Shahira Abousamra

Jakub R. Kaczmarzyk, Tahsin M. Kurc, Shahira Abousamra et al.

Histopathology remains the gold standard for diagnosis of various cancers. Recent advances in computer vision, specifically deep learning, have facilitated the analysis of histopathology images for various tasks, including immune cell detection and microsatellite instability classification. The state-of-the-art for each task often employs base architectures that have been pretrained for image classification on ImageNet. The standard approach to develop classifiers in histopathology tends to focus narrowly on optimizing models for a single task, not considering the aspects of modeling innovations that improve generalization across tasks. Here we present ChampKit (Comprehensive Histopathology Assessment of Model Predictions toolKit): an extensible, fully reproducible benchmarking toolkit that consists of a broad collection of patch-level image classification tasks across different cancers. ChampKit enables a way to systematically document the performance impact of proposed improvements in models and methodology. ChampKit source code and data are freely accessible at https://github.com/kaczmarj/champkit .

Meilong Xu, Xiaoling Hu, Saumya Gupta et al.

In digital pathology, segmenting densely distributed objects like glands and nuclei is crucial for downstream analysis. Since detailed pixel-wise annotations are very time-consuming, we need semi-supervised segmentation methods that can learn from unlabeled images. Existing semi-supervised methods are often prone to topological errors, e.g., missing or incorrectly merged/separated glands or nuclei. To address this issue, we propose TopoSemiSeg, the first semi-supervised method that learns the topological representation from unlabeled histopathology images. The major challenge is for unlabeled images; we only have predictions carrying noisy topology. To this end, we introduce a noise-aware topological consistency loss to align the representations of a teacher and a student model. By decomposing the topology of the prediction into signal topology and noisy topology, we ensure that the models learn the true topological signals and become robust to noise. Extensive experiments on public histopathology image datasets show the superiority of our method, especially on topology-aware evaluation metrics. Code is available at https://github.com/Melon-Xu/TopoSemiSeg.

Chen Li, Xiaoling Hu, Shahira Abousamra et al.

Generative models, such as GANs and diffusion models, have been used to augment training sets and boost performances in different tasks. We focus on generative models for cell detection instead, i.e., locating and classifying cells in given pathology images. One important information that has been largely overlooked is the spatial patterns of the cells. In this paper, we propose a spatial-pattern-guided generative model for cell layout generation. Specifically, a novel diffusion model guided by spatial features and generates realistic cell layouts has been proposed. We explore different density models as spatial features for the diffusion model. In downstream tasks, we show that the generated cell layouts can be used to guide the generation of high-quality pathology images. Augmenting with these images can significantly boost the performance of SOTA cell detection methods. The code is available at https://github.com/superlc1995/Diffusion-cell.

Shahira Abousamra, Rajarsi Gupta, Tahsin Kurc et al.

In digital pathology, the spatial context of cells is important for cell classification, cancer diagnosis and prognosis. To model such complex cell context, however, is challenging. Cells form different mixtures, lineages, clusters and holes. To model such structural patterns in a learnable fashion, we introduce several mathematical tools from spatial statistics and topological data analysis. We incorporate such structural descriptors into a deep generative model as both conditional inputs and a differentiable loss. This way, we are able to generate high quality multi-class cell layouts for the first time. We show that the topology-rich cell layouts can be used for data augmentation and improve the performance of downstream tasks such as cell classification.

Mahmudul Hasan, Jakub R. Kaczmarzyk, David Paredes et al.

Understanding the impact of tumor biology on the composition of nearby cells often requires characterizing the impact of biologically distinct tumor regions. Biomarkers have been developed to label biologically distinct tumor regions, but challenges arise because of differences in the spatial extent and distribution of differentially labeled regions. In this work, we present a framework for systematically investigating the impact of distinct tumor regions on cells near the tumor borders, accounting their cross spatial distributions. We apply the framework to multiplex immunohistochemistry (mIHC) studies of pancreatic cancer and show its efficacy in demonstrating how biologically different tumor regions impact the immune response in the tumor microenvironment. Furthermore, we show that the proposed framework can be extended to largescale whole slide image analysis.

