Raphaël Bourgade

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.

Raphaël Bourgade, Guillaume Balezo, Hana Feki et al.

Mitotic figures represent a key histoprognostic feature in tumor pathology, providing crucial insights into tumor aggressiveness and proliferation. However, their identification remains challenging, subject to significant inter-observer variability, even among experienced pathologists. To address this issue, the MItosis DOmain Generalization (MIDOG) 2025 challenge marks the third edition of an international competition aiming to develop robust mitosis detection algorithms. In this paper, we present a mitotic figure detection approach based on the state-of-the-art YOLOv12 object detection architecture. Our method achieved an F1-score of 0.801 on the preliminary test set (hotspots only) and ranked second on the final test leaderboard with an F1-score of 0.7216 across complex and heterogeneous whole-slide regions, without relying on external data.

Guillaume Balezo, Hana Feki, Raphaël Bourgade et al.

Atypical mitotic figures (AMFs) represent abnormal cell division associated with poor prognosis. Yet their detection remains difficult due to low prevalence, subtle morphology, and inter-observer variability. The MIDOG 2025 challenge introduces a benchmark for AMF classification across multiple domains. In this work, we fine-tuned the recently published DINOv3-H+ vision transformer, pretrained on natural images, using low-rank adaptation (LoRA), training only ~1.3M parameters in combination with extensive augmentation and a domain-weighted Focal Loss to handle domain heterogeneity. Despite the domain gap, our fine-tuned DINOv3 transfers effectively to histopathology, reaching first place on the final test set. These results highlight the advantages of DINOv3 pretraining and underline the efficiency and robustness of our fine-tuning strategy, yielding state-of-the-art results for the atypical mitosis classification challenge in MIDOG 2025.