Importance Application of deep learning algorithms to whole-slide pathology images can potentially improve diagnostic accuracy and efficiency. Objective Assess the performance of automated deep learning algorithms at detecting metastases in hematoxylin and eosin–stained tissue sections of lymph nodes of women with breast cancer and compare it with pathologists’ diagnoses in a diagnostic setting. Design, Setting, and Participants Researcher challenge competition (CAMELYON16) to develop automated solutions for detecting lymph node metastases (November 2015-November 2016). A training data set of whole-slide images from 2 centers in the Netherlands with (n = 110) and without (n = 160) nodal metastases verified by immunohistochemical staining were provided to challenge participants to build algorithms. Algorithm performance was evaluated in an independent test set of 129 whole-slide images (49 with and 80 without metastases). The same test set of corresponding glass slides was also evaluated by a panel of 11 pathologists with time constraint (WTC) from the Netherlands to ascertain likelihood of nodal metastases for each slide in a flexible 2-hour session, simulating routine pathology workflow, and by 1 pathologist without time constraint (WOTC). Exposures Deep learning algorithms submitted as part of a challenge competition or pathologist interpretation. Main Outcomes and Measures The presence of specific metastatic foci and the absence vs presence of lymph node metastasis in a slide or image using receiver operating characteristic curve analysis. The 11 pathologists participating in the simulation exercise rated their diagnostic confidence as definitely normal, probably normal, equivocal, probably tumor, or definitely tumor. Results The area under the receiver operating characteristic curve (AUC) for the algorithms ranged from 0.556 to 0.994. The top-performing algorithm achieved a lesion-level, true-positive fraction comparable with that of the pathologist WOTC (72.4% [95% CI, 64.3%-80.4%]) at a mean of 0.0125 false-positives per normal whole-slide image. For the whole-slide image classification task, the best algorithm (AUC, 0.994 [95% CI, 0.983-0.999]) performed significantly better than the pathologists WTC in a diagnostic simulation (mean AUC, 0.810 [range, 0.738-0.884];P  Conclusions and Relevance In the setting of a challenge competition, some deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. Whether this approach has clinical utility will require evaluation in a clinical setting.

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Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer.

Two different formal definitions of gray-scale reconstruction are presented. The use of gray-scale reconstruction in various image processing applications discussed to illustrate the usefulness of this transformation for image filtering and segmentation tasks. The standard parallel and sequential approaches to reconstruction are reviewed. It is shown that their common drawback is their inefficiency on conventional computers. To improve this situation, an algorithm that is based on the notion of regional maxima and makes use of breadth-first image scannings implemented using a queue of pixels is introduced. Its combination with the sequential technique results in a hybrid gray-scale reconstruction algorithm which is an order of magnitude faster than any previously known algorithm. >

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Morphological grayscale reconstruction in image analysis: applications and efficient algorithms

Background Radiomic features may quantify characteristics present in medical imaging. However, the lack of standardized definitions and validated reference values have hampered clinical use. Purpose To standardize a set of 174 radiomic features. Materials and Methods Radiomic features were assessed in three phases. In phase I, 487 features were derived from the basic set of 174 features. Twenty-five research teams with unique radiomics software implementations computed feature values directly from a digital phantom, without any additional image processing. In phase II, 15 teams computed values for 1347 derived features using a CT image of a patient with lung cancer and predefined image processing configurations. In both phases, consensus among the teams on the validity of tentative reference values was measured through the frequency of the modal value and classified as follows: less than three matches, weak; three to five matches, moderate; six to nine matches, strong; 10 or more matches, very strong. In the final phase (phase III), a public data set of multimodality images (CT, fluorine 18 fluorodeoxyglucose PET, and T1-weighted MRI) from 51 patients with soft-tissue sarcoma was used to prospectively assess reproducibility of standardized features. Results Consensus on reference values was initially weak for 232 of 302 features (76.8%) at phase I and 703 of 1075 features (65.4%) at phase II. At the final iteration, weak consensus remained for only two of 487 features (0.4%) at phase I and 19 of 1347 features (1.4%) at phase II. Strong or better consensus was achieved for 463 of 487 features (95.1%) at phase I and 1220 of 1347 features (90.6%) at phase II. Overall, 169 of 174 features were standardized in the first two phases. In the final validation phase (phase III), most of the 169 standardized features could be excellently reproduced (166 with CT; 164 with PET; and 164 with MRI). Conclusion A set of 169 radiomics features was standardized, which enabled verification and calibration of different radiomics software. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Kuhl and Truhn in this issue.

https://pubs.rsna.org/doi/pdf/10.1148/radiol.2020191145

The Image Biomarker Standardization Initiative: Standardized Quantitative Radiomics for High-Throughput Image-based Phenotyping

The watershed transform is the method of choice for image segmentation in the field of mathematical morphology. We present a critical review of several definitions of the watershed transform and the associated sequential algorithms, and discuss various issues which often cause confusion in the literature. The need to distinguish between definition, algorithm specification and algorithm implementation is pointed out. Various examples are given which illustrate differences between watershed transforms based on different definitions and/or implementations. The second part of the paper surveys approaches for parallel implementation of sequential watershed algorithms.

