A Comprehensive Overview of Computational Nuclei Segmentation Methods in Digital Pathology

In the cancer diagnosis pipeline, digital pathology plays an instrumental role in the identification, staging, and grading of malignant areas on biopsy tissue specimens. High resolution histology images are subject to high variance in appearance, sourcing either from the acquisition devices or the H\&E staining process. Nuclei segmentation is an important task, as it detects the nuclei cells over background tissue and gives rise to the topology, size, and count of nuclei which are determinant factors for cancer detection. Yet, it is a fairly time consuming task for pathologists, with reportedly high subjectivity. Computer Aided Diagnosis (CAD) tools empowered by modern Artificial Intelligence (AI) models enable the automation of nuclei segmentation. This can reduce the subjectivity in analysis and reading time. This paper provides an extensive review, beginning from earlier works use traditional image processing techniques and reaching up to modern approaches following the Deep Learning (DL) paradigm. Our review also focuses on the weak supervision aspect of the problem, motivated by the fact that annotated data is scarce. At the end, the advantages of different models and types of supervision are thoroughly discussed. Furthermore, we try to extrapolate and envision how future research lines will potentially be, so as to minimize the need for labeled data while maintaining high performance. Future methods should emphasize efficient and explainable models with a transparent underlying process so that physicians can trust their output.Comment: 47 pages, 27 figures, 9 table

Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directions

Breast cancer has reached the highest incidence rate worldwide among all malignancies since 2020. Breast imaging plays a significant role in early diagnosis and intervention to improve the outcome of breast cancer patients. In the past decade, deep learning has shown remarkable progress in breast cancer imaging analysis, holding great promise in interpreting the rich information and complex context of breast imaging modalities. Considering the rapid improvement in the deep learning technology and the increasing severity of breast cancer, it is critical to summarize past progress and identify future challenges to be addressed. In this paper, we provide an extensive survey of deep learning-based breast cancer imaging research, covering studies on mammogram, ultrasound, magnetic resonance imaging, and digital pathology images over the past decade. The major deep learning methods, publicly available datasets, and applications on imaging-based screening, diagnosis, treatment response prediction, and prognosis are described in detail. Drawn from the findings of this survey, we present a comprehensive discussion of the challenges and potential avenues for future research in deep learning-based breast cancer imaging.Comment: Survey, 41 page

Nuclei & Glands Instance Segmentation in Histology Images: A Narrative Review

Instance segmentation of nuclei and glands in the histology images is an important step in computational pathology workflow for cancer diagnosis, treatment planning and survival analysis. With the advent of modern hardware, the recent availability of large-scale quality public datasets and the community organized grand challenges have seen a surge in automated methods focusing on domain specific challenges, which is pivotal for technology advancements and clinical translation. In this survey, 126 papers illustrating the AI based methods for nuclei and glands instance segmentation published in the last five years (2017-2022) are deeply analyzed, the limitations of current approaches and the open challenges are discussed. Moreover, the potential future research direction is presented and the contribution of state-of-the-art methods is summarized. Further, a generalized summary of publicly available datasets and a detailed insights on the grand challenges illustrating the top performing methods specific to each challenge is also provided. Besides, we intended to give the reader current state of existing research and pointers to the future directions in developing methods that can be used in clinical practice enabling improved diagnosis, grading, prognosis, and treatment planning of cancer. To the best of our knowledge, no previous work has reviewed the instance segmentation in histology images focusing towards this direction.Comment: 60 pages, 14 figure

Semi-supervised Pathological Image Segmentation via Cross Distillation of Multiple Attentions

Segmentation of pathological images is a crucial step for accurate cancer diagnosis. However, acquiring dense annotations of such images for training is labor-intensive and time-consuming. To address this issue, Semi-Supervised Learning (SSL) has the potential for reducing the annotation cost, but it is challenged by a large number of unlabeled training images. In this paper, we propose a novel SSL method based on Cross Distillation of Multiple Attentions (CDMA) to effectively leverage unlabeled images. Firstly, we propose a Multi-attention Tri-branch Network (MTNet) that consists of an encoder and a three-branch decoder, with each branch using a different attention mechanism that calibrates features in different aspects to generate diverse outputs. Secondly, we introduce Cross Decoder Knowledge Distillation (CDKD) between the three decoder branches, allowing them to learn from each other's soft labels to mitigate the negative impact of incorrect pseudo labels in training. Additionally, uncertainty minimization is applied to the average prediction of the three branches, which further regularizes predictions on unlabeled images and encourages inter-branch consistency. Our proposed CDMA was compared with eight state-of-the-art SSL methods on the public DigestPath dataset, and the experimental results showed that our method outperforms the other approaches under different annotation ratios. The code is available at \href{https://github.com/HiLab-git/CDMA}{https://github.com/HiLab-git/CDMA.}Comment: Provisional Accepted by MICCAI 202

Domain Generalization in Computational Pathology: Survey and Guidelines

Deep learning models have exhibited exceptional effectiveness in Computational Pathology (CPath) by tackling intricate tasks across an array of histology image analysis applications. Nevertheless, the presence of out-of-distribution data (stemming from a multitude of sources such as disparate imaging devices and diverse tissue preparation methods) can cause \emph{domain shift} (DS). DS decreases the generalization of trained models to unseen datasets with slightly different data distributions, prompting the need for innovative \emph{domain generalization} (DG) solutions. Recognizing the potential of DG methods to significantly influence diagnostic and prognostic models in cancer studies and clinical practice, we present this survey along with guidelines on achieving DG in CPath. We rigorously define various DS types, systematically review and categorize existing DG approaches and resources in CPath, and provide insights into their advantages, limitations, and applicability. We also conduct thorough benchmarking experiments with 28 cutting-edge DG algorithms to address a complex DG problem. Our findings suggest that careful experiment design and CPath-specific Stain Augmentation technique can be very effective. However, there is no one-size-fits-all solution for DG in CPath. Therefore, we establish clear guidelines for detecting and managing DS depending on different scenarios. While most of the concepts, guidelines, and recommendations are given for applications in CPath, we believe that they are applicable to most medical image analysis tasks as well.Comment: Extended Versio

Improved Breast Cancer Diagnosis through Transfer Learning on Hematoxylin and Eosin Stained Histology Images

Breast cancer is one of the leading causes of death for women worldwide. Early screening is essential for early identification, but the chance of survival declines as the cancer progresses into advanced stages. For this study, the most recent BRACS dataset of histological (H\&E) stained images was used to classify breast cancer tumours, which contains both the whole-slide images (WSI) and region-of-interest (ROI) images, however, for our study we have considered ROI images. We have experimented using different pre-trained deep learning models, such as Xception, EfficientNet, ResNet50, and InceptionResNet, pre-trained on the ImageNet weights. We pre-processed the BRACS ROI along with image augmentation, upsampling, and dataset split strategies. For the default dataset split, the best results were obtained by ResNet50 achieving 66\% f1-score. For the custom dataset split, the best results were obtained by performing upsampling and image augmentation which results in 96.2\% f1-score. Our second approach also reduced the number of false positive and false negative classifications to less than 3\% for each class. We believe that our study significantly impacts the early diagnosis and identification of breast cancer tumors and their subtypes, especially atypical and malignant tumors, thus improving patient outcomes and reducing patient mortality rates. Overall, this study has primarily focused on identifying seven (7) breast cancer tumor subtypes, and we believe that the experimental models can be fine-tuned further to generalize over previous breast cancer histology datasets as well.Comment: 11 pages, 4 figure

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201