Histopathological staining of human tissue is essential for disease diagnosis. Recent advances in virtual tissue staining technologies using artificial intelligence (AI) alleviate some of the costly and tedious steps involved in traditional histochemical staining processes, permitting multiplexed staining and tissue preservation. However, potential hallucinations and artifacts in these virtually stained tissue images pose concerns, especially for the clinical uses of these approaches. Quality assessment of histology images by experts can be subjective. Here, we present an autonomous quality and hallucination assessment method, AQuA, for virtual tissue staining and digital pathology. AQuA autonomously achieves 99.8% accuracy when detecting acceptable and unacceptable virtually stained tissue images without access to histochemically stained ground truth, and presents an agreement of 98.5% with the manual assessments made by board-certified pathologists, including identifying realistic-looking images that could mislead diagnosticians. We demonstrate the wide adaptability of AQuA across various virtually and histochemically stained human tissue images. This framework enhances the reliability of virtual tissue staining and provides autonomous quality assurance for image generation and transformation tasks in digital pathology and computational imaging.
Hematoxylin and Eosin (H&E) staining is widely regarded as the standard in pathology for diagnosing diseases and tracking tumor recurrence. While H&E staining shows tissue structures, it lacks the ability to reveal specific proteins that are associated with disease severity and treatment response. Immunohistochemical (IHC) stains use antibodies to highlight the expression of these proteins on their respective cell types, improving diagnostic accuracy, and assisting with drug selection for treatment. Despite their value, IHC stains require additional time and resources, limiting their utilization in some clinical settings. Recent advances in deep learning have positioned Image-to-Image (I2I) translation as a computational, cost-effective alternative for IHC. I2I generates high fidelity stain transformations digitally, potentially replacing manual staining in IHC. Diffusion models, the current state of the art in image generation and conditional tasks, are particularly well suited for virtual IHC due to their ability to produce high quality images and resilience to mode collapse. However, these models require extensive and diverse datasets (often millions of samples) to achieve a robust performance, a challenge in virtual staining applications where only thousands of samples are typically available. Inspired by the success of multitask deep learning models in scenarios with limited data, we introduce STAINDIFFUSER, a novel multitask diffusion architecture tailored to virtual staining that achieves convergence with smaller datasets. STAINDIFFUSER simultaneously trains two diffusion processes: (a) generating cell specific IHC stains from H&E images and (b) performing H&E based cell segmentation, utilizing coarse segmentation labels exclusively during training. STAINDIFFUSER generates high-quality virtual stains for two markers, outperforming over twenty I2I baselines.
Renal pathology, as the gold standard of kidney disease diagnosis, requires doctors to analyze a series of tissue slices stained by H&E staining and special staining like Masson, PASM, and PAS, respectively. These special staining methods are costly, time-consuming, and hard to standardize for wide use especially in primary hospitals. Advances of supervised learning methods have enabled the virtually conversion of H&E images into special staining images, but achieving pixel-to-pixel alignment for training remains challenging. In contrast, unsupervised learning methods regarding different stains as different style transfer domains can utilize unpaired data, but they ignore the spatial inter-domain correlations and thus decrease the trustworthiness of structural details for diagnosis. In this paper, we propose a novel virtual staining framework AGMDT to translate images into other domains by avoiding pixel-level alignment and meanwhile utilizing the correlations among adjacent tissue slices. We first build a high-quality multi-domain renal histological dataset where each specimen case comprises a series of slices stained in various ways. Based on it, the proposed framework AGMDT discovers patch-level aligned pairs across the serial slices of multi-domains through glomerulus detection and bipartite graph matching, and utilizes such correlations to supervise the end-to-end model for multi-domain staining transformation. Experimental results show that the proposed AGMDT achieves a good balance between the precise pixel-level alignment and unpaired domain transfer by exploiting correlations across multi-domain serial pathological slices, and outperforms the state-of-the-art methods in both quantitative measure and morphological details.