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The watershed transform: definitions, algorithms and parallelization strategies

Mass cytometry enables high-dimensional, single-cell analysis of cell type and state. In mass cytometry, rare earth metals are used as reporters on antibodies. Analysis of metal abundances using the mass cytometer allows determination of marker expression in individual cells. Mass cytometry has previously been applied only to cell suspensions. To gain spatial information, we have coupled immunohistochemical and immunocytochemical methods with high-resolution laser ablation to CyTOF mass cytometry. This approach enables the simultaneous imaging of 32 proteins and protein modifications at subcellular resolution; with the availability of additional isotopes, measurement of over 100 markers will be possible. We applied imaging mass cytometry to human breast cancer samples, allowing delineation of cell subpopulations and cell-cell interactions and highlighting tumor heterogeneity. Imaging mass cytometry complements existing imaging approaches. It will enable basic studies of tissue heterogeneity and function and support the transition of medicine toward individualized molecularly targeted diagnosis and therapies.

Highly multiplexed imaging of tumor tissues with subcellular resolution by mass cytometry

This paper presents a technique for the generation of a segmentation pyramid for a video sequence, designed for use in an interactive segmentation context. The pyramid is represented as a minimum spanning tree, which allows an efficient access to the information and avoids unnecessary recalculations. Several ways to introduce user interaction are also proposed.

A Segmentation Pyramid for the Interactive Segmentation of 3-D Images and Video Sequences

This paper deals with the use of some morphological tools for video coding at very low bit rates. Rather than describing a complete coding algorithm, the purpose of this paper is to focus on morphological connected operators and segmentation tools that have proved to be attractive for compression.

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Morphological operators for very low bit rate video coding

Keywords: LTS1 Reference LTS-CONF-1994-048 Record created on 2006-06-14, modified on 2016-08-08

The geodesic morphological skeleton and its fast reconstruction

The aim of this paper is to propose efficient tools for analysing shape families using morphological operators. The developments include the definition of shape statistics (mean and variance of shapes, modes of shape variation) and the interpolation/extrapolation in shape geodesic paths. The main required ingredients for the operators and the algorithms here introduced are well known in mathematical morphology such as the median set, the watershed on distance functions or the interpolation function. In addition, the projection of shapes in spaces with reduced dimensions using PCA or ISOMAP techniques permits to apply morphological interpolation techniques in shape manifolds.

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Morphological Exploration of Shape Spaces

The watershed is a powerful tool for segmenting objects whose contours appear as crest lines on a gradient image. The watershed transform associates to a topographic surface a partition into catchment basins, defined as attraction zones of a drop of water falling on the relief and following a line of steepest descent. Unfortunately, catchment basins may overlap and do not form a partition. Moreover, current watershed algorithms, being shortsighted, do not correctly estimate the steepness of the downwards trajectories and overestimate the overlapping zones of catchment basins. An arbitrary division of these zones between adjacent catchment basin results in a poor localization of the contours. We propose an algorithm without myopia, which considers the total length of a trajectory for estimating its steepness. We first consider topographic surfaces defined on node weighted graphs. The graphs are pruned in order to eliminate all downwards trajectories which are not the steepest. An iterative algorithm with simple neighborhood operations performs the pruning and constructs the catchment basins. The algorithm is then adapted to gray tone images. The graph structure itself is encoded as an image thanks to the fixed neighborhood structure of grids. A pair of adaptative erosions and dilations prune the graph and extend the catchment basins. As a result one obtains a precise detection of the catchment basins and a graph of the steepest trajectories. A last iterative algorithm allows to follow selected downwards trajectories in order to detect particular structures such as rivers or thalweg lines of the topographic surface.

Fernand Meyer

Papers

A Segmentation Pyramid for the Interactive Segmentation of 3-D Images and Video Sequences

Morphological operators for very low bit rate video coding

The geodesic morphological skeleton and its fast reconstruction

Morphological Exploration of Shape Spaces

The steepest watershed: from graphs to images