Shortcomings and areas for improvement in digital pathology image segmentation challenges.

Digital pathology image analysis challenges have been organised regularly since 2010, often with events hosted at major conferences and results published in high-impact journals. These challenges mobilise a lot of energy from organisers, participants, and expert annotators (especially for image segmentation challenges). This study reviews image segmentation challenges in digital pathology and the top-ranked methods, with a particular focus on how reference annotations are generated and how the methods' predictions are evaluated. We found important shortcomings in the handling of inter-expert disagreement and the relevance of the evaluation process chosen. We also noted key problems with the quality control of various challenge elements that can lead to uncertainties in the published results. Our findings show the importance of greatly increasing transparency in the reporting of challenge results, and the need to make publicly available the evaluation codes, test set annotations and participants' predictions. The aim is to properly ensure the reproducibility and interpretation of the results and to increase the potential for exploitation of the substantial work done in these challenges.

Panoptic quality should be avoided as a metric for assessing cell nuclei segmentation and classification in digital pathology.

Panoptic Quality (PQ), designed for the task of "Panoptic Segmentation" (PS), has been used in several digital pathology challenges and publications on cell nucleus instance segmentation and classification (ISC) since its introduction in 2019. Its purpose is to encompass the detection and the segmentation aspects of the task in a single measure, so that algorithms can be ranked according to their overall performance. A careful analysis of the properties of the metric, its application to ISC and the characteristics of nucleus ISC datasets, shows that is not suitable for this purpose and should be avoided. Through a theoretical analysis we demonstrate that PS and ISC, despite their similarities, have some fundamental differences that make PQ unsuitable. We also show that the use of the Intersection over Union as a matching rule and as a segmentation quality measure within PQ is not adapted for such small objects as nuclei. We illustrate these findings with examples taken from the NuCLS and MoNuSAC datasets. The code for replicating our results is available on GitHub ( https://github.com/adfoucart/panoptic-quality-suppl ).

Strategies to Reduce the Expert Supervision Required for Deep Learning-Based Segmentation of Histopathological Images.

The emergence of computational pathology comes with a demand to extract more and more information from each tissue sample. Such information extraction often requires the segmentation of numerous histological objects (e.g., cell nuclei, glands, etc.) in histological slide images, a task for which deep learning algorithms have demonstrated their effectiveness. However, these algorithms require many training examples to be efficient and robust. For this purpose, pathologists must manually segment hundreds or even thousands of objects in histological images, i.e., a long, tedious and potentially biased task. The present paper aims to review strategies that could help provide the very large number of annotated images needed to automate the segmentation of histological images using deep learning. This review identifies and describes four different approaches: the use of immunohistochemical markers as labels, realistic data augmentation, Generative Adversarial Networks (GAN), and transfer learning. In addition, we describe alternative learning strategies that can use imperfect annotations. Adding real data with high-quality annotations to the training set is a safe way to improve the performance of a well configured deep neural network. However, the present review provides new perspectives through the use of artificially generated data and/or imperfect annotations, in addition to transfer learning opportunities.