Alexander S. Baras

Ramin Nakhli, Puria Azadi Moghadam, Haoyang Mi et al.

Processing giga-pixel whole slide histopathology images (WSI) is a computationally expensive task. Multiple instance learning (MIL) has become the conventional approach to process WSIs, in which these images are split into smaller patches for further processing. However, MIL-based techniques ignore explicit information about the individual cells within a patch. In this paper, by defining the novel concept of shared-context processing, we designed a multi-modal Graph Transformer (AMIGO) that uses the celluar graph within the tissue to provide a single representation for a patient while taking advantage of the hierarchical structure of the tissue, enabling a dynamic focus between cell-level and tissue-level information. We benchmarked the performance of our model against multiple state-of-the-art methods in survival prediction and showed that ours can significantly outperform all of them including hierarchical Vision Transformer (ViT). More importantly, we show that our model is strongly robust to missing information to an extent that it can achieve the same performance with as low as 20% of the data. Finally, in two different cancer datasets, we demonstrated that our model was able to stratify the patients into low-risk and high-risk groups while other state-of-the-art methods failed to achieve this goal. We also publish a large dataset of immunohistochemistry images (InUIT) containing 1,600 tissue microarray (TMA) cores from 188 patients along with their survival information, making it one of the largest publicly available datasets in this context.

Cristina Almagro-Pérez, Andrew H. Song, Luca Weishaupt et al.

A comprehensive three-dimensional (3D) map of tissue architecture and gene expression is crucial for illuminating the complexity and heterogeneity of tissues across diverse biomedical applications. However, most spatial transcriptomics (ST) approaches remain limited to two-dimensional (2D) sections of tissue. Although current 3D ST methods hold promise, they typically require extensive tissue sectioning, are complex, are not compatible with non-destructive 3D tissue imaging technologies, and often lack scalability. Here, we present VOlumetrically Resolved Transcriptomics EXpression (VORTEX), an AI framework that leverages 3D tissue morphology and minimal 2D ST to predict volumetric 3D ST. By pretraining on diverse 3D morphology-transcriptomic pairs from heterogeneous tissue samples and then fine-tuning on minimal 2D ST data from a specific volume of interest, VORTEX learns both generic tissue-related and sample-specific morphological correlates of gene expression. This approach enables dense, high-throughput, and fast 3D ST, scaling seamlessly to large tissue volumes far beyond the reach of existing 3D ST techniques. By offering a cost-effective and minimally destructive route to obtaining volumetric molecular insights, we anticipate that VORTEX will accelerate biomarker discovery and our understanding of morphomolecular associations and cell states in complex tissues. Interactive 3D ST volumes can be viewed at https://vortex-demo.github.io/

Andrew H. Song, Richard J. Chen, Guillaume Jaume et al.

Multimodal survival methods combining gigapixel histology whole-slide images (WSIs) and transcriptomic profiles are particularly promising for patient prognostication and stratification. Current approaches involve tokenizing the WSIs into smaller patches (>10,000 patches) and transcriptomics into gene groups, which are then integrated using a Transformer for predicting outcomes. However, this process generates many tokens, which leads to high memory requirements for computing attention and complicates post-hoc interpretability analyses. Instead, we hypothesize that we can: (1) effectively summarize the morphological content of a WSI by condensing its constituting tokens using morphological prototypes, achieving more than 300x compression; and (2) accurately characterize cellular functions by encoding the transcriptomic profile with biological pathway prototypes, all in an unsupervised fashion. The resulting multimodal tokens are then processed by a fusion network, either with a Transformer or an optimal transport cross-alignment, which now operates with a small and fixed number of tokens without approximations. Extensive evaluation on six cancer types shows that our framework outperforms state-of-the-art methods with much less computation while unlocking new interpretability analyses.

Jingwen Wang, Richard J. Chen, Ming Y. Lu et al.

Histology-based grade classification is clinically important for many cancer types in stratifying patients distinct treatment groups. In prostate cancer, the Gleason score is a grading system used to measure the aggressiveness of prostate cancer from the spatial organization of cells and the distribution of glands. However, the subjective interpretation of Gleason score often suffers from large interobserver and intraobserver variability. Previous work in deep learning-based objective Gleason grading requires manual pixel-level annotation. In this work, we propose a weakly-supervised approach for grade classification in tissue micro-arrays (TMA) using graph convolutional networks (GCNs), in which we model the spatial organization of cells as a graph to better capture the proliferation and community structure of tumor cells. As node-level features in our graph representation, we learn the morphometry of each cell using a contrastive predictive coding (CPC)-based self-supervised approach. We demonstrate that on a five-fold cross validation our method can achieve $0.9659\pm0.0096$ AUC using only TMA-level labels. Our method demonstrates a 39.80\% improvement over standard GCNs with texture features and a 29.27% improvement over GCNs with VGG19 features. Our proposed pipeline can be used to objectively stratify low and high risk cases, reducing inter- and intra-observer variability and pathologist workload.

Faisal Mahmood, Daniel Borders, Richard Chen et al.

Nuclei segmentation is a fundamental task that is critical for various computational pathology applications including nuclei morphology analysis, cell type classification, and cancer grading. Conventional vision-based methods for nuclei segmentation struggle in challenging cases and deep learning approaches have proven to be more robust and generalizable. However, CNNs require large amounts of labeled histopathology data. Moreover, conventional CNN-based approaches lack structured prediction capabilities which are required to distinguish overlapping and clumped nuclei. Here, we present an approach to nuclei segmentation that overcomes these challenges by utilizing a conditional generative adversarial network (cGAN) trained with synthetic and real data. We generate a large dataset of H&E training images with perfect nuclei segmentation labels using an unpaired GAN framework. This synthetic data along with real histopathology data from six different organs are used to train a conditional GAN with spectral normalization and gradient penalty for nuclei segmentation. This adversarial regression framework enforces higher order consistency when compared to conventional CNN models. We demonstrate that this nuclei segmentation approach generalizes across different organs, sites, patients and disease states, and outperforms conventional approaches, especially in isolating individual and overlapping nuclei.