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    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Errors and Artefacts in Histopathological Imaging</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Antony Galton</string-name>
          <email>apgalton@ex.ac.uk</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Shereen Fouad</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Gabriel Landini</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>David Randell</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Computer Science, University of Exeter</institution>
          ,
          <addr-line>Exeter</addr-line>
          ,
          <country country="UK">UK</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>School of Dentistry, Institute of Clinical Sciences, University of Birmingham</institution>
          ,
          <country country="UK">UK</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Fig. 1. The Histological Imaging Pipeline segmentation</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>INTRODUCTION</title>
      <p>Preparation of histological samples for digital imaging, followed by
image formation and capture, forms only the start of an extended
pipeline running from biopsy to diagnosis or analysis. Artefacts
arising at these early stages form the best documented part of a
heterogeneous catalogue of things that can go wrong in the course of
following the pipeline. The literature on this subject mainly covers
problems arising at the stage of specimen preparation and how these
affect what is seen by the microscopist. With the advent of digital
microsopy and telepathology, however, new kinds of digitisation
artefacts or imaging errors can arise during slide image capture,
and further types of error emerge when we process, interpret, and
make inferences from the digital images. In this work we provide a
classification and explanation of such phenomena, and how, where,
and why they arise in the imaging pipeline, so that they can at least
be mitigated at the point at which they are generated.</p>
      <p>Human
patient
slicing,
mounting,
staining
image
formation
and capture
Microscope
slide</p>
      <p>Digital image
(pixel array)
treatment</p>
      <p>Diagnosis
quantitation,
evaluation</p>
      <p>Histological model
(image segments
interpreted as
depicting entities
in tissue sample)
interpretation
and label ing
Segmented image
(potential y meaningful
sets of pixels)</p>
      <p>The histological imaging pipeline (Figure 1) comprises a
sequence of stages leading from extraction of biological tissue from
an organism to yield a tissue sample which is then prepared for
imaging and segmentation, to the application of histological theory
to interpret the segmented regions as depicting actual histological
entities present in the original sample. This interpretation and
labelling results in a histological model for the sample; only on the
basis of such a model can diagnostic inferences be made, leading to
the possibility of selecting the most appropriate treatment.
THE SYSTEM OF ONTOLOGICAL LEVELS</p>
      <sec id="sec-1-1">
        <title>In order to classify the different types of error or artefact in the</title>
        <p>
          histological imaging pipeline, we adopt the ontological framework
used in
          <xref ref-type="bibr" rid="ref1">(Galton et al. 2016)</xref>
          , according to which each stage of the
pipeline is characterised by an ontologically distinct assemblage of
entities that are handled at that stage. We refer to these assemblages
as levels; they form a series as shown in Figure 2.
The inhabitants of level 3 are image segments labelled with
level 0 category names; as such, level 3 models are quite distinct
from the level 0 entities they represent. Such models always
represent simplified versions of reality, being two-dimensional
representations of three-dimensional realities, capturing only a tiny
fraction of the information that could potentially be extracted from
those realities by a hypothetical “omniscient” histologist.
        </p>
        <p>Level 0 comprises physical entities (real biological material),
whereas levels 1 upwards comprise information entities, abstract
patterns that may be instantiated in physical bearers (e.g., computer
memory, screen display, hard-copy printout). We distinguish digital
artefacts, arising from errors in the production of an information
entity (at levels 1 and above), from non-digital artefacts, arising
from errors occurring wholly within level 0.</p>
        <sec id="sec-1-1-1">
          <title>Level 3: Histological Models</title>
          <p>Labelled image segments interpretable as
model cells, model nuclei, etc</p>
        </sec>
        <sec id="sec-1-1-2">
          <title>Level 2: Segmented Images</title>
          <p>Image segments as candidate cells,
candidate nuclei, etc</p>
        </sec>
        <sec id="sec-1-1-3">
          <title>Level 1: Captured Images</title>
          <p>Pixel arrays</p>
        </sec>
        <sec id="sec-1-1-4">
          <title>Level 0:Biological Reality</title>
          <p>Tissues, cells, nuclei, etc</p>
          <p>Biopsy samples, histological preparations, etc
LEVEL-DEPENDENT ERROR-TYPES</p>
        </sec>
      </sec>
      <sec id="sec-1-2">
        <title>Here we present a brief overview of the kinds of errors that are encountered during the transition from each level to the next.</title>