With the advent of digital scanners and deep learning, diagnostic operations may move from a microscope to a desktop. Hematoxylin and Eosin (H&E) staining is one of the most frequently used stains for disease analysis, diagnosis, and grading, but pathologists do need different immunohistochemical (IHC) stains to analyze specific structures or cells. Obtaining all of these stains (H&E and different IHCs) on a single specimen is a tedious and time-consuming task. Consequently, virtual staining has emerged as an essential research direction. Here, we propose a novel generative model, Structural Cycle-GAN (SC-GAN), for synthesizing IHC stains from H&E images, and vice versa. Our method expressly incorporates structural information in the form of edges (in addition to color data) and employs attention modules exclusively in the decoder of the proposed generator model. This integration enhances feature localization and preserves contextual information during the generation process. In addition, a structural loss is incorporated to ensure accurate structure alignment between the generated and input markers. To demonstrate the efficacy of the proposed model, experiments are conducted with two IHC markers emphasizing distinct structures of glands in the colon: the nucleus of epithelial cells (CDX2) and the cytoplasm (CK818). Quantitative metrics such as FID and SSIM are frequently used for the analysis of generative models, but they do not correlate explicitly with higher-quality virtual staining results. Therefore, we propose two new quantitative metrics that correlate directly with the virtual staining specificity of IHC markers.
Histological examination is a crucial step in an autopsy; however, the traditional histochemical staining of post-mortem samples faces multiple challenges, including the inferior staining quality due to autolysis caused by delayed fixation of cadaver tissue, as well as the resource-intensive nature of chemical staining procedures covering large tissue areas, which demand substantial labor, cost, and time. These challenges can become more pronounced during global health crises when the availability of histopathology services is limited, resulting in further delays in tissue fixation and more severe staining artifacts. Here, we report the first demonstration of virtual staining of autopsy tissue and show that a trained neural network can rapidly transform autofluorescence images of label-free autopsy tissue sections into brightfield equivalent images that match hematoxylin and eosin (H&E) stained versions of the same samples, eliminating autolysis-induced severe staining artifacts inherent in traditional histochemical staining of autopsied tissue. Our virtual H&E model was trained using >0.7 TB of image data and a data-efficient collaboration scheme that integrates the virtual staining network with an image registration network. The trained model effectively accentuated nuclear, cytoplasmic and extracellular features in new autopsy tissue samples that experienced severe autolysis, such as COVID-19 samples never seen before, where the traditional histochemical staining failed to provide consistent staining quality. This virtual autopsy staining technique can also be extended to necrotic tissue, and can rapidly and cost-effectively generate artifact-free H&E stains despite severe autolysis and cell death, also reducing labor, cost and infrastructure requirements associated with the standard histochemical staining.
Accurate and fast histological staining is crucial in histopathology, impacting diagnostic precision and reliability. Traditional staining methods are time-consuming and subjective, causing delays in diagnosis. Digital pathology plays a vital role in advancing and optimizing histology processes to improve efficiency and reduce turnaround times. This study introduces a novel deep learning-based framework for virtual histological staining using photon absorption remote sensing (PARS) images. By extracting features from PARS time-resolved signals using a variant of the K-means method, valuable multi-modal information is captured. The proposed multi-channel cycleGAN (MC-GAN) model expands on the traditional cycleGAN framework, allowing the inclusion of additional features. Experimental results reveal that specific combinations of features outperform the conventional channels by improving the labeling of tissue structures prior to model training. Applied to human skin and mouse brain tissue, the results underscore the significance of choosing the optimal combination of features, as it reveals a substantial visual and quantitative concurrence between the virtually stained and the gold standard chemically stained hematoxylin and eosin (H&E) images, surpassing the performance of other feature combinations. Accurate virtual staining is valuable for reliable diagnostic information, aiding pathologists in disease classification, grading, and treatment planning. This study aims to advance label-free histological imaging and opens doors for intraoperative microscopy applications.
The field of histology relies heavily on antiquated tissue processing and staining techniques that limit the efficiency of pathologic diagnoses of cancer and other diseases. Current staining and advanced labeling methods are often destructive and mutually incompatible, requiring new tissue sections for each stain. This prolongs the diagnostic process and depletes valuable biopsy samples. In this study, we present an alternative label-free histology platform using the first transmission-mode Photon Absorption Remote Sensing microscope. Optimized for automated whole slide scanning of unstained tissue samples, the system provides slide images at magnifications up to 40x that are fully compatible with existing digital pathology tools. The scans capture high quality and high-resolution images with subcellular diagnostic detail. After imaging, samples remain suitable for histochemical, immunohistochemical, and other staining techniques. Scattering and absorption (radiative and non-radiative) contrasts are shown in whole slide images of malignant human breast and skin tissues samples. Clinically relevant features are highlighted, and close correspondence and analogous contrast is demonstrated with one-to-one gold standard H&E stained images. Our previously reported pix2pix virtual staining model is applied to an entire whole slide image, showcasing the potential of this approach in whole slide label-free H&E emulation. This work is a critical advance for integrating label-free optical methods into standard histopathology workflows, both enhancing diagnostic efficiency, and broadening the number of stains that can be applied while preserving valuable tissue samples.
