The Human BioMolecular Atlas Program (HuBMAP) aims to create a multi-scale spatial atlas of the healthy human body at single-cell resolution by applying advanced technologies and disseminating resources to the community. As the HuBMAP moves past its first phase, creating ontologies, protocols and pipelines, this Perspective introduces the production phase: the generation of reference spatial maps of functional tissue units across many organs from diverse populations and the creation of mapping tools and infrastructure to advance biomedical research.HuBMAP was founded with the goal of establishing state-of-the-art frameworks for building spatial multiomic maps of non-diseased human organs at single-cell resolution 1 . During the first phase (2018)(2019)(2020)(2021)(2022), the priorities of the project included the validation and development of assay platforms; workflows for data processing, management, exploration and visualization; and the establishment of protocols, quality control standards and standard operating procedures. Extensive infrastructure was established through a coordinated effort among the various HuB-MAP integration, visualization and engagement teams, tissue-mapping centres, technology and tools development and rapid technology implementation teams and working groups 1 . Single-cell maps, predominantly consisting of two-dimensional (2D) spatial data as well as data from dissociated cells, were generated for several organs. The HuBMAP Data Portal (https://portal.hubmapconsortium.org) was established for open access to experimental tissue data and reference atlas data.The infrastructure was augmented with software tools for tissue data registration, processing, annotation, visualization, cell segmentation and automated annotation of cell types and cellular neighbourhoods from spatial data. Computational methods were developed for integrating multiple data types across scales and interpretation 2 . Standard reference terminology and a common coordinate framework spanning anatomical to biomolecular scales were established to ensure interoperability across organs, research groups and consortia 3 . Guidelines to capture high-quality multiplexed spatial data 4 were established including validated panels of cell-and structure-specific antibodies 5 . The first phase produced a large number of manuscripts (https://commonfund.nih.gov/ publications?pid=43) including spatially resolved single-cell maps [6][7][8][9][10][11] .The production phase of HuBMAP was launched in the autumn of 2022. The focus is on scaling data production spanning diverse biological variables (for example, age and ethnicity) and deployment and enhancement of analytical, visualization and navigational tools to generate high-resolution 3D accessible maps of major functional tissue units from more than 20 organs. This phase involves over 60 institutions and 400 researchers with opportunities for active intra-and inter-consortia collaborations and building a foundational resource for new biological insights and precision medicine. Below, ...
The Ki-67 index is an established prognostic factor in gastrointestinal neuroendocrine tumors (GI-NETs) and defines tumor grade. It is currently estimated by microscopically examining tumor tissue single-immunostained (SS) for Ki-67 and counting the number of Ki-67-positive and Ki-67negative tumor cells within a subjectively picked hot-spot. Intraobserver variability in this procedure as well as difficulty in distinguishing tumor from non-tumor cells can lead to inaccurate Ki-67 indices and possibly incorrect tumor grades. We introduce two computational tools that utilize Ki-67 and synaptophysin double-immunostained (DS) slides to improve the accuracy of Ki-67 index quantitation in GI-NETs: (1) Synaptophysin-KI-Estimator (SKIE), a pipeline automating Ki-67 index quantitation via whole-slide image (WSI) analysis and (2) deep-SKIE, a deep learner-based approach where a Ki-67 index heatmap is generated throughout the tumor. Ki-67 indices for 50 GI-NETs were quantitated using SKIE and compared with DS slide assessments by three pathologists using a microscope and a fourth pathologist via manually ticking off each cell, the latter of which was deemed the gold standard (GS). Compared to the GS, SKIE achieved a grading accuracy of 90% and substantial agreement (linearweighted Cohen's kappa 0.62). Using DS WSIs, deep-SKIE displayed a training, validation, and testing accuracy of 98.4%, 90.9%, and 91.0%, respectively, significantly higher than using SS WSIs. Since DS slides are not standard clinical practice, we also integrated a cycle generative adversarial network into our pipeline to transform SS into DS WSIs. The proposed methods can improve accuracy and potentially save a significant amount of time if implemented into clinical practice. The Ki-67 index is an important prognostic marker and the most widely used parameter for grading gastrointestinal neuroendocrine tumors (GI-NETs) 1-3. The current practice for obtaining the Ki-67 index involves microscopic examination of tumor tissue that is immunostained for only Ki-67 (henceforth referred to as singleimmunostained or SS). First, a hot-spot (tumor region with the highest density of Ki-67-positive tumor cells) is selected, which is then used to manually obtain the percentage of Ki-67-positive tumor cells by counting a total of 500 to 2000 tumor cells 2,3. Current GI-NET grading, as proposed by the World Health Organization (WHO) 2017 recommendations 4,5 is based entirely on the mitotic count and Ki-67 index, of which the latter has proven to more accurately reflect biological behavior 6,7. A Ki-67 index of < 3% is grade 1 (G1), between 3 and 20% is grade 2 (G2), and > 20% is grade 3 (G3) 4,5. Nevertheless, the Ki-67 index still suffers from intra-and inter-observer variability 8 , especially for differentiating G1 from G2 GI-NETs, given the subjective nature of hot-spot selection as well as the common practice of "eyeball" estimation among pathologists due to the cumbersome process of manually counting individual tumor cells 9. Thus, an automated method of quantifying...
While it is impossible to deny the performance gains achieved through the incorporation of deep learning (DL) and other artificial intelligence (AI)-based techniques in pathology, minimal work has been done to answer the crucial question of why these algorithms predict what they predict. Tracing back classification decisions to specific input features allows for the quick identification of model bias as well as providing additional information toward understanding underlying biological mechanisms. In digital pathology, increasing the explainability of AI models would have the largest and most immediate impact for the image classification task. In this review, we detail some considerations that should be made in order to develop models with a focus on explainability.
Accurate quantification of renal fibrosis has profound importance in the assessment of chronic kidney disease (CKD). Visual analysis of a biopsy stained with trichrome under the microscope by a pathologist is the gold standard for evaluation of fibrosis. Trichrome helps to highlight collagen and ultimately interstitial fibrosis. However, trichrome stains are not always reproducible, can underestimate collagen content and are not sensitive to subtle fibrotic patterns. Using the Dual-mode emission and transmission (DUET) microscopy approach, it is possible to capture both brightfield and fluorescence images from the same area of a tissue stained with hematoxylin and eosin (H&E) enabling reproducible extraction of collagen with high sensitivity and specificity. Manual extraction of spectrally overlapping collagen signals from tubular epithelial cells and red blood cells is still an intensive task. We employed a UNet++ architecture for pixel-level segmentation and quantification of collagen using 760 whole slide image (WSI) patches from six cases of varying stages of fibrosis. Our trained model (Deep-DUET) used the supervised extracted collagen mask as ground truth and was able to predict the extent of collagen signal with a MSE of 0.05 in a holdout testing set while achieving an average AUC of 0.94 for predicting regions of collagen deposits. Expanding this work to the level of the WSI can greatly improve the ability of pathologists and machine learning (ML) tools to quantify the extent of renal fibrosis reproducibly and reliably.
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