Prostate cancer is a common cancer type in men, yet some of its traits are still under-explored. One reason for this is high molecular and morphological heterogeneity. The purpose of this study was to develop a method to gain new insights into the connection between morphological changes and underlying molecular patterns. We used artificial intelligence (AI) to analyze the morphology of seven hematoxylin and eosin (H & E)-stained prostatectomy slides from a patient with multi-focal prostate cancer. We also paired the slides with spatially resolved expression for thousands of genes obtained by a novel spatial transcriptomics (ST) technique. As both spaces are highly dimensional, we focused on dimensionality reduction before seeking associations between them. Consequently, we extracted morphological features from H & E images using an ensemble of pre-trained convolutional neural networks and proposed a workflow for dimensionality reduction. To summarize the ST data into genetic profiles, we used a previously proposed factor analysis. We found that the regions were automatically defined, outlined by unsupervised clustering, associated with independent manual annotations, in some cases, finding further relevant subdivisions. The morphological patterns were also correlated with molecular profiles and could predict the spatial variation of individual genes. This novel approach enables flexible unsupervised studies relating morphological and genetic heterogeneity using AI to be carried out.

Spatial-omics techniques are used for profiling the local gene expression of a sample, while imaging is typically used for capturing the phenotype, in turn determined by the gene expression. However, the correlation between them may not necessarily be direct. Tissue morphology can also reflect genes expressed during development, or gene expression may not yet have resulted in tissue restructuring. Thus, recent efforts have shown that integration of spatial-omics with imaging provides additional information of biological relevance. In this work, we show that morphological feature extraction on H&E images using self-supervised learning is more versatile for capturing relevant tissue domains compared with the previously proposed approaches. Furthermore, self-supervised learning allows the novel use of DAPI for domain identification, which enables morphological integration also for experiments where H&E staining is not available.

Automatic segmentation of histopathology whole -slide images (WSI) usually involves supervised training of deep learning models with pixel -level labels to classify each pixel of the WSI into tissue regions such as benign or cancerous. However, fully supervised segmentation requires large-scale data manually annotated by experts, which can be expensive and time-consuming to obtain. Non -fully supervised methods, ranging from semi -supervised to unsupervised, have been proposed to address this issue and have been successful in WSI segmentation tasks. But these methods have mainly been focused on technical advancements in algorithmic performance rather than on the development of practical tools that could be used by pathologists or researchers in real -world scenarios. In contrast, we present DEPICTER (Deep rEPresentatIon ClusTERing), an interactive segmentation tool for histopathology annotation that produces a patch -wise dense segmentation map at WSI level. The interactive nature of DEPICTER leverages self- and semi -supervised learning approaches to allow the user to participate in the segmentation producing reliable results while reducing the workload. DEPICTER consists of three steps: first, a pretrained model is used to compute embeddings from image patches. Next, the user selects a number of benign and cancerous patches from the multi -resolution image. Finally, guided by the deep representations, label propagation is achieved using our novel seeded iterative clustering method or by directly interacting with the embedding space via feature space gating. We report both real-time interaction results with three pathologists and evaluate the performance on three public cancer classification dataset benchmarks through simulations. The code and demos of DEPICTER are publicly available at https://github.com/eduardchelebian/depicter.