The analysis of FFPE tissue sections stained with haematoxylin and eosin (H&E) or immunohistochemistry (IHC) is an essential part of the pathologic assessment of surgically resected breast cancer specimens. IHC staining has been broadly adopted into diagnostic guidelines and routine workflows to manually assess status and scoring of several established biomarkers, including ER, PGR, HER2 and KI67. However, this is a task that can also be facilitated by computational pathology image analysis methods. The research in computational pathology has recently made numerous substantial advances, often based on publicly available whole slide image (WSI) data sets. However, the field is still considerably limited by the sparsity of public data sets. In particular, there are no large, high quality publicly available data sets with WSIs of matching IHC and H&E-stained tissue sections. Here, we publish the currently largest publicly available data set of WSIs of tissue sections from surgical resection specimens from female primary breast cancer patients with matched WSIs of corresponding H&E and IHC-stained tissue, consisting of 4,212 WSIs from 1,153 patients. The primary purpose of the data set was to facilitate the ACROBAT WSI registration challenge, aiming at accurately aligning H&E and IHC images. For research in the area of image registration, automatic quantitative feedback on registration algorithm performance remains available through the ACROBAT challenge website, based on more than 37,000 manually annotated landmark pairs from 13 annotators. Beyond registration, this data set has the potential to enable many different avenues of computational pathology research, including stain-guided learning, virtual staining, unsupervised pre-training, artefact detection and stain-independent models.
Histological staining is the gold standard for tissue examination in clinical pathology and life-science research, which visualizes the tissue and cellular structures using chromatic dyes or fluorescence labels to aid the microscopic assessment of tissue. However, the current histological staining workflow requires tedious sample preparation steps, specialized laboratory infrastructure, and trained histotechnologists, making it expensive, time-consuming, and not accessible in resource-limited settings. Deep learning techniques created new opportunities to revolutionize staining methods by digitally generating histological stains using trained neural networks, providing rapid, cost-effective, and accurate alternatives to standard chemical staining methods. These techniques, broadly referred to as virtual staining, were extensively explored by multiple research groups and demonstrated to be successful in generating various types of histological stains from label-free microscopic images of unstained samples; similar approaches were also used for transforming images of an already stained tissue sample into another type of stain, performing virtual stain-to-stain transformations. In this Review, we provide a comprehensive overview of the recent research advances in deep learning-enabled virtual histological staining techniques. The basic concepts and the typical workflow of virtual staining are introduced, followed by a discussion of representative works and their technical innovations. We also share our perspectives on the future of this emerging field, aiming to inspire readers from diverse scientific fields to further expand the scope of deep learning-enabled virtual histological staining techniques and their applications.
Virtual stain transfer is a promising area of research in Computational Pathology, which has a great potential to alleviate important limitations when applying deeplearningbased solutions such as lack of annotations and sensitivity to a domain shift. However, in the literature, the majority of virtual staining approaches are trained for a specific staining or stain combination, and their extension to unseen stainings requires the acquisition of additional data and training. In this paper, we propose HistoStarGAN, a unified framework that performs stain transfer between multiple stainings, stain normalisation and stain invariant segmentation, all in one inference of the model. We demonstrate the generalisation abilities of the proposed solution to perform diverse stain transfer and accurate stain invariant segmentation over numerous unseen stainings, which is the first such demonstration in the field. Moreover, the pre-trained HistoStar-GAN model can serve as a synthetic data generator, which paves the way for the use of fully annotated synthetic image data to improve the training of deep learning-based algorithms. To illustrate the capabilities of our approach, as well as the potential risks in the microscopy domain, inspired by applications in natural images, we generated KidneyArtPathology, a fully annotated artificial image dataset for renal pathology.