Chen Li, Xiaoling Hu, Shahira Abousamra et al.

Semi-supervised crowd counting is an important yet challenging task. A popular approach is to iteratively generate pseudo-labels for unlabeled data and add them to the training set. The key is to use uncertainty to select reliable pseudo-labels. In this paper, we propose a novel method to calibrate model uncertainty for crowd counting. Our method takes a supervised uncertainty estimation strategy to train the model through a surrogate function. This ensures the uncertainty is well controlled throughout the training. We propose a matching-based patch-wise surrogate function to better approximate uncertainty for crowd counting tasks. The proposed method pays a sufficient amount of attention to details, while maintaining a proper granularity. Altogether our method is able to generate reliable uncertainty estimation, high quality pseudolabels, and achieve state-of-the-art performance in semisupervised crowd counting.

Meilong Xu, Saumya Gupta, Xiaoling Hu et al.

Accurately modeling multi-class cell topology is crucial in digital pathology, as it provides critical insights into tissue structure and pathology. The synthetic generation of cell topology enables realistic simulations of complex tissue environments, enhances downstream tasks by augmenting training data, aligns more closely with pathologists' domain knowledge, and offers new opportunities for controlling and generalizing the tumor microenvironment. In this paper, we propose a novel approach that integrates topological constraints into a diffusion model to improve the generation of realistic, contextually accurate cell topologies. Our method refines the simulation of cell distributions and interactions, increasing the precision and interpretability of results in downstream tasks such as cell detection and classification. To assess the topological fidelity of generated layouts, we introduce a new metric, Topological Frechet Distance (TopoFD), which overcomes the limitations of traditional metrics like FID in evaluating topological structure. Experimental results demonstrate the effectiveness of our approach in generating multi-class cell layouts that capture intricate topological relationships. Code is available at https://github.com/Melon-Xu/TopoCellGen.

Meilong Xu, Qingqiao Hu, Xiaoling Hu et al.

Topological correctness is crucial for tubular structures such as blood vessels, nerve fibers, and road networks. Existing topology-preserving methods rely on domain-specific ground truth, which is costly and rarely transfers across domains. When deployed to a new domain without annotations, a key question arises: how can we detect topological anomalies without ground-truth supervision? We reframe this as topological anomaly detection, a structured visual reasoning task requiring a model to locate and classify topological errors in predicted segmentation masks. Vision-Language Models (VLMs) are natural candidates; however, we find that state-of-the-art VLMs perform nearly at random, lacking the fine-grained, topology-aware perception needed to identify sparse connectivity errors in dense structures. To bridge this gap, we develop an automated data-curation pipeline that synthesizes diverse topological anomalies with verifiable annotations across progressively difficult levels, thereby constructing the first large-scale, multi-domain benchmark for this task. We then introduce Topo-R1, a framework that endows VLMs with topology-aware perception via two-stage training: supervised fine-tuning followed by reinforcement learning with Group Relative Policy Optimization (GRPO). Central to our approach is a topology-aware composite reward that integrates type-aware Hungarian matching for structured error classification, spatial localization scoring, and a centerline Dice (clDice) reward that directly penalizes connectivity disruptions, thereby jointly incentivizing semantic precision and structural fidelity. Extensive experiments demonstrate that Topo-R1 establishes a new paradigm for annotation-free topological quality assessment, consistently outperforming general-purpose VLMs and supervised baselines across all evaluation protocols.

Meilong Xu, Xiaoling Hu, Shahira Abousamra et al.

