Deciphering oxygen distribution and hypoxia profiles in the tumor microenvironment: a data-driven mechanistic modeling approach.

OBJECTIVE: The distribution of hypoxia within tissues plays a critical role in tumor diagnosis and prognosis. Recognizing the significance of tumor oxygenation and hypoxia gradients, we introduce mathematical frameworks grounded in mechanistic modeling approaches for their quantitative assessment within a tumor microenvironment. By utilizing known blood vasculature, we aim to predict hypoxia levels across different tumor types. APPROACH: Our approach offers a computational method to measure and predict hypoxia using known blood vasculature. By formulating a reaction-diffusion model for oxygen distribution, we derive the corresponding hypoxia profile. Main Results: The framework successfully replicates observed inter- and intra-tumor heterogeneity in experimentally obtained hypoxia profiles across various tumor types (breast, ovarian, pancreatic). Additionally, we propose a data-driven method to deduce partial differential equation (PDE) models with spatially dependent parameters, which allows us to comprehend the variability of hypoxia profiles within tissues. The versatility of our framework lies in capturing diverse and dynamic behaviors of tumor oxygenation, as well as categorizing states of vascularization based on the dynamics of oxygen molecules, as identified by the model parameters. SIGNIFICANCE: The proposed data-informed mechanistic method quantitatively assesses hypoxia in the tumor microenvironment by integrating diverse histopathological data and making predictions across different types of data. The framework contributes valuable insights from both modeling and biological perspectives, advancing our comprehension of spatio-temporal dynamics of tumor oxygenation.

Automated deep learning segmentation of neuritic plaques and neurofibrillary tangles in Alzheimer disease brain sections using a proprietary software.

Neuropathological diagnosis of Alzheimer disease (AD) relies on semiquantitative analysis of phosphorylated tau-positive neurofibrillary tangles (NFTs) and neuritic plaques (NPs), without consideration of lesion heterogeneity in individual cases. We developed a deep learning workflow for automated annotation and segmentation of NPs and NFTs from AT8-immunostained whole slide images (WSIs) of AD brain sections. Fifteen WSIs of frontal cortex from 4 biobanks with varying tissue quality, staining intensity, and scanning formats were analyzed. We established an artificial intelligence (AI)-driven iterative procedure to improve the generation of expert-validated annotation datasets for NPs and NFTs thereby increasing annotation quality by >50%. This strategy yielded an expert-validated annotation database with 5013 NPs and 5143 NFTs. We next trained two U-Net convolutional neural networks for detection and segmentation of NPs or NFTs, achieving high accuracy and consistency (mean Dice similarity coefficient: NPs, 0.77; NFTs, 0.81). The workflow showed high generalization performance across different cases. This study serves as a proof-of-concept for the utilization of proprietary image analysis software (Visiopharm) in the automated deep learning segmentation of NPs and NFTs, demonstrating that AI can significantly improve the annotation quality of complex neuropathological features and enable the creation of highly precise models for identifying these markers in AD brain sections.

Multi-scale feature fusion for prediction of IDH1 mutations in glioma histopathological images.

BACKGROUND AND OBJECTIVE: Mutations in isocitrate dehydrogenase 1 (IDH1) play a crucial role in the prognosis, diagnosis, and treatment of gliomas. However, current methods for determining its mutation status, such as immunohistochemistry and gene sequencing, are difficult to implement widely in routine clinical diagnosis. Recent studies have shown that using deep learning methods based on pathological images of glioma can predict the mutation status of the IDH1 gene. However, our research focuses on utilizing multi-scale information in pathological images to improve the accuracy of predicting IDH1 gene mutations, thereby providing an accurate and cost-effective prediction method for routine clinical diagnosis. METHODS: In this paper, we propose a multi-scale fusion gene identification network (MultiGeneNet). The network first uses two feature extractors to obtain feature maps at different scale images, and then by employing a bilinear pooling layer based on Hadamard product to realize the fusion of multi-scale features. Through fully exploiting the complementarity among features at different scales, we are able to obtain a more comprehensive and rich representation of multi-scale features. RESULTS: Based on the Hematoxylin and Eosin stained pathological section dataset of 296 patients, our method achieved an accuracy of 83.575 % and an AUC of 0.886, thus significantly outperforming other single-scale methods. CONCLUSIONS: Our method can be deployed in medical aid systems at very low cost, serving as a diagnostic or prognostic tool for glioma patients in medically underserved areas.

