The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
Whole-Slide Mitosis Detection in H&E Breast Histology Using PHH3 as a Reference to Train Distilled Stain-Invariant Convolutional Networks
Open accessAbstract
Manual counting of mitotic tumor cells in tissue sections constitutes one of the strongest prognostic markers for breast cancer. This procedure, however, is time-consuming and error-prone. We developed a method to automatically detect mitotic figures in breast cancer tissue sections based on convolutional neural networks (CNNs). Application of CNNs to hematoxylin and eosin (H&E) stained histological tissue sections is hampered by noisy and expensive reference standards established by pathologists, lack of generalization due to staining variation across laboratories, and high computational requirements needed to process gigapixel whole-slide images (WSIs). In this paper, we present a method to train and evaluate CNNs to specifically solve these issues in the context of mitosis detection in breast cancer WSIs. First, by combining image analysis of mitotic activity in phosphohistone-H3 restained slides and registration, we built a reference standard for mitosis detection in entire H&E WSIs requiring minimal manual annotation effort. Second, we designed a data augmentation strategy that creates diverse and realistic H&E stain variations by modifying H&E color channels directly. Using it during training combined with network ensembling resulted in a stain invariant mitosis detector. Third, we applied knowledge distillation to reduce the computational requirements of the mitosis detection ensemble with a negligible loss of performance. The system was trained in a single-center cohort and evaluated in an independent multicenter cohort from the cancer genome atlas on the three tasks of the tumor proliferation assessment challenge. We obtained a performance within the top three best methods for most of the tasks of the challenge.
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“Many specialized methods have been developed to handle stain variation in the context of digital histopathology.”
From WILDS: A Benchmark of in-the-Wild Distribution Shifts (2020) · cites this paper as Tellez et al. (2018)
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Cites
ImageNet: A large-scale hierarchical image database
Deng, J., Dong, W., Socher, R., Li, L.-J., Li, K., & Fei-Fei, L. (2009) · 2009 IEEE Conference on Computer Vision and Pattern Recognition · doi:10.1109/cvpr.2009.5206848 · Cited by 65,333
A survey on deep learning in medical image analysis
Litjens, G., Kooi, T., Bejnordi, B. E., Setio, A. A. A., Ciompi, F., Ghafoorian, M., van der Laak, J. A. W. M., van Ginneken, B., & Sánchez, C. I. (2017) · Medical Image Analysis · doi:10.1016/j.media.2017.07.005 · Cited by 15,332
Self-citationThe cancer genome atlas pan-cancer analysis project
The Cancer Genome Atlas Research Network, Weinstein, J. N., Collisson, E. A., Mills, G. B., Shaw, K. R. M., Ozenberger, B. A., Ellrott, K., Shmulevich, I., Sander, C., & Stuart, J. M. (2013) · Nature Genetics · doi:10.1038/ng.2764 · Cited by 9,092
Histological Grading and Prognosis in Breast Cancer
Bloom, H. J. G., & Richardson, W. (1957) · British Journal of Cancer · doi:10.1038/bjc.1957.43 · Cited by 2,962
Best practices for convolutional neural networks applied to visual document analysis
Simard, P. Y., Steinkraus, D., & Platt, J. C. (2005) · IAPR International Conference on Document Analysis and Recognition (ICDAR) · doi:10.1109/icdar.2003.1227801 · Cited by 2,862
Quantification of histochemical staining by color deconvolution.
