{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:57:13Z","timestamp":1790740633418,"version":"4.1.0"},"reference-count":56,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Korean Government (MSIT)","award":["(2021R1A2C2013630)"],"award-info":[{"award-number":["(2021R1A2C2013630)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>A Pleural effusion cytology is vital for treating metastatic breast cancer; however, concerns have arisen regarding the low accuracy and inter-observer variability in cytologic diagnosis. Although artificial intelligence-based image analysis has shown promise in cytopathology research, its application in diagnosing breast cancer in pleural fluid remains unexplored. To overcome these limitations, we evaluate the diagnostic accuracy of an artificial intelligence-based model using a large collection of cytopathological slides, to detect the malignant pleural effusion cytology associated with breast cancer. This study includes a total of 569 cytological slides of malignant pleural effusion of metastatic breast cancer from various institutions. We extracted 34,221 augmented image patches from whole-slide images and trained and validated a deep convolutional neural network model (DCNN) (Inception-ResNet-V2) with the images. Using this model, we classified 845 randomly selected patches, which were reviewed by three pathologists to compare their accuracy. The DCNN model outperforms the pathologists by demonstrating higher accuracy, sensitivity, and specificity compared to the pathologists (81.1% vs. 68.7%, 95.0% vs. 72.5%, and 98.6% vs. 88.9%, respectively). The pathologists reviewed the discordant cases of DCNN. After re-examination, the average accuracy, sensitivity, and specificity of the pathologists improved to 87.9, 80.2, and 95.7%, respectively. This study shows that DCNN can accurately diagnose malignant pleural effusion cytology in breast cancer and has the potential to support pathologists.<\/jats:p>","DOI":"10.3390\/cells12141847","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:28:06Z","timestamp":1689294486000},"page":"1847","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Deep Learning-Based Computational Cytopathologic Diagnosis of Metastatic Breast Carcinoma in Pleural Fluid"],"prefix":"10.3390","volume":"12","author":[{"given":"Hong Sik","family":"Park","sequence":"first","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8615-3064","authenticated-orcid":false,"given":"Yosep","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2840-6603","authenticated-orcid":false,"given":"Yujin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8767-9033","authenticated-orcid":false,"given":"Kwangil","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1908-9696","authenticated-orcid":false,"given":"Kyung Jin","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisu","family":"Hwang","sequence":"additional","affiliation":[{"name":"AI Team, DeepNoid Inc., Seoul 08376, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"AI Team, DeepNoid Inc., Seoul 08376, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyungyub","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Asan Medical Center, Seoul 05505, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0045-6441","authenticated-orcid":false,"given":"Nam Hoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Woo","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cancer Center, Ilsan, Goyang-si 10408, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2292-424X","authenticated-orcid":false,"given":"Hyun Joo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. 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