The presence and density of specific types of immune cells are important to understand a patient's immune response to cancer. However, immunofluorescence staining required to identify T cell subtypes is expensive, time-consuming, and rarely performed in clinical settings. We present a framework to virtually stain Hoechst images (which are cheap and widespread) with both CD3 and CD8 to identify T cell subtypes in clear cell renal cell carcinoma using generative adversarial networks. Our proposed method jointly learns both staining tasks, incentivising the network to incorporate mutually beneficial information from each task. We devise a novel metric to quantify the virtual staining quality, and use it to evaluate our method.
Pathological diagnosis relies on the visual inspection of histologically stained thin tissue specimens, where different types of stains are applied to bring contrast to and highlight various desired histological features. However, the destructive histochemical staining procedures are usually irreversible, making it very difficult to obtain multiple stains on the same tissue section. Here, we demonstrate a virtual stain transfer framework via a cascaded deep neural network (C-DNN) to digitally transform hematoxylin and eosin (H&E) stained tissue images into other types of histological stains. Unlike a single neural network structure which only takes one stain type as input to digitally output images of another stain type, C-DNN first uses virtual staining to transform autofluorescence microscopy images into H&E and then performs stain transfer from H&E to the domain of the other stain in a cascaded manner. This cascaded structure in the training phase allows the model to directly exploit histochemically stained image data on both H&E and the target special stain of interest. This advantage alleviates the challenge of paired data acquisition and improves the image quality and color accuracy of the virtual stain transfer from H&E to another stain. We validated the superior performance of this C-DNN approach using kidney needle core biopsy tissue sections and successfully transferred the H&E-stained tissue images into virtual PAS (periodic acid-Schiff) stain. This method provides high-quality virtual images of special stains using existing, histochemically stained slides and creates new opportunities in digital pathology by performing highly accurate stain-to-stain transformations.
Deep learning-based virtual staining was developed to introduce image contrast to label-free tissue sections, digitally matching the histological staining, which is time-consuming, labor-intensive, and destructive to tissue. Standard virtual staining requires high autofocusing precision during the whole slide imaging of label-free tissue, which consumes a significant portion of the total imaging time and can lead to tissue photodamage. Here, we introduce a fast virtual staining framework that can stain defocused autofluorescence images of unlabeled tissue, achieving equivalent performance to virtual staining of in-focus label-free images, also saving significant imaging time by lowering the microscope's autofocusing precision. This framework incorporates a virtual-autofocusing neural network to digitally refocus the defocused images and then transforms the refocused images into virtually stained images using a successive network. These cascaded networks form a collaborative inference scheme: the virtual staining model regularizes the virtual-autofocusing network through a style loss during the training. To demonstrate the efficacy of this framework, we trained and blindly tested these networks using human lung tissue. Using 4x fewer focus points with 2x lower focusing precision, we successfully transformed the coarsely-focused autofluorescence images into high-quality virtually stained H&E images, matching the standard virtual staining framework that used finely-focused autofluorescence input images. Without sacrificing the staining quality, this framework decreases the total image acquisition time needed for virtual staining of a label-free whole-slide image (WSI) by ~32%, together with a ~89% decrease in the autofocusing time, and has the potential to eliminate the laborious and costly histochemical staining process in pathology.
We propose a virtual staining methodology based on Generative Adversarial Networks to map histopathology images of breast cancer tissue from H&E stain to PHH3 and vice versa. We use the resulting synthetic images to build Convolutional Neural Networks (CNN) for automatic detection of mitotic figures, a strong prognostic biomarker used in routine breast cancer diagnosis and grading. We propose several scenarios, in which CNN trained with synthetically generated histopathology images perform on par with or even better than the same baseline model trained with real images. We discuss the potential of this application to scale the number of training samples without the need for manual annotations.
Histological staining is a vital step used to diagnose various diseases and has been used for more than a century to provide contrast to tissue sections, rendering the tissue constituents visible for microscopic analysis by medical experts. However, this process is time-consuming, labor-intensive, expensive and destructive to the specimen. Recently, the ability to virtually-stain unlabeled tissue sections, entirely avoiding the histochemical staining step, has been demonstrated using tissue-stain specific deep neural networks. Here, we present a new deep learning-based framework which generates virtually-stained images using label-free tissue, where different stains are merged following a micro-structure map defined by the user. This approach uses a single deep neural network that receives two different sources of information at its input: (1) autofluorescence images of the label-free tissue sample, and (2) a digital staining matrix which represents the desired microscopic map of different stains to be virtually generated at the same tissue section. This digital staining matrix is also used to virtually blend existing stains, digitally synthesizing new histological stains. We trained and blindly tested this virtual-staining network using unlabeled kidney tissue sections to generate micro-structured combinations of Hematoxylin and Eosin (H&E), Jones silver stain, and Masson's Trichrome stain. Using a single network, this approach multiplexes virtual staining of label-free tissue with multiple types of stains and paves the way for synthesizing new digital histological stains that can be created on the same tissue cross-section, which is currently not feasible with standard histochemical staining methods.