Ruifrok, A. C. C., & Johnston, D. A. (2001) · PubMed · Cited by 2,029
Pathological prognostic factors in breast cancer
Elston, C. W. (1999) · Critical Reviews in Oncology/Hematology · doi:10.1016/s1040-8428(99)00034-7 · Cited by 1,744
Mitosis Detection in Breast Cancer Histology Images with Deep Neural Networks
Cireşan, D. C., Giusti, A., Gambardella, L. M., & Schmidhuber, J. (2013) · Lecture Notes in Computer Science · doi:10.1007/978-3-642-40763-5_51 · Cited by 1,536
A method for normalizing histology slides for quantitative analysis
Macenko, M., Niethammer, M., Marron, J. S., Borland, D., Woosley, J. T., Guan, X., Schmitt, C., & Thomas, N. E. (2009) · 2009 IEEE International Symposium on Biomedical Imaging: From Nano to Macro · doi:10.1109/isbi.2009.5193250 · Cited by 1,482
Nielsen, T. O., Parker, J. S., Leung, S. C. Y., Voduc, D. K., Ebbert, M., Vickery, T. L., Davies, S. R., Snider, J., Stijleman, I. J., Reed, J. P., et al. (2010) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-10-1282 · Cited by 825
Khan, A. M., Rajpoot, N., Treanor, D. E., & Magee, D. (2014) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2014.2303294 · Cited by 522
Detecting Cancer Metastases on Gigapixel Pathology Images
Liu, Y., Gadepalli, K., Norouzi, M., Dahl, G. E., Kohlberger, T., Boyko, A., Venugopalan, S., Timofeev, A., Nelson, P. Q., Corrado, G. S., et al. (2017) · arXiv · doi:10.48550/arxiv.1703.02442 · Cited by 506
Assessment of algorithms for mitosis detection in breast cancer histopathology images
Veta, M., van Diest, P. J., Willems, S. M., Wang, H., Madabhushi, A., Cruz-Roa, Á., Gonzalez, F. A., Larsen, A., Vestergaard, J. S., Dahl, A. B., et al. (2014) · Medical Image Analysis · doi:10.1016/j.media.2014.11.010 · Cited by 480
Prognostic value of proliferation in invasive breast cancer: a review: Table 1
van Diest, P. J., van der Wall, E., & Baak, J. P. A. (2004) · Journal of Clinical Pathology · doi:10.1136/jcp.2003.010777 · Cited by 388
Mitosis detection in breast cancer histological images An ICPR 2012 contest
Roux, L., Racoceanu, D., Loménie, N., Kulikova, M. S., Irshad, H., Jacques, K., Capron, F., Genestie, C., Naour, G. L., & Gurcan Metin, N. (2013) · Journal of Pathology Informatics · doi:10.4103/2153-3539.112693 · Cited by 303
Stain Specific Standardization of Whole-Slide Histopathological Images
Bejnordi, B. E., Litjens, G. J. S., Timofeeva, N., Otte‐Höller, I., Homeyer, A., Karssemeijer, N., & van der Laak, J. A. W. M. (2015) · IEEE Transactions on Medical Imaging · doi:10.1109/tmi.2015.2476509 · Cited by 291
Self-citationRibalta, T., McCutcheon, I. E., Aldape, K., Bruner, J. M., & Fuller, G. N. (2004) · The American Journal of Surgical Pathology · doi:10.1097/01.pas.0000141389.06925.d5 · Cited by 140
Colman, H., Giannini, C., Huang, L., Gonzalez, J., Hess, K. R., Bruner, J., Fuller, G. N., Langford, L. A., Pelloski, C. E., Aaron, J., et al. (2006) · The American Journal of Surgical Pathology · doi:10.1097/01.pas.0000202048.28203.25 · Cited by 137
Veta, M., van Diest, P. J., Jiwa, M., Al-Janabi, S., & Pluim, J. P. W. (2016) · PLOS ONE · doi:10.1371/journal.pone.0161286 · Cited by 127
Wide residual networks for mitosis detection
Zerhouni, E., Lányi, D., Viana, M. P., & Gabrani, M. (2017) · IEEE International Symposium on Biomedical Imaging (ISBI) · doi:10.1109/isbi.2017.7950667 · Cited by 59
Comparison of different methods for tissue segmentation in histopathological whole-slide images
Bándi, P., van de Loo, R., Intezar, M., Geijs, D. J., Ciompi, F., van Ginneken, B., van der Laak, J. A. W. M., & Litjens, G. J. S. (2017) · IEEE International Symposium on Biomedical Imaging (ISBI) · doi:10.1109/isbi.2017.7950590 · Cited by 56
Self-citationFukushima, S., Terasaki, M., Sakata, K., Miyagi, N., Kato, S., Sugita, Y., & Shigemori, M. (2009) · Brain Tumor Pathology · doi:10.1007/s10014-009-0249-9 · Cited by 55
Evaluation of Mitotic Activity Index in Breast Cancer Using Whole Slide Digital Images
