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

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Computational Pathology: A Survey Review and The Way Forward

Computational Pathology CPath is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field's future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath (https://github.com/AtlasAnalyticsLab/CPath_Survey).Comment: Accepted in Elsevier Journal of Pathology Informatics (JPI) 202

Deep Domain Adaptation Learning Framework for Associating Image Features to Tumour Gene Profile

While medical imaging and general pathology are routine in cancer diagnosis, genetic sequencing is not always assessable due to the strong phenotypic and genetic heterogeneity of human cancers. Image-genomics integrates medical imaging and genetics to provide a complementary approach to optimise cancer diagnosis by associating tumour imaging traits with clinical data and has demonstrated its potential in identifying imaging surrogates for tumour biomarkers. However, existing image-genomics research has focused on quantifying tumour visual traits according to human understanding, which may not be optimal across different cancer types. The challenge hence lies in the extraction of optimised imaging representations in an objective data-driven manner. Such an approach requires large volumes of annotated image data that are difficult to acquire. We propose a deep domain adaptation learning framework for associating image features to tumour genetic information, exploiting the ability of domain adaptation technique to learn relevant image features from close knowledge domains. Our proposed framework leverages the current state-of-the-art in image object recognition to provide image features to encode subtle variations of tumour phenotypic characteristics with domain adaptation techniques. The proposed framework was evaluated with current state-of-the-art in: (i) tumour histopathology image classification and; (ii) image-genomics associations. The proposed framework demonstrated improved accuracy of tumour classification, as well as providing additional data-derived representations of tumour phenotypic characteristics that exhibit strong image-genomics association. This thesis advances and indicates the potential of image-genomics research to reveal additional imaging surrogates to genetic biomarkers, which has the potential to facilitate cancer diagnosis

Multi-Magnification Search in Digital Pathology

This research study investigates the effect of magnification on content-based image search in digital pathology archives and proposes to use multi-magnification image representation. Image search in large archives of digital pathology slides provides researchers and medical professionals with an opportunity to match records of current and past patients and learn from evidently diagnosed and treated cases. When working with microscopes, pathologists switch between different magnification levels while examining tissue specimens to find and evaluate various morphological features. Inspired by the conventional pathology workflow, this thesis investigates several magnification levels in digital pathology and their combinations to minimize the gap between AI-enabled image search methods and clinical settings. This thesis suggests two approaches for combining magnification levels and compares their performance. The first approach obtains a single-vector deep feature representation for a WSI, whereas the second approach works with a multi-vector deep feature representation. The proposed content-based searching framework does not rely on any pixel-level annotation and potentially applies to millions of unlabelled (raw) WSIs. This thesis proposes using binary masks generated by U-Net as the primary step of patch preparation to locating tissue regions in a WSI. As a part of this thesis, a multi-magnification dataset of histopathology patches is created by applying the proposed patch preparation method on more than 8,000 WSIs of TCGA repository. The performance of both MMS methods is evaluated by investigating the top three most similar WSIs to a query WSI found by the search. The search is considered successful if two out of three matched cases have the same malignancy subtype as the query WSI. Experimental search results across tumors of several anatomical sites at different magnification levels, i.e., 20×, 10×, and 5× magnifications and their combinations, are reported in this thesis. The experiments verify that cell-level information at the highest magnification is essential for searching for diagnostic purposes. In contrast, low-magnification information may improve this assessment depending on the tumor type. Both proposed search methods generally performed more accurately at 20× magnification or the combination of the 20× magnification with 10×, 5×, or both. The multi-magnification searching approach achieved up to 11% increase in F1-score for searching among some tumor types, including the urinary tract and brain tumor subtypes compared to the single-magnification image search

Deep Learning based HEp-2 Image Classification: A Comprehensive Review

Classification of HEp-2 cell patterns plays a significant role in the indirect immunofluorescence test for identifying autoimmune diseases in the human body. Many automatic HEp-2 cell classification methods have been proposed in recent years, amongst which deep learning based methods have shown impressive performance. This paper provides a comprehensive review of the existing deep learning based HEp-2 cell image classification methods. These methods perform HEp-2 image classification at two levels, namely, cell-level and specimen-level. Both levels are covered in this review. At each level, the methods are organized with a deep network usage based taxonomy. The core idea, notable achievements, and key strengths and weaknesses of each method are critically analyzed. Furthermore, a concise review of the existing HEp-2 datasets that are commonly used in the literature is given. The paper ends with a discussion on novel opportunities and future research directions in this field. It is hoped that this paper would provide readers with a thorough reference of this novel, challenging, and thriving field.Comment: Published in Medical Image Analysi

