Chronic kidney disease (CKD) is a major global health issue, affecting over 10% of the population and causing significant mortality. While kidney biopsy remains the gold standard for CKD diagnosis and treatment, the lack of comprehensive benchmarks for kidney pathology segmentation hinders progress in the field. To address this, we organized the Kidney Pathology Image Segmentation (KPIs) Challenge, introducing a dataset that incorporates preclinical rodent models of CKD with over 10,000 annotated glomeruli from 60+ Periodic Acid Schiff (PAS)-stained whole slide images. The challenge includes two tasks, patch-level segmentation and whole slide image segmentation and detection, evaluated using the Dice Similarity Coefficient (DSC) and F1-score. By encouraging innovative segmentation methods that adapt to diverse CKD models and tissue conditions, the KPIs Challenge aims to advance kidney pathology analysis, establish new benchmarks, and enable precise, large-scale quantification for disease research and diagnosis.

This short abstract describes a solution to the COSAS 2024 competition on Cross-Organ and Cross-Scanner Adenocarcinoma Segmentation from histopathological image patches. The main challenge in the task of segmenting this type of cancer is a noticeable domain shift encountered when changing acquisition devices (microscopes) and also when tissue comes from different organs. The two tasks proposed in COSAS were to train on a dataset of images from three different organs, and then predict segmentations on data from unseen organs (dataset T1), and to train on a dataset of images acquired on three different scanners and then segment images acquired with another unseen microscope. We attempted to bridge the domain shift gap by experimenting with three different strategies: standard training for each dataset, pretraining on dataset T1 and then fine-tuning on dataset T2 (and vice-versa, a strategy we call \textit{Cross-Task Pretraining}), and training on the combination of dataset A and B. Our experiments showed that Cross-Task Pre-training is a more promising approach to domain generalization.

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neuro-vascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited public datasets with annotations on CoW anatomy, especially for CTA. Therefore we organized the TopCoW Challenge in 2023 with the release of an annotated CoW dataset. The TopCoW dataset was the first public dataset with voxel-level annotations for thirteen possible CoW vessel components, enabled by virtual-reality (VR) technology. It was also the first large dataset with paired MRA and CTA from the same patients. TopCoW challenge formalized the CoW characterization problem as a multiclass anatomical segmentation task with an emphasis on topological metrics. We invited submissions worldwide for the CoW segmentation task, which attracted over 140 registered participants from four continents. The top performing teams managed to segment many CoW components to Dice scores around 90%, but with lower scores for communicating arteries and rare variants. There were also topological mistakes for predictions with high Dice scores. Additional topological analysis revealed further areas for improvement in detecting certain CoW components and matching CoW variant topology accurately. TopCoW represented a first attempt at benchmarking the CoW anatomical segmentation task for MRA and CTA, both morphologically and topologically.

The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

In spite of the dominant performances of deep neural networks, recent works have shown that they are poorly calibrated, resulting in over-confident predictions. Miscalibration can be exacerbated by overfitting due to the minimization of the cross-entropy during training, as it promotes the predicted softmax probabilities to match the one-hot label assignments. This yields a pre-softmax activation of the correct class that is significantly larger than the remaining activations. Recent evidence from the literature suggests that loss functions that embed implicit or explicit maximization of the entropy of predictions yield state-of-the-art calibration performances. We provide a unifying constrained-optimization perspective of current state-of-the-art calibration losses. Specifically, these losses could be viewed as approximations of a linear penalty (or a Lagrangian) imposing equality constraints on logit distances. This points to an important limitation of such underlying equality constraints, whose ensuing gradients constantly push towards a non-informative solution, which might prevent from reaching the best compromise between the discriminative performance and calibration of the model during gradient-based optimization. Following our observations, we propose a simple and flexible generalization based on inequality constraints, which imposes a controllable margin on logit distances. Comprehensive experiments on a variety of image classification, semantic segmentation and NLP benchmarks demonstrate that our method sets novel state-of-the-art results on these tasks in terms of network calibration, without affecting the discriminative performance. The code is available at https://github.com/by-liu/MbLS .

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multi-center study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and postprocessing (66%). The "typical" lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work.

Delivering meaningful uncertainty estimates is essential for a successful deployment of machine learning models in the clinical practice. A central aspect of uncertainty quantification is the ability of a model to return predictions that are well-aligned with the actual probability of the model being correct, also known as model calibration. Although many methods have been proposed to improve calibration, no technique can match the simple, but expensive approach of training an ensemble of deep neural networks. In this paper we introduce a form of simplified ensembling that bypasses the costly training and inference of deep ensembles, yet it keeps its calibration capabilities. The idea is to replace the common linear classifier at the end of a network by a set of heads that are supervised with different loss functions to enforce diversity on their predictions. Specifically, each head is trained to minimize a weighted Cross-Entropy loss, but the weights are different among the different branches. We show that the resulting averaged predictions can achieve excellent calibration without sacrificing accuracy in two challenging datasets for histopathological and endoscopic image classification. Our experiments indicate that Multi-Head Multi-Loss classifiers are inherently well-calibrated, outperforming other recent calibration techniques and even challenging Deep Ensembles' performance.

The early detection of glaucoma is essential in preventing visual impairment. Artificial intelligence (AI) can be used to analyze color fundus photographs (CFPs) in a cost-effective manner, making glaucoma screening more accessible. While AI models for glaucoma screening from CFPs have shown promising results in laboratory settings, their performance decreases significantly in real-world scenarios due to the presence of out-of-distribution and low-quality images. To address this issue, we propose the Artificial Intelligence for Robust Glaucoma Screening (AIROGS) challenge. This challenge includes a large dataset of around 113,000 images from about 60,000 patients and 500 different screening centers, and encourages the development of algorithms that are robust to ungradable and unexpected input data. We evaluated solutions from 14 teams in this paper, and found that the best teams performed similarly to a set of 20 expert ophthalmologists and optometrists. The highest-scoring team achieved an area under the receiver operating characteristic curve of 0.99 (95% CI: 0.98-0.99) for detecting ungradable images on-the-fly. Additionally, many of the algorithms showed robust performance when tested on three other publicly available datasets. These results demonstrate the feasibility of robust AI-enabled glaucoma screening.

Active Learning methods create an optimized and labeled training set from unlabeled data. We introduce a novel Online Active Deep Learning method for Medical Image Analysis. We extend our MedAL active learning framework to present new results in this paper. Experiments on three medical image datasets show that our novel online active learning model requires significantly less labelings, is more accurate, and is more robust to class imbalances than existing methods. Our method is also more accurate and computationally efficient than the baseline model. Compared to random sampling and uncertainty sampling, the method uses 275 and 200 (out of 768) fewer labeled examples, respectively. For Diabetic Retinopathy detection, our method attains a 5.88% accuracy improvement over the baseline model when 80% of the dataset is labeled, and the model reaches baseline accuracy when only 40% is labeled.

We propose UOLO, a novel framework for the simultaneous detection and segmentation of structures of interest in medical images. UOLO consists of an object segmentation module which intermediate abstract representations are processed and used as input for object detection. The resulting system is optimized simultaneously for detecting a class of objects and segmenting an optionally different class of structures. UOLO is trained on a set of bounding boxes enclosing the objects to detect, as well as pixel-wise segmentation information, when available. A new loss function is devised, taking into account whether a reference segmentation is accessible for each training image, in order to suitably backpropagate the error.