Al‐Janabi, S., van Slooten, H.-J., Visser, M., van der Ploeg, T., van Diest, P. J., & Jiwa, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082576 · Cited by 53
Skaland, I., Janssen, E. A. M., Gudlaugsson, E. G., Kłos, J., Kjellevold, K. H., Søiland, H., & Baak, J. P. A. (2008) · Breast Cancer Research and Treatment · doi:10.1007/s10549-008-9980-x · Cited by 53
Immunohistochemical dual staining as an adjunct in assessment of mitotic activity in melanoma
Ikenberg, K., Pfaltz, M., Rakozy, C. K., & Kempf, W. (2012) · Journal of Cutaneous Pathology · doi:10.1111/j.1600-0560.2011.01858.x · Cited by 41
Skaland, I., van Diest, P. J., Janssen, E. A. M., Gudlaugsson, E. G., & Baak, J. P. A. (2008) · Human Pathology · doi:10.1016/j.humpath.2007.08.016 · Cited by 26
Focke, C. M., Finsterbusch, K., Decker, T. W., & van Diest, P. J. (2016) · Applied immunohistochemistry & molecular morphology · doi:10.1097/pai.0000000000000390 · Cited by 7
Flagged first, then by citations
Research works printed but not linked: 8
- Roux, 2014, Mitosis Detection in Breast Cancer Histological Images
- Veta, 2016, Tumor Proliferation Assessment Challenge
- Goodfellow, 2016, Deep Learning
- Paeng, 2016, A unified framework for tumor proliferation score prediction in breast histopathology
- Hinton, 2015, Distilling the knowledge in a neural network
- Springenberg, 2014, Striving for simplicity: The all convolutional net
- Team, 2016, Theano: A Python framework for fast computation of mathematical expressions
- Dieleman, 2015, Lasagne: First Release
Cited by
Sorted by citations
Deep learning in histopathology: the path to the clinic
van der Laak, J., Litjens, G., & Ciompi, F. (2021) · Nature Medicine · doi:10.1038/s41591-021-01343-4 · Cited by 902
Self-citationA whole-slide foundation model for digital pathology from real-world data
Xu, H., Usuyama, N., Bagga, J., Zhang, S., Rao, R., Naumann, T., Wong, C., Gero, Z., González, J., Gu, Y., et al. (2024) · Nature · doi:10.1038/s41586-024-07441-w · Cited by 921
Deep neural network models for computational histopathology: A survey
Srinidhi, C. L., Ciga, O., & Martel, A. L. (2021) · Medical Image Analysis · doi:10.1016/j.media.2020.101813 · Cited by 749
Tellez, D., Litjens, G., Bándi, P., Bulten, W., Bokhorst, J.-M., Ciompi, F., & van der Laak, J. (2019) · Medical Image Analysis · doi:10.1016/j.media.2019.101544 · Cited by 649
Self-citationAbels, E., Pantanowitz, L., Aeffner, F., Zarella, M. D., van der Laak, J. A. W. M., Bui, M. M., Vemuri, V. N. P., Parwani, A. V., Gibbs, J., Agosto‐Arroyo, E., et al. (2019) · The Journal of Pathology · doi:10.1002/path.5331 · Cited by 469
Metadata
- Authors
- Tellez, D., Balkenhol, M., Otte-Höller, I., van de Loo, R., Vogels, R., Bult, P., Wauters, C., Vreuls, W., Mol, S., Karssemeijer, N., Litjens, G., van der Laak, J., & Ciompi, F.
- Affiliations
- Radboud University Medical Center (NL)
- Canisius-Wilhelmina Ziekenhuis (NL)
- Jeroen Bosch Ziekenhuis (NL)
- Venue
- IEEE Transactions on Medical Imaging
- Published
- 2018-09
- Volume
- 37
- Issue
- 9
- Pages
- 2126-2136
- ISSN
- 0278-0062 (ISSN-L)
- 1558-254X
- OpenAlex
- W2794616003
- Cited by
- 288
- References
- 27
- Citations by year
- 2026: 16 · 2025: 27 · 2024: 49 · 2023: 41 · 2022: 47 · 2021: 41 · 2020: 39 · 2019: 24 · 2018: 3
- FWCI
- 15.06
- Type
- journal article
- Language
- en
- Open access
- green
- arxiv.org
- Licence
- Locations
- IEEE Transactions on Medical Imaging (publishedVersion)
- PubMed (publishedVersion)
- arXiv (Cornell University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- arXiv (Cornell University)
- Funders
- Radboud Universitair Medisch Centrum
- Topics
- Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biophysics › Cell Image Analysis Techniques
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Digital Imaging for Blood Diseases
- Keywords
- mitosis detection, breast cancer, whole slide images, H&E staining, knowledge distillation, data augmentation, image registration, tumor cell proliferation, histopathology, convolutional neural networks
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