Causal probabilistic modeling for malignancy grading in pathology with explanations of dependency to the related histological features.

This work demonstrates that histological grading of brain tumors and astrocytomas can be accurately predicted and causally explained with the help of causal probabilistic models, also known as Bayesian networks (BN). Although created statistically, this allows individual identification of the grade of malignancy as an internal cause that has enabled the development of the histological features to their observed state. The BN models are built from data representing 794 cases of astrocytomas with their malignant grading and corresponding histological features. The computerized learning process is improved when pre-specified knowledge (from the pathologist) about simple dependency relations to the histological features is taken into account. We use the BN models for both grading and causal analysis. In addition, the BN models provide a causal explanation of dependency between the histological features and the grading. This can offer the biggest potential for choice of an efficient treatment, since it concentrates on the malignancy grade as the cause of pathological observations. The causal analysis shows that all ten histological features are important for the grading. The histological features are causally ordered, implying that features of first order are of higher priority, e.g. for the choice of treatment in order not to allow the malignancy to progress to a higher degree. Due to the explanations of feature relations, the causal analysis can be considered as a powerful complement to any malignancy classification tool and allows reproducible comparison of malignancy grading.