PhagoStat a scalable and interpretable end to end framework for efficient quantification of cell phagocytosis in neurodegenerative disease studies.

Quantifying the phagocytosis of dynamic, unstained cells is essential for evaluating neurodegenerative diseases. However, measuring rapid cell interactions and distinguishing cells from background make this task very challenging when processing time-lapse phase-contrast video microscopy. In this study, we introduce an end-to-end, scalable, and versatile real-time framework for quantifying and analyzing phagocytic activity. Our proposed pipeline is able to process large data-sets and includes a data quality verification module to counteract potential perturbations such as microscope movements and frame blurring. We also propose an explainable cell segmentation module to improve the interpretability of deep learning methods compared to black-box algorithms. This includes two interpretable deep learning capabilities: visual explanation and model simplification. We demonstrate that interpretability in deep learning is not the opposite of high performance, by additionally providing essential deep learning algorithm optimization insights and solutions. Besides, incorporating interpretable modules results in an efficient architecture design and optimized execution time. We apply this pipeline to quantify and analyze microglial cell phagocytosis in frontotemporal dementia (FTD) and obtain statistically reliable results showing that FTD mutant cells are larger and more aggressive than control cells. The method has been tested and validated on several public benchmarks by generating state-of-the art performances. To stimulate translational approaches and future studies, we release an open-source end-to-end pipeline and a unique microglial cells phagocytosis dataset for immune system characterization in neurodegenerative diseases research. This pipeline and the associated dataset will consistently crystallize future advances in this field, promoting the development of efficient and effective interpretable algorithms dedicated to the critical domain of neurodegenerative diseases' characterization. https://github.com/ounissimehdi/PhagoStat .

Weakly Supervised Framework for Cancer Region Detection of Hepatocellular Carcinoma in Whole-Slide Pathologic Images Based on Multiscale Attention Convolutional Neural Network.

Visual inspection of hepatocellular carcinoma cancer regions by experienced pathologists in whole-slide images (WSIs) is a challenging, labor-intensive, and time-consuming task because of the large scale and high resolution of WSIs. Therefore, a weakly supervised framework based on a multiscale attention convolutional neural network (MSAN-CNN) was introduced into this process. Herein, patch-based images with image-level normal/tumor annotation (rather than images with pixel-level annotation) were fed into a classification neural network. To further improve the performances of cancer region detection, multiscale attention was introduced into the classification neural network. A total of 100 cases were obtained from The Cancer Genome Atlas and divided into 70 training and 30 testing data sets that were fed into the MSAN-CNN framework. The experimental results showed that this framework significantly outperforms the single-scale detection method according to the area under the curve and accuracy, sensitivity, and specificity metrics. When compared with the diagnoses made by three pathologists, MSAN-CNN performed better than a junior- and an intermediate-level pathologist, and slightly worse than a senior pathologist. Furthermore, MSAN-CNN provided a very fast detection time compared with the pathologists. Therefore, a weakly supervised framework based on MSAN-CNN has great potential to assist pathologists in the fast and accurate detection of cancer regions of hepatocellular carcinoma on WSIs.

Best Practice Recommendations for the Implementation of a Digital Pathology Workflow in the Anatomic Pathology Laboratory by the European Society of Digital and Integrative Pathology (ESDIP).

