Lymph node (LN) metastasis is one of the most important prognostic factors in several common malignancies such as
gastric cancer and breast cancer. The frozen section method is widely used for intraoperative pathological diagnosis.
However, there are some issues with this process. In other words, experience is essential for specimen preparation and
diagnosis, and freezing causes severe tissue damage. Microscopy with ultraviolet surface excitation (MUSE) has
potential to provide rapid diagnosis with simple technique comparing to conventional histopathology based on
hematoxylin and eosin (H&E) staining. We established a fluorescent staining protocol for Deep UV-excitation
fluorescence imaging by using terbium ion and Hoechst 33342 that has enabled clear discrimination of nucleoplasm,
nucleolus, and cytoplasm. In formalin-fixed paraffin-embedded (FFPE) thin-sliced tissue sections of metastasis-positive/-
negative LNs of gastric cancer patients, the performance of cancer detection by patch-based training with a
deep convolutional neural network (DCNN) on the fluorescence images was comparable with that of H&E images.
However, MUSE images from non-thin-sliced tissue are difficult for pathologists to label training data for a supervised
learning manner. We attempt a deep-learning pipeline model for LN metastasis detection, in which CycleGAN translates
MUSE images to FFPE thin-sliced tissue images, and diagnostic prediction is performed using deep convolutional neural
network trained on FFPE images. The modality translation using CycleGAN was able to improve the pathological
diagnosis of non-thin-sliced surface images using DCNN model trained by FFPE images.
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