Lavish Ramchandani

Marc Aubreville, Jonas Ammeling, Sweta Banerjee et al.

Automated mitosis detection is a well-established task in computational pathology. While previous benchmarks focused on scanner-induced domain shift, clinical "real-world" application requires models to be robust across the vast variance to be expected in the histological landscape. The MItosis DOmain Generalization (MIDOG) 2025 challenge was designed to evaluate algorithmic performance across unprecedented biological and contextual diversity. We curated a test dataset of 365 cases, encompassing 12 distinct human, canine and feline tumor types, digitized across multiple scanning platforms. Moving beyond hand-selected hotspots, the challenge required detection also in random tissue areas (representative of the whole slide detection situation) and challenging areas (areas rich in hard negatives). In the second track, we introduced the classification of atypical mitotic figures (AMFs). There were 18 teams submitting to the detection track, with F1 scores ranging up to 0.740. In the AMF detection track, we had 21 submissions with balanced accuracy values up to 0.908. Our analysis reveals that while most models perform reliably in traditional hotspots, significant performance degradation occurs in challenging ROIs, where false positive rates tripled. Furthermore, performance varied significantly across the 12 tumor types, highlighting "blind spots" in current state-of-the-art architectures when encountering rare or highly pleomorphic malignancies. Moreover, we evaluated the effectiveness of ensembling and found a mean increases of 1.5 and 1.3 percentage points in F1 score and balanced accuracy, respectively. In contrast, TTA showed no relevant improvement. MIDOG 2025 demonstrates that "in the wild" mitosis detection remains a significant hurdle. The transition from hotspot-only evaluation to a multi-contextual framework provides a more realistic proxy for clinical reliability.

Lavish Ramchandani, Aashay Tinaikar, Dev Kumar Das et al.

In recent years, foundation models such as CLIP, DINO,and CONCH have demonstrated remarkable domain generalization and unsupervised feature extraction capabilities across diverse imaging tasks. However, systematic and independent evaluations of these models for pixel-level semantic segmentation in histopathology remain scarce. In this study, we propose a robust benchmarking approach to asses 10 foundational models on four histopathological datasets covering both morphological tissue-region and cellular/nuclear segmentation tasks. Our method leverages attention maps of foundation models as pixel-wise features, which are then classified using a machine learning algorithm, XGBoost, enabling fast, interpretable, and model-agnostic evaluation without finetuning. We show that the vision language foundation model, CONCH performed the best across datasets when compared to vision-only foundation models, with PathDino as close second. Further analysis shows that models trained on distinct histopathology cohorts capture complementary morphological representations, and concatenating their features yields superior segmentation performance. Concatenating features from CONCH, PathDino and CellViT outperformed individual models across all the datasets by 7.95% (averaged across the datasets), suggesting that ensembles of foundation models can better generalize to diverse histopathological segmentation tasks.

Lavish Ramchandani, Gunjan Deotale, Dev Kumar Das

Atypical mitotic figures (AMFs) are rare abnormal cell divisions associated with tumor aggressiveness and poor prognosis. Their detection remains a significant challenge due to subtle morphological cues, class imbalance, and inter-observer variability among pathologists. The MIDOG 2025 challenge introduced a dedicated track for atypical mitosis classification, enabling systematic evaluation of deep learning methods. In this study, we investigated the use of large vision foundation models, including Virchow, Virchow2, and UNI, with Low-Rank Adaptation (LoRA) for parameter-efficient fine-tuning. We conducted extensive experiments with different LoRA ranks, as well as random and group-based data splits, to analyze robustness under varied conditions. Our best approach, Virchow with LoRA rank 8 and ensemble of three-fold cross-validation, achieved a balanced accuracy of 88.37% on the preliminary test set, ranking joint 9th in the challenge leaderboard. These results highlight the promise of foundation models with efficient adaptation strategies for the classification of atypical mitosis, while underscoring the need for improvements in specificity and domain generalization.