VIMs: Virtual Immunohistochemistry Multiplex staining via Text-to-Stain Diffusion Trained on Uniplex Stains

This paper introduces a Virtual Immunohistochemistry Multiplex staining (VIMs) model designed to generate multiple immunohistochemistry (IHC) stains from a single hematoxylin and eosin (H&E) stained tissue section. IHC stains are crucial in pathology practice for resolving complex diagnostic questions and guiding patient treatment decisions. While commercial laboratories offer a wide array of up to 400 different antibody-based IHC stains, small biopsies often lack sufficient tissue for multiple stains while preserving material for subsequent molecular testing. This highlights the need for virtual IHC staining. Notably, VIMs is the first model to address this need, leveraging a large vision-language single-step diffusion model for virtual IHC multiplexing through text prompts for each IHC marker. VIMs is trained on uniplex paired H&E and IHC images, employing an adversarial training module. Testing of VIMs includes both paired and unpaired image sets. To enhance computational efficiency, VIMs utilizes a pre-trained large latent diffusion model fine-tuned with small, trainable weights through the Low-Rank Adapter (LoRA) approach. Experiments on nuclear and cytoplasmic IHC markers demonstrate that VIMs outperforms the base diffusion model and achieves performance comparable to Pix2Pix, a standard generative model for paired image translation. Multiple evaluation methods, including assessments by two pathologists, are used to determine the performance of VIMs. Additionally, experiments with different prompts highlight the impact of text conditioning. This paper represents the first attempt to accelerate histopathology research by demonstrating the generation of multiple IHC stains from a single H&E input using a single model trained solely on uniplex data.

Weakly SSM : On the Viability of Weakly Supervised Segmentations for Statistical Shape Modeling

Statistical Shape Models (SSMs) excel at identifying population level anatomical variations, which is at the core of various clinical and biomedical applications, including morphology-based diagnostics and surgical planning. However, the effectiveness of SSM is often constrained by the necessity for expert-driven manual segmentation, a process that is both time-intensive and expensive, thereby restricting their broader application and utility. Recent deep learning approaches enable the direct estimation of Statistical Shape Models (SSMs) from unsegmented images. While these models can predict SSMs without segmentation during deployment, they do not address the challenge of acquiring the manual annotations needed for training, particularly in resource-limited settings. Semi-supervised and foundation models for anatomy segmentation can mitigate the annotation burden. Yet, despite the abundance of available approaches, there are no established guidelines to inform end-users on their effectiveness for the downstream task of constructing SSMs. In this study, we systematically evaluate the potential of weakly supervised methods as viable alternatives to manual segmentation's for building SSMs. We establish a new performance benchmark by employing various semi-supervised and foundational model methods for anatomy segmentation under low annotation settings, utilizing the predicted segmentation's for the task of SSM. We compare the modes of shape variation and use quantitative metrics to compare against a shape model derived from a manually annotated dataset. Our results indicate that some methods produce noisy segmentation, which is very unfavorable for SSM tasks, while others can capture the correct modes of variations in the population cohort with 60-80\% reduction in required manual annotation.

Probabilistic 3D Correspondence Prediction from Sparse Unsegmented Images

The study of physiology demonstrates that the form (shape)of anatomical structures dictates their functions, and analyzing the form of anatomies plays a crucial role in clinical research. Statistical shape modeling (SSM) is a widely used tool for quantitative analysis of forms of anatomies, aiding in characterizing and identifying differences within a population of subjects. Despite its utility, the conventional SSM construction pipeline is often complex and time-consuming. Additionally, reliance on linearity assumptions further limits the model from capturing clinically relevant variations. Recent advancements in deep learning solutions enable the direct inference of SSM from unsegmented medical images, streamlining the process and improving accessibility. However, the new methods of SSM from images do not adequately account for situations where the imaging data quality is poor or where only sparse information is available. Moreover, quantifying aleatoric uncertainty, which represents inherent data variability, is crucial in deploying deep learning for clinical tasks to ensure reliable model predictions and robust decision-making, especially in challenging imaging conditions. Therefore, we propose SPI-CorrNet, a unified model that predicts 3D correspondences from sparse imaging data. It leverages a teacher network to regularize feature learning and quantifies data-dependent aleatoric uncertainty by adapting the network to predict intrinsic input variances. Experiments on the LGE MRI left atrium dataset and Abdomen CT-1K liver datasets demonstrate that our technique enhances the accuracy and robustness of sparse image-driven SSM.