The interest in implementing digital pathology (DP) workflows to obtain whole slide image (WSI) files for diagnostic purposes has increased in the last few years. The increasing performance of technical components and the Food and Drug Administration (FDA) approval of systems for primary diagnosis led to increased interest in applying DP workflows. However, despite this revolutionary transition, real world data suggest that a fully digital approach to the histological workflow has been implemented in only a minority of pathology laboratories. The objective of this study is to facilitate the implementation of DP workflows in pathology laboratories, helping those involved in this process of transformation to identify: (a) the scope and the boundaries of the DP transformation; (b) how to introduce automation to reduce errors; (c) how to introduce appropriate quality control to guarantee the safety of the process and (d) the hardware and software needed to implement DP systems inside the pathology laboratory. The European Society of Digital and Integrative Pathology (ESDIP) provided consensus-based recommendations developed through discussion among members of the Scientific Committee. The recommendations are thus based on the expertise of the panel members and on the agreement obtained after virtual meetings. Prior to publication, the recommendations were reviewed by members of the ESDIP Board. The recommendations comprehensively cover every step of the implementation of the digital workflow in the anatomic pathology department, emphasizing the importance of interoperability, automation and tracking of the entire process before the introduction of a scanning facility. Compared to the available national and international guidelines, the present document represents a practical, handy reference for the correct implementation of the digital workflow in Europe.

Deep Learning for Semantic Segmentation vs. Classification in Computational Pathology: Application to Mitosis Analysis in Breast Cancer Grading.

Existing computational approaches have not yet resulted in effective and efficient computer-aided tools that are used in pathologists' daily practice. Focusing on a computer-based qualification for breast cancer diagnosis, the present study proposes two deep learning architectures to efficiently and effectively detect and classify mitosis in a histopathological tissue sample. The first method consists of two parts, entailing a preprocessing of the digital histological image and a free-handcrafted-feature Convolutional Neural Network (CNN) used for binary classification. Results show that the methodology proposed can achieve 95% accuracy in testing, with an F1-score of 94.35%. This result is higher than the results using classical image processing techniques and also higher than the approaches combining CCNs with handcrafted features. The second approach is an end-to-end methodology using semantic segmentation. Results showed that this algorithm can achieve an accuracy higher than 95% in testing and an average Dice index of 0.6, higher than the existing results using CNNs (0.9 F1-score). Additionally, due to the semantic properties of the deep learning approach, an end-to-end deep learning framework is viable to perform both tasks: detection and classification of mitosis. The results show the potential of deep learning in the analysis of Whole Slide Images (WSI) and its integration to computer-aided systems. The extension of this work to whole slide images is also addressed in the last sections; as well as, some computational key points that are useful when constructing a computer-aided-system inspired by the proposed technology.

Efficient deep learning model for mitosis detection using breast histopathology images.

Mitosis detection is one of the critical factors of cancer prognosis, carrying significant diagnostic information required for breast cancer grading. It provides vital clues to estimate the aggressiveness and the proliferation rate of the tumour. The manual mitosis quantification from whole slide images is a very labor-intensive and challenging task. The aim of this study is to propose a supervised model to detect mitosis signature from breast histopathology WSI images. The model has been designed using deep learning architecture with handcrafted features. We used handcrafted features issued from previous medical challenges MITOS @ ICPR 2012, AMIDA-13 and projects (MICO ANR TecSan) expertise. The deep learning architecture mainly consists of five convolution layers, four max-pooling layers, four rectified linear units (ReLU), and two fully connected layers. ReLU has been used after each convolution layer as an activation function. Dropout layer has been included after first fully connected layer to avoid overfitting. Handcrafted features mainly consist of morphological, textural and intensity features. The proposed architecture has shown to have an improved 92% precision, 88% recall and 90% F-score. Prospectively, the proposed model will be very beneficial in routine exam, providing pathologists with efficient and - as we will prove - effective second opinion for breast cancer grading from whole slide images. Last but not the least, this model could lead junior and senior pathologists, as medical researchers, to a superior understanding and evaluation of breast cancer stage and genesis.

Perceived Age and Life Style. The Specific Contributions of Seven Factors Involved in Health and Beauty.

