Prostate cancer grading: use of graph cut and spatial arrangement of nuclei.

Tissue image grading is one of the most important steps in prostate cancer diagnosis, where the pathologist relies on the gland structure to assign a Gleason grade to the tissue image. In this grading scheme, the discrimination between grade 3 and grade 4 is the most difficult, and receives the most attention from researchers. In this study, we propose a novel method (called nuclei-based method) that 1) utilizes graph theory techniques to segment glands and 2) computes a gland-score (based on the spatial arrangement of nuclei) to estimate how similar a segmented region is to a gland. Next, we create a fusion method by combining this nuclei-based method with the lumen-based method presented in our previous work to improve the performance of grade 3 versus grade 4 classification problem (the accuracy is now improved to 87.3% compared to 81.1% of the lumen-based method alone). To segment glands, we build a graph of nuclei and lumina in the image, and use the normalized cut method to partition the graph into different components, each corresponding to a gland. Unlike most state-of-the-art lumen-based gland segmentation method, the nuclei-based method is able to segment glands without lumen or glands with multiple lumina. Moreover, another important contribution in this research is the development of a set of measures to exploit the difference in nuclei spatial arrangement between grade 3 images (where nuclei form closed chain structure on the gland boundary) and grade 4 image (where nuclei distribute more randomly in the gland). These measures are combined to generate a single gland-score value, which estimates how similar a segmented region (which is a set of nuclei and lumina) is to a gland.