In semi-supervised segmentation, capturing meaningful semantic structures from unlabeled data is essential. This is particularly challenging in histopathology image analysis, where objects are densely distributed. To address this issue, we propose a semi-supervised segmentation framework designed to robustly identify and preserve relevant topological features. Our method leverages multiple perturbed predictions obtained through stochastic dropouts and temporal training snapshots, enforcing topological consistency across these varied outputs. This consistency mechanism helps distinguish biologically meaningful structures from transient and noisy artifacts. A key challenge in this process is to accurately match the corresponding topological features across the predictions in the absence of ground truth. To overcome this, we introduce a novel matching strategy that integrates spatial overlap with global structural alignment, minimizing discrepancies among predictions. Extensive experiments demonstrate that our approach effectively reduces topological errors, resulting in more robust and accurate segmentations essential for reliable downstream analysis. Code is available at \href{https://github.com/Melon-Xu/MATCH}{https://github.com/Melon-Xu/MATCH}.

Han Le, Rajarsi Gupta, Le Hou et al.

Quantitative assessment of Tumor-TIL spatial relationships is increasingly important in both basic science and clinical aspects of breast cancer research. We have developed and evaluated convolutional neural network (CNN) analysis pipelines to generate combined maps of cancer regions and tumor infiltrating lymphocytes (TILs) in routine diagnostic breast cancer whole slide tissue images (WSIs). We produce interactive whole slide maps that provide 1) insight about the structural patterns and spatial distribution of lymphocytic infiltrates and 2) facilitate improved quantification of TILs. We evaluated both tumor and TIL analyses using three CNN networks - Resnet-34, VGG16 and Inception v4, and demonstrated that the results compared favorably to those obtained by what believe are the best published methods. We have produced open-source tools and generated a public dataset consisting of tumor/TIL maps for 1,015 TCGA breast cancer images. We also present a customized web-based interface that enables easy visualization and interactive exploration of high-resolution combined Tumor-TIL maps for 1,015TCGA invasive breast cancer cases that can be downloaded for further downstream analyses.

Wentao Huang, Meilong Xu, Xiaoling Hu et al.

Spatial transcriptomics (ST) provides essential spatial context by mapping gene expression within tissue, enabling detailed study of cellular heterogeneity and tissue organization. However, aligning ST data with histology images poses challenges due to inherent spatial distortions and modality-specific variations. Existing methods largely rely on direct alignment, which often fails to capture complex cross-modal relationships. To address these limitations, we propose a novel framework that aligns gene and image features using a ranking-based alignment loss, preserving relative similarity across modalities and enabling robust multi-scale alignment. To further enhance the alignment's stability, we employ self-supervised knowledge distillation with a teacher-student network architecture, effectively mitigating disruptions from high dimensionality, sparsity, and noise in gene expression data. Extensive experiments on seven public datasets that encompass gene expression prediction, slide-level classification, and survival analysis demonstrate the efficacy of our method, showing improved alignment and predictive performance over existing methods.

Ujjwal Baid, Sarthak Pati, Tahsin M. Kurc et al.

We evaluate the performance of federated learning (FL) in developing deep learning models for analysis of digitized tissue sections. A classification application was considered as the example use case, on quantifiying the distribution of tumor infiltrating lymphocytes within whole slide images (WSIs). A deep learning classification model was trained using 50*50 square micron patches extracted from the WSIs. We simulated a FL environment in which a dataset, generated from WSIs of cancer from numerous anatomical sites available by The Cancer Genome Atlas repository, is partitioned in 8 different nodes. Our results show that the model trained with the federated training approach achieves similar performance, both quantitatively and qualitatively, to that of a model trained with all the training data pooled at a centralized location. Our study shows that FL has tremendous potential for enabling development of more robust and accurate models for histopathology image analysis without having to collect large and diverse training data at a single location.

Shahira Abousamra, David Belinsky, John Van Arnam et al.

In digital pathology, both detection and classification of cells are important for automatic diagnostic and prognostic tasks. Classifying cells into subtypes, such as tumor cells, lymphocytes or stromal cells is particularly challenging. Existing methods focus on morphological appearance of individual cells, whereas in practice pathologists often infer cell classes through their spatial context. In this paper, we propose a novel method for both detection and classification that explicitly incorporates spatial contextual information. We use the spatial statistical function to describe local density in both a multi-class and a multi-scale manner. Through representation learning and deep clustering techniques, we learn advanced cell representation with both appearance and spatial context. On various benchmarks, our method achieves better performance than state-of-the-arts, especially on the classification task. We also create a new dataset for multi-class cell detection and classification in breast cancer and we make both our code and data publicly available.

