ArticleNature communications2025
Pathologist-like explainable AI for interpretable Gleason grading in prostate cancer.
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Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5citing papers in PubMed
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Who cites it
5 citing papers in PubMed.
- Artificial intelligence-assisted histopathological diagnosis of endocervical gastric-type adenocarcinoma: a multicenter model development and validation study.The journal of pathology. Clinical research · 2026Article
- A human-in-the-loop explanation framework for morphologically transparent AI predictions from whole-slide images.NPJ digital medicine · 2026Article
- Artificial intelligence in urological malignancy diagnosis and prognosis: current status and future prospects.The Canadian journal of urology · 2026Review
- Concordance among experts in assessing apical mucosal preservation during holmium laser enucleation of the prostate (HoLEP): implications for artificial intelligence model development.World journal of urology · 2025Article
- Pathologist-like explainable AI for interpretable Gleason grading in prostate cancer.Nature communications · 2025Article
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Authors and funding
67 authors.
Gesa Mittmann *Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0009-0005-0375-4689
Sara Laiouar-Pedari *Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Hendrik A Mehrtens *Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Sarah HaggenmüllerDivision of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Tabea-Clara BucherDivision of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Tirtha ChandaDivision of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0009-0009-0649-9301
Nadine T GaisaInstitute of Pathology, RWTH Aachen University, Aachen, Germany.
Mathias WagnerDepartment of Pathology, University of Saarland, Homburg Saar Campus, Homburg Saar, Germany.
Gilbert Georg KlammingerDepartment of Pathology, University of Saarland, Homburg Saar Campus, Homburg Saar, Germany.
Tilman T RauHeinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany.
Christina NepplHeinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany.
Eva Maria CompératDepartment of Pathology, Medical University of Vienna, Vienna, Austria.
Andreas GochtInstitute of Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany.
Monika HaemmerleInstitute of Pathology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.ORCID http://orcid.org/0000-0003-3145-0541
Niels J RuppDepartment of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
Jula WesthoffInstitute of Pathology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
Irene KrückenInstitute of Pathology, Klinikum Bremen Mitte, Bremen, Germany.
Maximilian SeidlHeinrich-Heine-University and University Hospital Düsseldorf, Düsseldorf, Germany.ORCID http://orcid.org/0000-0002-5559-4980
Christian M SchürchDepartment of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany.ORCID http://orcid.org/0000-0002-1792-1768
Marcus BauerInstitute of Pathology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.ORCID http://orcid.org/0000-0002-0657-6831
Wiebke SolassInstitute of Tissue Medicine and Pathology, University Bern, Bern, Switzerland.
Yu Chun TamInstitute of Pathology, Georgius Agricola Foundation Ruhr, Ruhr University Bochum, Bochum, Germany.
Florian WeberInstitute of Pathology, University of Regensburg, Regensburg, Germany.ORCID http://orcid.org/0000-0001-7480-8828
Rainer GrobholzFaculty of Medicine, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-1901-7967
Jaroslaw AugustyniakLaborteam Pathology, Goldach, Switzerland.
Thomas KalinskiInstitute of Pathology, Brandenburg Medical School Theodor Fontane, University Hospital Brandenburg an der Havel, Brandenburg an der Havel, Germany.
Christian HörnerInstitute for Pathology, University Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Kirsten D MertzInstitute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.
Constanze DöringPathology Zwickau, MVZ diagnosticum Stollberg, Zweigpraxis Zwickau, Zwickau, Germany.
Andreas ErbersdoblerInstitute of Pathology, University Medicine Rostock, Rostock, Germany.
Gabriele DeublerInstitute of Pathology, Kreiskliniken Reutlingen, Reutlingen, Germany.
Felix BremmerInstitute of Pathology, University Medical Center Goettingen, Goettingen, Germany.
Ulrich SommerInstitute of Pathology, University Hospital of Dresden, Dresden, Germany.
Michael BrodhunInstitute of Pathology and Neuropathology, HELIOS Klinikum Erfurt, Erfurt, Germany.
Jon GriffinSchool of Medicine and Population Health, University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0003-3969-7637
Maria Sarah L LenonDepartment of Pathology, University of Santo Tomas Hospital, Manila, Philippines.
