too much on the output of an AI system, leading to diagnostic errors and loss of clinical competence. The reporting pathologist must ultimately be responsible for accepting or rejecting the diagnosis proposed by AI.