Sarthak Pati, Siddhesh P. Thakur, İbrahim Ethem Hamamcı et al.

Deep Learning (DL) has the potential to optimize machine learning in both the scientific and clinical communities. However, greater expertise is required to develop DL algorithms, and the variability of implementations hinders their reproducibility, translation, and deployment. Here we present the community-driven Generally Nuanced Deep Learning Framework (GaNDLF), with the goal of lowering these barriers. GaNDLF makes the mechanism of DL development, training, and inference more stable, reproducible, interpretable, and scalable, without requiring an extensive technical background. GaNDLF aims to provide an end-to-end solution for all DL-related tasks in computational precision medicine. We demonstrate the ability of GaNDLF to analyze both radiology and histology images, with built-in support for k-fold cross-validation, data augmentation, multiple modalities and output classes. Our quantitative performance evaluation on numerous use cases, anatomies, and computational tasks supports GaNDLF as a robust application framework for deployment in clinical workflows.

Shahira Abousamra, Minh Hoai, Dimitris Samaras et al.

We address the problem of crowd localization, i.e., the prediction of dots corresponding to people in a crowded scene. Due to various challenges, a localization method is prone to spatial semantic errors, i.e., predicting multiple dots within a same person or collapsing multiple dots in a cluttered region. We propose a topological approach targeting these semantic errors. We introduce a topological constraint that teaches the model to reason about the spatial arrangement of dots. To enforce this constraint, we define a persistence loss based on the theory of persistent homology. The loss compares the topographic landscape of the likelihood map and the topology of the ground truth. Topological reasoning improves the quality of the localization algorithm especially near cluttered regions. On multiple public benchmarks, our method outperforms previous localization methods. Additionally, we demonstrate the potential of our method in improving the performance in the crowd counting task.

Robert M. Patton, J. Travis Johnston, Steven R. Young et al.

Deep learning, through the use of neural networks, has demonstrated remarkable ability to automate many routine tasks when presented with sufficient data for training. The neural network architecture (e.g. number of layers, types of layers, connections between layers, etc.) plays a critical role in determining what, if anything, the neural network is able to learn from the training data. The trend for neural network architectures, especially those trained on ImageNet, has been to grow ever deeper and more complex. The result has been ever increasing accuracy on benchmark datasets with the cost of increased computational demands. In this paper we demonstrate that neural network architectures can be automatically generated, tailored for a specific application, with dual objectives: accuracy of prediction and speed of prediction. Using MENNDL--an HPC-enabled software stack for neural architecture search--we generate a neural network with comparable accuracy to state-of-the-art networks on a cancer pathology dataset that is also $16\times$ faster at inference. The speedup in inference is necessary because of the volume and velocity of cancer pathology data; specifically, the previous state-of-the-art networks are too slow for individual researchers without access to HPC systems to keep pace with the rate of data generation. Our new model enables researchers with modest computational resources to analyze newly generated data faster than it is collected.

Shahira Abousamra, Le Hou, Rajarsi Gupta et al.

Deep learning classifiers for characterization of whole slide tissue morphology require large volumes of annotated data to learn variations across different tissue and cancer types. As is well known, manual generation of digital pathology training data is time consuming and expensive. In this paper, we propose a semi-automated method for annotating a group of similar instances at once, instead of collecting only per-instance manual annotations. This allows for a much larger training set, that reflects visual variability across multiple cancer types and thus training of a single network which can be automatically applied to each cancer type without human adjustment. We apply our method to the important task of classifying Tumor Infiltrating Lymphocytes (TILs) in H&E images. Prior approaches were trained for individual cancer types, with smaller training sets and human-in-the-loop threshold adjustment. We utilize these thresholded results as large scale "semi-automatic" annotations. Combined with existing manual annotations, our trained deep networks are able to automatically produce better TIL prediction results in 12 cancer types, compared to the human-in-the-loop approach.