November 6, 2023
Nature Communications

Validation of MSIntuit as an AI-based pre-screening tool for MSI detection from colorectal cancer histology slides


Mismatch Repair Deficiency (dMMR)/Microsatellite Instability (MSI) is a key biomarker in colorectal cancer (CRC). Universal screening of CRC patients for MSI status is now recommended, but contributes to increased workload for pathologists and delayed therapeutic decisions. Deep learning has the potential to ease dMMR/MSI testing and accelerate oncologist decision making in clinical practice, yet no comprehensive validation of a clinically approved tool has been conducted. We developed MSIntuit, a clinically approved artificial intelligence (AI) based pre-screening tool for MSI detection from haematoxylin-eosin (H&E) stained slides. After training on samples from The Cancer Genome Atlas (TCGA), a blind validation is performed on an independent dataset of 600 consecutive CRC patients. Inter-scanner reliability is studied by digitising each slide using two different scanners. MSIntuit yields a sensitivity of 0.96-0.98, a specificity of 0.47-0.46, and an excellent inter-scanner agreement (Cohen’s κ: 0.82). By reaching high sensitivity comparable to gold standard methods while ruling out almost half of the non-MSI population, we show that MSIntuit can effectively serve as a pre-screening tool to alleviate MSI testing burden in clinical practice.

Charlie Saillard
Remy Dubois
Oussama Tchita
Nicolas Loiseau
Thierry Garcia
Aurélie Adriansen
Séverine Carpentier
Joelle Reyre
Diana Enea
Aurélie Kamoun
Stéphane Rossat
Meriem Sefta
Michael Auffret
Lionel Guillou
Arnaud Fouillet
Jakob Nikolas Kather
Katharina Von Loga
Corentin Wiscart
Magali Svrcek