OBJECTIVES: The skin is a dynamic, visible organ, showing the most obvious signs of aging. The mechanisms of extrinsic aging, most of them presented in this paper, are currently well known and also the only ones that can be counteracted. Therefore, the transition of this knowledge in the general population is of the most importance, in order to introduce healthy aging strategies, to prevent the development of chronic or malignant diseases and psychological burden related to old age. MATERIALS AND METHODS: A thorough review of the literature has been performed in order to identify the main factors involved in skin health and aging. OUTCOMES: This concept article represents a compilation of seven anti-ageing directions regarding major factors involved in health, aging and beauty, respectively sun, sugar, smoking, skin care, stress, sleep and second (the passage of time), easy to comprehend by the general public but sustained by a strong scientific documentation. CONCLUSIONS: Despite its final destination, every quality concept has to pass through academic purgatory as, once accepted, it comes to respond to ever more educated society's demands in terms of anti-ageing.

Bridging the Semantic Gap Between Diagnostic Histopathology and Image Analysis.

With the wider acceptance of Whole Slide Images (WSI) in histopathology domain, automatic image analysis algorithms represent a very promising solution to support pathologist's laborious tasks during the diagnosis process, to create a quantification-based second opinion and to enhance inter-observer agreement. In this context, reference vocabularies and formalization of the associated knowledge are especially needed to annotate histopathology images with labels complying with semantic standards. In this work, we elaborate a sustainable triptych able to bridge the gap between pathologists and image analysis scientists. The proposed paradigm is structured along three components: i) extracting a relevant semantic repository from the College of American Pathologists (CAP) organ-specific Cancer Checklists and associated Protocols (CC&P); ii) identifying imaging formalized knowledge issued from effective histopathology imaging methods highlighted by recent Digital Pathology (DP) contests and iii) proposing a formal representation of the imaging concepts and functionalities issued from major biomedical imaging software (MATLAB, ITK, ImageJ). Since the first step i) has been the object of a recent publication of our team, this study focuses on the steps ii) and iii). Our hypothesis is that the management of available semantic resources concerning the histopathology imaging tasks associated with effective methods highlighted by the recent DP challenges will facilitate the integration of WSI in clinical routine and support new generation of DP protocols.

Gland segmentation in colon histology images: The glas challenge contest.

Colorectal adenocarcinoma originating in intestinal glandular structures is the most common form of colon cancer. In clinical practice, the morphology of intestinal glands, including architectural appearance and glandular formation, is used by pathologists to inform prognosis and plan the treatment of individual patients. However, achieving good inter-observer as well as intra-observer reproducibility of cancer grading is still a major challenge in modern pathology. An automated approach which quantifies the morphology of glands is a solution to the problem. This paper provides an overview to the Gland Segmentation in Colon Histology Images Challenge Contest (GlaS) held at MICCAI'2015. Details of the challenge, including organization, dataset and evaluation criteria, are presented, along with the method descriptions and evaluation results from the top performing methods.

Semantic Integrative Digital Pathology: Insights into Microsemiological Semantics and Image Analysis Scalability.

Being able to provide a traceable and dynamic second opinion has become an ethical priority for patients and health care professionals in modern computer-aided medicine. In this perspective, a semantic cognitive virtual microscopy approach has been recently initiated, the MICO project, by focusing on cognitive digital pathology. This approach supports the elaboration of pathology-compliant daily protocols dedicated to breast cancer grading, in particular mitotic counts and nuclear atypia. A proof of concept has thus been elaborated, and an extension of these approaches is now underway in a collaborative digital pathology framework, the FlexMIm project. As important milestones on the way to routine digital pathology, a series of pioneer international benchmarking initiatives have been launched for mitosis detection (MITOS), nuclear atypia grading (MITOS-ATYPIA) and glandular structure detection (GlaS), some of the fundamental grading components in diagnosis and prognosis. These initiatives allow envisaging a consolidated validation referential database for digital pathology in the very near future. This reference database will need coordinated efforts from all major teams working in this area worldwide, and it will certainly represent a critical bottleneck for the acceptance of all future imaging modules in clinical practice. In line with recent advances in molecular imaging and genetics, keeping the microscopic modality at the core of future digital systems in pathology is fundamental to insure the acceptance of these new technologies, as well as for a deeper systemic, structured comprehension of the pathologies. After all, at the scale of routine whole-slide imaging (WSI; ∼0.22 µm/pixel), the microscopic image represents a structured 'genomic cluster', enabling a naturally structured support for integrative digital pathology approaches. In order to accelerate and structure the integration of this heterogeneous information, a major effort is and will continue to be devoted to morphological microsemiology (microscopic morphology semantics). Besides insuring the traceability of the results (second opinion) and supporting the orchestration of high-content image analysis modules, the role of semantics will be crucial for the correlation between digital pathology and noninvasive medical imaging modalities. In addition, semantics has an important role in modelling the links between traditional microscopy and recent label-free technologies. The massive amount of visual data is challenging and represents a characteristic intrinsic to digital pathology. The design of an operational integrative microscopy framework needs to focus on scalable multiscale imaging formalism. In this sense, we prospectively consider some of the most recent scalable methodologies adapted to digital pathology as marked point processes for nuclear atypia and point-set mathematical morphology for architecture grading. To orchestrate this scalable framework, semantics-based WSI management (analysis, exploration, indexing, retrieval and report generation support) represents an important means towards approaches to integrating big data into biomedicine. This insight reflects our vision through an instantiation of essential bricks of this type of architecture. The generic approach introduced here is applicable to a number of challenges related to molecular imaging, high-content image management and, more generally, bioinformatics.

