Segmentation of diagnostic tissue compartments on whole slide images with renal thrombotic microangiopathies (TMAs)

The thrombotic microangiopathies (TMAs) manifest in renal biopsy histology with a broad spectrum of acute and chronic findings. Precise diagnostic criteria for a renal biopsy diagnosis of TMA are missing. As a first step towards a machine learning- and computer vision-based analysis of wholes slide images from renal biopsies, we trained a segmentation model for the decisive diagnostic kidney tissue compartments artery, arteriole, glomerulus on a set of whole slide images from renal biopsies with TMAs and Mimickers (distinct diseases with a similar nephropathological appearance as TMA like severe benign nephrosclerosis, various vasculitides, Bevacizumab-plug glomerulopathy, arteriolar light chain deposition disease). Our segmentation model combines a U-Net-based tissue detection with a Shifted windows-transformer architecture to reach excellent segmentation results for even the most severely altered glomeruli, arterioles and arteries, even on unseen staining domains from a different nephropathology lab. With accurate automatic segmentation of the decisive renal biopsy compartments in human renal vasculopathies, we have laid the foundation for large-scale compartment-specific machine learning and computer vision analysis of renal biopsy repositories with TMAs.

StyPath: Style-Transfer Data Augmentation For Robust Histology Image Classification

The classification of Antibody Mediated Rejection (AMR) in kidney transplant remains challenging even for experienced nephropathologists; this is partly because histological tissue stain analysis is often characterized by low inter-observer agreement and poor reproducibility. One of the implicated causes for inter-observer disagreement is the variability of tissue stain quality between (and within) pathology labs, coupled with the gradual fading of archival sections. Variations in stain colors and intensities can make tissue evaluation difficult for pathologists, ultimately affecting their ability to describe relevant morphological features. Being able to accurately predict the AMR status based on kidney histology images is crucial for improving patient treatment and care. We propose a novel pipeline to build robust deep neural networks for AMR classification based on StyPath, a histological data augmentation technique that leverages a light weight style-transfer algorithm as a means to reduce sample-specific bias. Each image was generated in 1.84 +- 0.03 seconds using a single GTX TITAN V gpu and pytorch, making it faster than other popular histological data augmentation techniques. We evaluated our model using a Monte Carlo (MC) estimate of Bayesian performance and generate an epistemic measure of uncertainty to compare both the baseline and StyPath augmented models. We also generated Grad-CAM representations of the results which were assessed by an experienced nephropathologist; we used this qualitative analysis to elucidate on the assumptions being made by each model. Our results imply that our style-transfer augmentation technique improves histological classification performance (reducing error from 14.8% to 11.5%) and generalization ability.