Visualizing the details of different cellular structures is of great importance to elucidate cellular functions. However, it is challenging to obtain high quality images of different structures directly due to complex cellular environments. Fluorescence staining is a popular technique to label different structures but has several drawbacks. In particular, label staining is time consuming and may affect cell morphology, and simultaneous labels are inherently limited. This raises the need of building computational models to learn relationships between unlabeled microscopy images and labeled fluorescence images, and to infer fluorescence labels of other microscopy images excluding the physical staining process. We propose to develop a novel deep model for virtual staining of unlabeled microscopy images. We first propose a novel network layer, known as the global pixel transformer layer, that fuses global information from inputs effectively. The proposed global pixel transformer layer can generate outputs with arbitrary dimensions, and can be employed for all the regular, down-sampling, and up-sampling operators. We then incorporate our proposed global pixel transformer layers and dense blocks to build an U-Net like network. We believe such a design can promote feature reusing between layers. In addition, we propose a multi-scale input strategy to encourage networks to capture features at different scales. We conduct evaluations across various fluorescence image prediction tasks to demonstrate the effectiveness of our approach. Both quantitative and qualitative results show that our method outperforms the state-of-the-art approach significantly. It is also shown that our proposed global pixel transformer layer is useful to improve the fluorescence image prediction results.
Histopathological evaluation of tissue samples is a key practice in patient diagnosis and drug development, especially in oncology. Historically, Hematoxylin and Eosin (H&E) has been used by pathologists as a gold standard staining. However, in many cases, various target specific stains, including immunohistochemistry (IHC), are needed in order to highlight specific structures in the tissue. As tissue is scarce and staining procedures are tedious, it would be beneficial to generate images of stained tissue virtually. Virtual staining could also generate in-silico multiplexing of different stains on the same tissue segment. In this paper, we present a sample application that generates FAP-CK virtual IHC images from Ki67-CD8 real IHC images using an unsupervised deep learning approach based on CycleGAN. We also propose a method to deal with tiling artifacts caused by normalization layers and we validate our approach by comparing the results of tissue analysis algorithms for virtual and real images.
Using a deep neural network, we demonstrate a digital staining technique, which we term PhaseStain, to transform quantitative phase images (QPI) of labelfree tissue sections into images that are equivalent to brightfield microscopy images of the same samples that are histochemically stained. Through pairs of image data (QPI and the corresponding brightfield images, acquired after staining) we train a generative adversarial network (GAN) and demonstrate the effectiveness of this virtual staining approach using sections of human skin, kidney and liver tissue, matching the brightfield microscopy images of the same samples stained with Hematoxylin and Eosin, Jones' stain, and Masson's trichrome stain, respectively. This digital staining framework might further strengthen various uses of labelfree QPI techniques in pathology applications and biomedical research in general, by eliminating the need for chemical staining, reducing sample preparation related costs and saving time. Our results provide a powerful example of some of the unique opportunities created by data driven image transformations enabled by deep learning.
Histological analysis of tissue samples is one of the most widely used methods for disease diagnosis. After taking a sample from a patient, it goes through a lengthy and laborious preparation, which stains the tissue to visualize different histological features under a microscope. Here, we demonstrate a label-free approach to create a virtually-stained microscopic image using a single wide-field auto-fluorescence image of an unlabeled tissue sample, bypassing the standard histochemical staining process, saving time and cost. This method is based on deep learning, and uses a convolutional neural network trained using a generative adversarial network model to transform an auto-fluorescence image of an unlabeled tissue section into an image that is equivalent to the bright-field image of the stained-version of the same sample. We validated this method by successfully creating virtually-stained microscopic images of human tissue samples, including sections of salivary gland, thyroid, kidney, liver and lung tissue, also covering three different stains. This label-free virtual-staining method eliminates cumbersome and costly histochemical staining procedures, and would significantly simplify tissue preparation in pathology and histology fields.