Kiril TrpkovDepartment of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Rockyview General Hospital, Calgary, AB, Canada.
Liang ChengDepartment 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, USA.ORCID http://orcid.org/0000-0001-6049-5293
Fei ChenDepartment of Pathology, NYU Langone Health, New York, NY, USA.ORCID http://orcid.org/0000-0001-8005-4399
Angelique LeviDepartment of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Guoping CaiDepartment of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Tri Q NguyenDepartment of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Ali AminDepartment of Pathology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Alessia CimadamorePathological Anatomy, University of Udine, Udine, Friuli-Venezia Giulia, Italy.
Ahmed ShabaikDepartment of Pathology, UC San Diego School of Medicine, La Jolla, CA, USA.
Varsha ManuchaDepartment of Pathology, University of Mississippi Medical Center, Jackson, MS, USA.
Nazeel AhmadUniversity of South Florida, Morsani College of Medicine, Department of Pathology & Cell Biology and James A. Haley Veterans' Hospital, Tampa, FL, USA.
Nidia MessiasDepartment of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA.
Francesca SanguedolceDepartment of Pathology, University of Foggia, Foggia, Italy.
Diana TaheriIsfahan Kidney Diseases Research Center, Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran.
Ezra BarabanDepartment of Pathology, Johns Hopkins University, Baltimore, MD, USA.
Liwei JiaDepartment of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Rajal B ShahDepartment of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Farshid SiadatDepartment of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Rockyview General Hospital, Calgary, AB, Canada.
Nicole SwarbrickDepartment of Anatomical Pathology, PathWest Laboratory Medicine WA, Perth, WA, Australia.
Kyung ParkDepartment of Pathology, NYU Langone Health, New York, NY, USA.
Oudai HassanDepartment of Pathology, Henry Ford Health System, Detroit, MI, USA.
Siamak SakhaieDepartment of Anatomical Pathology, Frankston Laboratory, Dorevitch Pathology, Frankston, VIC, Australia.
Michelle R DownesAnatomic Pathology, Precision Diagnostics & Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Hiroshi MiyamotoDepartment of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.ORCID http://orcid.org/0000-0001-7610-7769
Sean R WilliamsonDepartment of Pathology, Diagnostics Institute, Cleveland Clinic, Cleveland, OH, USA.
Tim Holland-LetzDivision of Biostatistics, German Cancer Research Center(DKFZ), Heidelberg, Germany.
Christoph WiesDivision of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0001-7136-298X
Carolin V SchneiderDepartment of Internal Medicine, University Hospital Aachen, RWTH University of Aachen, Aachen, Germany.
Jakob Nikolas KatherElse Kroener Fresenius Center for Digital Health, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Yuri TolkachInstitute of Pathology, University Hospital Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0001-5239-2841
Titus J BrinkerDivision of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany. titus.brinker@dkfz.de.ORCID http://orcid.org/0000-0002-3620-5919
Funding
Integration of epidemiology, pathology, immunology and outcomes in colorectal cancerR01CA263318 · NCI · BECKMAN RESEARCH INSTITUTE/CITY OF HOPE · PI STEPHEN B GRUBER · 2022 to 2026
$3.4MNCI NIH HHS R01 CA263318
Abstract
The aggressiveness of prostate cancer is primarily assessed from histopathological data using the Gleason scoring system. Conventional artificial intelligence (AI) approaches can predict Gleason scores, but often lack explainability, which may limit clinical acceptance. Here, we present an alternative, inherently explainable AI that circumvents the need for post-hoc explainability methods. The model was trained on 1,015 tissue microarray core images, annotated with detailed pattern descriptions by 54 international pathologists following standardized guidelines. It uses pathologist-defined terminology and was trained using soft labels to capture data uncertainty. This approach enables robust Gleason pattern segmentation despite high interobserver variability. The model achieved comparable or superior performance to direct Gleason pattern segmentation (Dice score:
Indexed as
Artificial IntelligenceNeoplasm GradingProstatic NeoplasmsHumansMaleObserver VariationPathologistsProstate
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.