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Main Authors: Boman, Sol Erika, Mulliqi, Nita, Blilie, Anders, Ji, Xiaoyi, Szolnoky, Kelvin, Gudlaugsson, Einar, Janssen, Emiel A. M., Kjosavik, Svein R., Asenjo, José, Gambacorta, Marcello, Libretti, Paolo, Braun, Marcin, Kordek, Radzislaw, Łowicki, Roman, Hotakainen, Kristina, Väre, Päivi, Pedersen, Bodil Ginnerup, Sørensen, Karina Dalsgaard, Ulhøi, Benedicte Parm, Egevad, Lars, Kartasalo, Kimmo
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2503.23021
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author Boman, Sol Erika
Mulliqi, Nita
Blilie, Anders
Ji, Xiaoyi
Szolnoky, Kelvin
Gudlaugsson, Einar
Janssen, Emiel A. M.
Kjosavik, Svein R.
Asenjo, José
Gambacorta, Marcello
Libretti, Paolo
Braun, Marcin
Kordek, Radzislaw
Łowicki, Roman
Hotakainen, Kristina
Väre, Päivi
Pedersen, Bodil Ginnerup
Sørensen, Karina Dalsgaard
Ulhøi, Benedicte Parm
Egevad, Lars
Kartasalo, Kimmo
author_facet Boman, Sol Erika
Mulliqi, Nita
Blilie, Anders
Ji, Xiaoyi
Szolnoky, Kelvin
Gudlaugsson, Einar
Janssen, Emiel A. M.
Kjosavik, Svein R.
Asenjo, José
Gambacorta, Marcello
Libretti, Paolo
Braun, Marcin
Kordek, Radzislaw
Łowicki, Roman
Hotakainen, Kristina
Väre, Päivi
Pedersen, Bodil Ginnerup
Sørensen, Karina Dalsgaard
Ulhøi, Benedicte Parm
Egevad, Lars
Kartasalo, Kimmo
contents Tissue detection is a crucial first step in most digital pathology applications. Details of the segmentation algorithm are rarely reported, and there is a lack of studies investigating the downstream effects of a poor segmentation algorithm. Disregarding tissue detection quality could create a bottleneck for downstream performance and jeopardize patient safety if diagnostically relevant parts of the specimen are excluded from analysis in clinical applications. This study aims to determine whether performance of downstream tasks is sensitive to the tissue detection method, and to compare performance of classical and AI-based tissue detection. To this end, we trained an AI model for Gleason grading of prostate cancer in whole slide images (WSIs) using two different tissue detection algorithms: thresholding (classical) and UNet++ (AI). A total of 33,823 WSIs scanned on five digital pathology scanners were used to train the tissue detection AI model. The downstream Gleason grading algorithm was trained and tested using 70,524 WSIs from 13 clinical sites scanned on 13 different scanners. There was a decrease from 116 (0.43%) to 22 (0.08%) fully undetected tissue samples when switching from thresholding-based tissue detection to AI-based, suggesting an AI model may be more reliable than a classical model for avoiding total failures on slides with unusual appearance. On the slides where tissue could be detected by both algorithms, no significant difference in overall Gleason grading performance was observed. However, tissue detection dependent clinically significant variations in AI grading were observed in 3.5% of malignant slides, highlighting the importance of robust tissue detection for optimal clinical performance of diagnostic AI.
format Preprint
id arxiv_https___arxiv_org_abs_2503_23021
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle The impact of tissue detection on diagnostic artificial intelligence algorithms in digital pathology
Boman, Sol Erika
Mulliqi, Nita
Blilie, Anders
Ji, Xiaoyi
Szolnoky, Kelvin
Gudlaugsson, Einar
Janssen, Emiel A. M.
Kjosavik, Svein R.
Asenjo, José
Gambacorta, Marcello
Libretti, Paolo
Braun, Marcin
Kordek, Radzislaw
Łowicki, Roman
Hotakainen, Kristina
Väre, Päivi
Pedersen, Bodil Ginnerup
Sørensen, Karina Dalsgaard
Ulhøi, Benedicte Parm
Egevad, Lars
Kartasalo, Kimmo
Computer Vision and Pattern Recognition
Tissue detection is a crucial first step in most digital pathology applications. Details of the segmentation algorithm are rarely reported, and there is a lack of studies investigating the downstream effects of a poor segmentation algorithm. Disregarding tissue detection quality could create a bottleneck for downstream performance and jeopardize patient safety if diagnostically relevant parts of the specimen are excluded from analysis in clinical applications. This study aims to determine whether performance of downstream tasks is sensitive to the tissue detection method, and to compare performance of classical and AI-based tissue detection. To this end, we trained an AI model for Gleason grading of prostate cancer in whole slide images (WSIs) using two different tissue detection algorithms: thresholding (classical) and UNet++ (AI). A total of 33,823 WSIs scanned on five digital pathology scanners were used to train the tissue detection AI model. The downstream Gleason grading algorithm was trained and tested using 70,524 WSIs from 13 clinical sites scanned on 13 different scanners. There was a decrease from 116 (0.43%) to 22 (0.08%) fully undetected tissue samples when switching from thresholding-based tissue detection to AI-based, suggesting an AI model may be more reliable than a classical model for avoiding total failures on slides with unusual appearance. On the slides where tissue could be detected by both algorithms, no significant difference in overall Gleason grading performance was observed. However, tissue detection dependent clinically significant variations in AI grading were observed in 3.5% of malignant slides, highlighting the importance of robust tissue detection for optimal clinical performance of diagnostic AI.
title The impact of tissue detection on diagnostic artificial intelligence algorithms in digital pathology
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2503.23021