Neurite Tracing With Object Process.

In this paper we present a pipeline for automatic analysis of neuronal morphology: from detection, modeling to digital reconstruction. First, we present an automatic, unsupervised object detection framework using stochastic marked point process. It extracts connected neuronal networks by fitting special configuration of marked objects to the centreline of the neurite branches in the image volume giving us position, local width and orientation information. Semantic modeling of neuronal morphology in terms of critical nodes like bifurcations and terminals, generates various geometric and morphology descriptors such as branching index, branching angles, total neurite length, internodal lengths for statistical inference on characteristic neuronal features. From the detected branches we reconstruct neuronal tree morphology using robust and efficient numerical fast marching methods. We capture a mathematical model abstracting out the relevant position, shape and connectivity information about neuronal branches from the microscopy data into connected minimum spanning trees. Such digital reconstruction is represented in standard SWC format, prevalent for archiving, sharing, and further analysis in the neuroimaging community. Our proposed pipeline outperforms state of the art methods in tracing accuracy and minimizes the subjective variability in reconstruction, inherent to semi-automatic methods.

Methods for nuclei detection, segmentation, and classification in digital histopathology: a review-current status and future potential.

Digital pathology represents one of the major evolutions in modern medicine. Pathological examinations constitute the gold standard in many medical protocols, and also play a critical and legal role in the diagnosis process. In the conventional cancer diagnosis, pathologists analyze biopsies to make diagnostic and prognostic assessments, mainly based on the cell morphology and architecture distribution. Recently, computerized methods have been rapidly evolving in the area of digital pathology, with growing applications related to nuclei detection, segmentation, and classification. In cancer research, these approaches have played, and will continue to play a key (often bottleneck) role in minimizing human intervention, consolidating pertinent second opinions, and providing traceable clinical information. Pathological studies have been conducted for numerous cancer detection and grading applications, including brain, breast, cervix, lung, and prostate cancer grading. Our study presents, discusses, and extracts the major trends from an exhaustive overview of various nuclei detection, segmentation, feature computation, and classification techniques used in histopathology imagery, specifically in hematoxylin-eosin and immunohistochemical staining protocols. This study also enables us to measure the challenges that remain, in order to reach robust analysis of whole slide images, essential high content imaging with diagnostic biomarkers and prognosis support in digital pathology.

An analysis-synthesis approach for neurosphere modelisation under phase-contrast microscopy.

The study of stem cells is one of the most important biomedical research. Understanding their development could allow multiple applications in regenerative medicine. For this purpose, automated solutions for the observation of stem cell development process are needed. This study introduces an on-line analysis method for the modelling of neurosphere evolution during the early time of their development under phase contrast microscopy. From the corresponding phase contrast time-lapse sequences, we extract information from the neurosphere using a combination of phase contrast physics deconvolution and curve detection for locate the cells inside the neurosphere. Then, based on prior biological knowledge, we generate possible and optimal 3-dimensional configuration using 2D to 3D registration methods and evolutionary optimisation algorithm.