Digital Pathology: The Time Is Now to Bridge the Gap between Medicine and Technological Singularity

Digitalization of the imaging in radiology is a reality in several healthcare institutions worldwide. The challenges of filing, confidentiality, and manipulation have been brilliantly solved in radiology. However, digitalization of hematoxylin- and eosin-stained routine histological slides has shown slow movement. Although the application for external quality assurance is a reality for a pathologist with most of the continuing medical education programs utilizing virtual microscopy, the abandonment of traditional glass slides for routine diagnostics is far from the perspectives of many departments of laboratory medicine and pathology. Digital pathology images are captured as images by scanning and whole slide imaging/virtual microscopy can be obtained by microscopy (robotic) on an entire histological (microscopic) glass slide. Since 1986, services using telepathology for the transfer of images of anatomic pathology between detached locations have benefited countless patients globally, including the University of Alberta. The purpose of specialist recertification or re-validation for the Royal College of Pathologists of Canada belonging to the Royal College of Physicians and Surgeons of Canada and College of American Pathologists is a milestone in virtual reality. Challenges, such as high bandwidth requirement, electronic platforms, the stability of the operating systems, have been targeted and are improving enormously. The encryption of digital images may be a requirement for the accreditation of laboratory services—quantum computing results in quantum-mechanical phenomena, such as superposition and entanglement. Different from binary digital electronic computers based on transistors where data are encoded into binary digits (bits) with two different states (0 and 1), quantum computing uses quantum bits (qubits), which can be in superpositions of states. The use of quantum computing protocols on encrypted data is crucial for the permanent implementation of virtual pathology in hospitals and universities. Quantum computing may well represent the technological singularity to create new classifications and taxonomic rules in medicine

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumor-infiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment. Tumor-infiltrating lymphocytes (TILs) were identified from standard pathology cancer images by a deep-learning-derived \u201ccomputational stain\u201d developed by Saltz et al. They processed 5,202 digital images from 13 cancer types. Resulting TIL maps were correlated with TCGA molecular data, relating TIL content to survival, tumor subtypes, and immune profiles

Frameworks in medical image analysis with deep neural networks

In recent years, deep neural network based medical image analysis has become quite powerful and achieved similar results performance-wise as experts. Consequently, the integration of these tools into the clinical routine as clinical decision support systems is highly desired. The benefits of automatic image analysis for clinicians are massive, ranging from improved diagnostic as well as treatment quality to increased time-efficiency through automated structured reporting. However, implementations in the literature revealed a significant lack of standardization in pipeline building resulting in low reproducibility, high complexity through extensive knowledge requirements for building state-of-the-art pipelines, and difficulties for application in clinical research. The main objective of this work is the standardization of pipeline building in deep neural network based medical image segmentation and classification. This is why the Python frameworks MIScnn for medical image segmentation and AUCMEDI for medical image classification are proposed which simplify the implementation process through intuitive building blocks eliminating the need for time-consuming and error-prone implementation of common components from scratch. The proposed frameworks include state-of-the-art methodology, follow outstanding open-source principles like extensive documentation as well as stability, offer rapid as well as simple application capabilities for deep learning experts as well as clinical researchers, and provide cutting-edge high-performance competitive with the strongest implementations in the literature. As secondary objectives, this work presents more than a dozen in-house studies as well as discusses various external studies utilizing the proposed frameworks in order to prove the capabilities of standardized medical image analysis. The presented studies demonstrate excellent predictive capabilities in applications ranging from COVID-19 detection in computed tomography scans to the integration into a clinical study workflow for Gleason grading of prostate cancer microscopy sections and advance the state-of-the-art in medical image analysis by simplifying experimentation setups for research. Furthermore, studies for increasing reproducibility in performance assessment of medical image segmentation are presented including an open-source metric library for standardized evaluation and a community guideline on proper metric usage. The proposed contributions in this work improve the knowledge representation of the field, enable rapid as well as high-performing applications, facilitate further research, and strengthen the reproducibility of future studies