  While the Gleason score is the most important prognostic marker for prostate
cancer patients, it suffers from significant observer variability. Artificial
Intelligence (AI) systems, based on deep learning, have proven to achieve
pathologist-level performance at Gleason grading. However, the performance of
such systems can degrade in the presence of artifacts, foreign tissue, or other
anomalies. Pathologists integrating their expertise with feedback from an AI
system could result in a synergy that outperforms both the individual
pathologist and the system. Despite the hype around AI assistance, existing
literature on this topic within the pathology domain is limited. We
investigated the value of AI assistance for grading prostate biopsies. A panel
of fourteen observers graded 160 biopsies with and without AI assistance. Using
AI, the agreement of the panel with an expert reference standard significantly
increased (quadratically weighted Cohen's kappa, 0.799 vs 0.872; p=0.018). Our
results show the added value of AI systems for Gleason grading, but more
importantly, show the benefits of pathologist-AI synergy.

Image and Video Processing;Computer Vision and Pattern Recognition;Quantitative Methods