SCorP: Statistics-Informed Dense Correspondence Prediction Directly from Unsegmented Medical Images

Statistical shape modeling (SSM) is a powerful computational framework for quantifying and analyzing the geometric variability of anatomical structures, facilitating advancements in medical research, diagnostics, and treatment planning. Traditional methods for shape modeling from imaging data demand significant manual and computational resources. Additionally, these methods necessitate repeating the entire modeling pipeline to derive shape descriptors (e.g., surface-based point correspondences) for new data. While deep learning approaches have shown promise in streamlining the construction of SSMs on new data, they still rely on traditional techniques to supervise the training of the deep networks. Moreover, the predominant linearity assumption of traditional approaches restricts their efficacy, a limitation also inherited by deep learning models trained using optimized/established correspondences. Consequently, representing complex anatomies becomes challenging. To address these limitations, we introduce SCorP, a novel framework capable of predicting surface-based correspondences directly from unsegmented images. By leveraging the shape prior learned directly from surface meshes in an unsupervised manner, the proposed model eliminates the need for an optimized shape model for training supervision. The strong shape prior acts as a teacher and regularizes the feature learning of the student network to guide it in learning image-based features that are predictive of surface correspondences. The proposed model streamlines the training and inference phases by removing the supervision for the correspondence prediction task while alleviating the linearity assumption.

Estimation and Analysis of Slice Propagation Uncertainty in 3D Anatomy Segmentation

Supervised methods for 3D anatomy segmentation demonstrate superior performance but are often limited by the availability of annotated data. This limitation has led to a growing interest in self-supervised approaches in tandem with the abundance of available un-annotated data. Slice propagation has emerged as an self-supervised approach that leverages slice registration as a self-supervised task to achieve full anatomy segmentation with minimal supervision. This approach significantly reduces the need for domain expertise, time, and the cost associated with building fully annotated datasets required for training segmentation networks. However, this shift toward reduced supervision via deterministic networks raises concerns about the trustworthiness and reliability of predictions, especially when compared with more accurate supervised approaches. To address this concern, we propose the integration of calibrated uncertainty quantification (UQ) into slice propagation methods, providing insights into the model's predictive reliability and confidence levels. Incorporating uncertainty measures enhances user confidence in self-supervised approaches, thereby improving their practical applicability. We conducted experiments on three datasets for 3D abdominal segmentation using five UQ methods. The results illustrate that incorporating UQ improves not only model trustworthiness, but also segmentation accuracy. Furthermore, our analysis reveals various failure modes of slice propagation methods that might not be immediately apparent to end-users. This study opens up new research avenues to improve the accuracy and trustworthiness of slice propagation methods.

StainDiffuser: MultiTask Dual Diffusion Model for Virtual Staining

Hematoxylin and Eosin (H&E) staining is the most commonly used for disease diagnosis and tumor recurrence tracking. Hematoxylin excels at highlighting nuclei, whereas eosin stains the cytoplasm. However, H&E stain lacks details for differentiating different types of cells relevant to identifying the grade of the disease or response to specific treatment variations. Pathologists require special immunohistochemical (IHC) stains that highlight different cell types. These stains help in accurately identifying different regions of disease growth and their interactions with the cell's microenvironment. The advent of deep learning models has made Image-to-Image (I2I) translation a key research area, reducing the need for expensive physical staining processes. Pix2Pix and CycleGAN are still the most commonly used methods for virtual staining applications. However, both suffer from hallucinations or staining irregularities when H&E stain has less discriminate information about the underlying cells IHC needs to highlight (e.g.,CD3 lymphocytes). Diffusion models are currently the state-of-the-art models for image generation and conditional generation tasks. However, they require extensive and diverse datasets (millions of samples) to converge, which is less feasible for virtual staining applications.Inspired by the success of multitask deep learning models for limited dataset size, we propose StainDiffuser, a novel multitask dual diffusion architecture for virtual staining that converges under a limited training budget. StainDiffuser trains two diffusion processes simultaneously: (a) generation of cell-specific IHC stain from H&E and (b) H&E-based cell segmentation using coarse segmentation only during training. Our results show that StainDiffuser produces high-quality results for easier (CK8/18,epithelial marker) and difficult stains(CD3, Lymphocytes).

