{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:46Z","timestamp":1789609126545,"version":"build-2803163510"},"reference-count":11,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>This study investigates the potential of DALL\u00b7E 3, an artificial intelligence (AI) model, to generate synthetic pathologic images of prostate cancer (PCa) at varying Gleason grades. The aim is to enhance medical education and research resources, particularly by providing diverse case studies and valuable teaching tools.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>This study uses DALL\u00b7E 3 to generate 30 synthetic images of PCa across various Gleason grades, guided by standard Gleason pattern descriptions. Nine uropathologists evaluated these images for realism and accuracy compared with actual hematoxylin and eosin (H&amp;E)\u2013stained slides using a scoring system.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              The average realism and representativeness scores were 6.04 and 6.17, indicating satisfactory quality. Scores varied significantly among Gleason patterns (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt; .05), with Gleason 5 images achieving the highest scores and accurately depicting critical pathologic characteristics. Limitations included a lack of fine nuclear detail, essential for identifying malignancy, which may affect the images' diagnostic utility.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>DALL\u00b7E 3 shows promise in generating customized pathologic images that can aid in education and resource expansion within pathology. However, ethical concerns, such as the potential misuse of AI-generated images for data falsification, highlight the need for responsible oversight. Collaboration between technology firms and pathologists is essential for the ethical integration of AI in pathology practices.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/cci-24-00267","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T20:00:17Z","timestamp":1751486417000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Application of Large Language Models in Generating Pathologic Images"],"prefix":"10.1200","author":[{"given":"Lingxuan","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"},{"name":"Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yancheng","family":"Lai","sequence":"additional","affiliation":[{"name":"The First Clinical Medical School, Southern Medical University, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Ta","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1089-6516","authenticated-orcid":true,"given":"Weiming","family":"Mou","sequence":"additional","affiliation":[{"name":"Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3938-610X","authenticated-orcid":true,"given":"Rodolfo","family":"Montironi","sequence":"additional","affiliation":[{"name":"Molecular Medicine and Cell Therapy Foundation, Polytechnic University of the Marche Region, Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9603-6731","authenticated-orcid":true,"given":"Katrina","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Pathology, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1370-6435","authenticated-orcid":true,"given":"Kenneth A.","family":"Iczkowski","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of California\u2014Davis Health, Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-4399","authenticated-orcid":true,"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, New York University Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-8164","authenticated-orcid":true,"given":"Antonio","family":"Lopez-Beltran","sequence":"additional","affiliation":[{"name":"Department of Morphological Sciences, University of Cordoba Medical School, Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0514-3206","authenticated-orcid":true,"given":"Rui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5981-5590","authenticated-orcid":true,"given":"Huang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyan","family":"Pareek","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Hyams","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragan","family":"Golijanin","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Khaleel","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3933-1598","authenticated-orcid":true,"given":"Borivoj","family":"Golijanin","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-8987","authenticated-orcid":true,"given":"Kamil","family":"Malshy","sequence":"additional","affiliation":[{"name":"Division of Urology, The Minimally Invasive Urology Institute at The Miriam Hospital, Lifespan Academic Medical Center, The Legorreta Cancer Center at Brown University, Warren Alpert Medical School of Brown University, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5981-3514","authenticated-orcid":true,"given":"Alessia","family":"Cimadamore","sequence":"additional","affiliation":[{"name":"Department of Medicine, Institute of Pathological Anatomy, University of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5246-3284","authenticated-orcid":true,"given":"Tao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, National Cancer Center\/National Clinical Research Center for Cancer \/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6049-5293","authenticated-orcid":true,"given":"Liang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, the Legorreta Cancer Center at Brown University, and Brown University Health, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-2577","authenticated-orcid":true,"given":"Rui","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02643-7"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2023.08.002"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-018-0177-5"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01620-2"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30738-7"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.5509"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2022.102537"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02504-3"},{"key":"e_1_3_6_10_2","volume-title":"DALL\u00b7E 3","unstructured":"DALL\u00b7E 3. https:\/\/openai.com\/dall-e-3"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-024-01543-8"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.labinv.2023.100255"}],"container-title":["JCO Clinical Cancer Informatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/CCI-24-00267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T20:00:22Z","timestamp":1751486422000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/CCI-24-00267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1200\/CCI-24-00267"],"URL":"https:\/\/doi.org\/10.1200\/cci-24-00267","relation":{},"ISSN":["2473-4276"],"issn-type":[{"value":"2473-4276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2024-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-15","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2400267"}}