Multi-channels statistical and morphological features based mitosis detection in breast cancer histopathology.

Accurate counting of mitosis in breast cancer histopathology plays a critical role in the grading process. Manual counting of mitosis is tedious and subject to considerable inter- and intra-reader variations. This work aims at improving the accuracy of mitosis detection by selecting the color channels that better capture the statistical and morphological features having mitosis discrimination from other objects. The proposed framework includes comprehensive analysis of first and second order statistical features together with morphological features in selected color channels and a study on balancing the skewed dataset using SMOTE method for increasing the predictive accuracy of mitosis classification. The proposed framework has been evaluated on MITOS data set during an ICPR 2012 contest and ranked second from 17 finalists. The proposed framework achieved 74% detection rate, 70% precision and 72% F-Measure. In future work, we plan to apply our mitosis detection tool to images produced by different types of slide scanners, including multi-spectral and multi-focal microscopy.

Mitosis detection in breast cancer histological images An ICPR 2012 contest.

INTRODUCTION: In the framework of the Cognitive Microscope (MICO) project, we have set up a contest about mitosis detection in images of H and E stained slides of breast cancer for the conference ICPR 2012. Mitotic count is an important parameter for the prognosis of breast cancer. However, mitosis detection in digital histopathology is a challenging problem that needs a deeper study. Indeed, mitosis detection is difficult because mitosis are small objects with a large variety of shapes, and they can thus be easily confused with some other objects or artefacts present in the image. We added a further dimension to the contest by using two different slide scanners having different resolutions and producing red-green-blue (RGB) images, and a multi-spectral microscope producing images in 10 different spectral bands and 17 layers Z-stack. 17 teams participated in the study and the best team achieved a recall rate of 0.7 and precision of 0.89. CONTEXT: Several studies on automatic tools to process digitized slides have been reported focusing mainly on nuclei or tubule detection. Mitosis detection is a challenging problem that has not yet been addressed well in the literature. AIMS: Mitotic count is an important parameter in breast cancer grading as it gives an evaluation of the aggressiveness of the tumor. However, consistency, reproducibility and agreement on mitotic count for the same slide can vary largely among pathologists. An automatic tool for this task may help for reaching a better consistency, and at the same time reducing the burden of this demanding task for the pathologists. SUBJECTS AND METHODS: Professor Frιdιrique Capron team of the pathology department at Pitiι-Salpκtriθre Hospital in Paris, France, has selected a set of five slides of breast cancer. The slides are stained with H and E. They have been scanned by three different equipments: Aperio ScanScope XT slide scanner, Hamamatsu NanoZoomer 2.0-HT slide scanner and 10 bands multispectral microscope. The data set is made up of 50 high power fields (HPF) coming from 5 different slides scanned at ×40 magnification. There are 10 HPFs/slide. The pathologist has annotated all the mitotic cells manually. A HPF has a size of 512 µm × 512 µm (that is an area of 0.262 mm (2) , which is a surface equivalent to that of a microscope field diameter of 0.58 mm. These 50 HPFs contain a total of 326 mitotic cells on images of both scanners, and 322 mitotic cells on the multispectral microscope. RESULTS: Up to 129 teams have registered to the contest. However, only 17 teams submitted their detection of mitotic cells. The performance of the best team is very promising, with F-measure as high as 0.78. However, the database we provided is by far too small for a good assessment of reliability and robustness of the proposed algorithms. CONCLUSIONS: Mitotic count is an important criterion in the grading of many types of cancers, however, very little research has been made on automatic mitotic cell detection, mainly because of a lack of available data. A main objective of this contest was to propose a database of mitotic cells on digitized breast cancer histopathology slides to initiate works on automated mitotic cell detection. In the future, we would like to extend this database to have much more images from different patients and also for different types of cancers. In addition, mitotic cells should be annotated by several pathologists to reflect the partial agreement among them.