MASSM: An End-to-End Deep Learning Framework for Multi-Anatomy Statistical Shape Modeling Directly From Images

Statistical Shape Modeling (SSM) is an effective method for quantitatively analyzing anatomical variations within populations. However, its utility is limited by the need for manual segmentations of anatomies, a task that relies on the scarce expertise of medical professionals. Recent advances in deep learning have provided a promising approach that automatically generates statistical representations from unsegmented images. Once trained, these deep learning-based models eliminate the need for manual segmentation for new subjects. Nonetheless, most current methods still require manual pre-alignment of image volumes and specifying a bounding box around the target anatomy prior for inference, resulting in a partially manual inference process. Recent approaches facilitate anatomy localization but only estimate statistical representations at the population level. However, they cannot delineate anatomy directly in images and are limited to modeling a single anatomy. Here, we introduce MASSM, a novel end-to-end deep learning framework that simultaneously localizes multiple anatomies in an image, estimates population-level statistical representations, and delineates each anatomy. Our findings emphasize the crucial role of local correspondences, showcasing their indispensability in providing superior shape information for medical imaging tasks.

EfficientMorph: Parameter-Efficient Transformer-Based Architecture for 3D Image Registration

Transformers have emerged as the state-of-the-art architecture in medical image registration, outperforming convolutional neural networks (CNNs) by addressing their limited receptive fields and overcoming gradient instability in deeper models. Despite their success, transformer-based models require substantial resources for training, including data, memory, and computational power, which may restrict their applicability for end users with limited resources. In particular, existing transformer-based 3D image registration architectures face three critical gaps that challenge their efficiency and effectiveness. Firstly, while mitigating the quadratic complexity of full attention by focusing on local regions, window-based attention mechanisms often fail to adequately integrate local and global information. Secondly, feature similarities across attention heads that were recently found in multi-head attention architectures indicate a significant computational redundancy, suggesting that the capacity of the network could be better utilized to enhance performance. Lastly, the granularity of tokenization, a key factor in registration accuracy, presents a trade-off; smaller tokens improve detail capture at the cost of higher computational complexity, increased memory demands, and a risk of overfitting. Here, we propose EfficientMorph, a transformer-based architecture for unsupervised 3D image registration. It optimizes the balance between local and global attention through a plane-based attention mechanism, reduces computational redundancy via cascaded group attention, and captures fine details without compromising computational efficiency, thanks to a Hi-Res tokenization strategy complemented by merging operations. Notably, EfficientMorph sets a new benchmark for performance on the OASIS dataset with 16-27x fewer parameters.

Particle-Based Shape Modeling for Arbitrary Regions-of-Interest

Statistical Shape Modeling (SSM) is a quantitative method for analyzing morphological variations in anatomical structures. These analyses often necessitate building models on targeted anatomical regions of interest to focus on specific morphological features. We propose an extension to \particle-based shape modeling (PSM), a widely used SSM framework, to allow shape modeling to arbitrary regions of interest. Existing methods to define regions of interest are computationally expensive and have topological limitations. To address these shortcomings, we use mesh fields to define free-form constraints, which allow for delimiting arbitrary regions of interest on shape surfaces. Furthermore, we add a quadratic penalty method to the model optimization to enable computationally efficient enforcement of any combination of cutting-plane and free-form constraints. We demonstrate the effectiveness of this method on a challenging synthetic dataset and two medical datasets.

Structural Cycle GAN for Virtual Immunohistochemistry Staining of Gland Markers in the Colon

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.