        <p>Level 0 to level 0.5. Errors here include tissue sampling errors,
arising from the process of extracting tissue samples from organisms
(e.g., destruction or degradation of samples, incorrectly targeted
sampling, crush, splits, fragmentation, haemorrage; tears and
missing parts, scratches from a damaged microtome blade,
tissue sections too thick, ill-chosen cut direction (Fig. 3a)); and
tissue preparation errors, occurring during slicing, staining, and
mounting (e.g., fixation failure, tissue shrinkage, folds (Fig.</p>
      </sec>
      <sec id="sec-1-3">
        <title>3b), contamination with foreign matter or air bubbles, over- or</title>
        <p>understaining, faded stain; lack of stoichiometry of certain dyes;
immunohistochemistry-related issues such as background staining
and antibody cross reactivity; misplaced tissue micro-array cores).</p>
      </sec>
      <sec id="sec-1-4">
        <title>Level 0.5 to level 1. These are imaging errors, relating to image</title>
        <p>formation in the imaging device (e.g., a microscope), or
imagecapture in the capture device (e.g., a camera). In each case we
distinguish device errors and deployment errors:</p>
      </sec>
      <sec id="sec-1-5">
        <title>Image formation</title>
      </sec>
      <sec id="sec-1-6">
        <title>Image capture</title>
      </sec>
      <sec id="sec-1-7">
        <title>Device errors</title>
      </sec>
      <sec id="sec-1-8">
        <title>Chromatic aberration (Fig. 3d)</title>
      </sec>
      <sec id="sec-1-9">
        <title>Spatial distortion</title>
      </sec>
      <sec id="sec-1-10">
        <title>Bayer mask errors “Hot” and “dead” pixels (Fig. 3e)</title>
      </sec>
      <sec id="sec-1-11">
        <title>Deployment errors</title>
      </sec>
      <sec id="sec-1-12">
        <title>Coverslip scratches</title>
      </sec>
      <sec id="sec-1-13">
        <title>Uneven background illumination (Fig.3c)</title>
      </sec>
      <sec id="sec-1-14">
        <title>Thermal noise</title>
      </sec>
      <sec id="sec-1-15">
        <title>Interference and banding</title>
        <p>Level 1 to level 2. These are image-processing errors that occur
during the process of manipulating the initially captured image in
order to enable discovery of relevant information from it.</p>
      </sec>
      <sec id="sec-1-16">
        <title>Segmentation picks out some distinguished subset of pixels in the</title>
        <p>image and treats each of its connected components (segments) as an
“object”. The goal is to find segments which depict level 0 entities.</p>
      </sec>
      <sec id="sec-1-17">
        <title>Errors occur when the technique used leads to segmented images</title>
        <p>that fail to correspond to reality. These include oversegmentation,
where disconnected image segments derive from a single connected
object in reality, and undersegmentation, where one segment
represents a group of distinct objects in reality (Fig. 3f).
Level 2 to level 3. These are interpretation errors, involving
incorrect labelling of level 2 entities by level 0 categories.</p>
        <p>
          Level 3 entities are histological models, represented as image
segments labelled by histological categories in conformity with
theoretical expectations (e.g., nuclei should be proper parts of their
cell bodies). Often the segmentation must be manipulated before
category labels can be conformably assigned; such resegmentation
operations
          <xref ref-type="bibr" rid="ref3">(Randell et al. 2013)</xref>
          may introduce other errors if
not deployed carefully. Uncorrected errors from any earlier stage
in the pipeline may result in histological models which, though
theoretically acceptable, do not correspond to reality.
        </p>
      </sec>
      <sec id="sec-1-18">
        <title>Mitigation of interpretation errors depends on tests based on prior theoretical understanding of the target entities, e.g., typical</title>
        <p>
          shape and size range of nuclei. Some tests can be embedded in the
segmentation process itself, resulting in level 2 entities already more
nearly conformable with level 3
          <xref ref-type="bibr" rid="ref1 ref2">(Landini et al. 2016)</xref>
          .
        </p>
        <p>Beyond level 3. This is a miscellaneous collection of histological
inference errors, leading to a faulty diagnosis. These can arise from
faulty or incorrectly-used software systems (e.g., for
computeraided diagnosis) used in digitised image analysis. Errors may occur
at any stage in the software development, from design, through
implementation and testing, up to final deployment. Systematic
consideration of such errors is relatively new to the histological
imaging community, but in view of recent advances in the field it
is important to recognise them as a significant class.</p>
      </sec>
      <sec id="sec-1-19">
        <title>In pattern recognition algorithms, for example, histological</title>
        <p>images are represented by vector quantisation, where each object in
the segmented image is characterized by a set of features. A variety
of errors can arise from inappropriate choice of feature set.</p>
      </sec>
      <sec id="sec-1-20">
        <title>In general these high-level errors arise if too much trust is placed in necessarily imperfect software; it should not be used “blindly” but under the scrutiny of a trained pathologist whose judgment can supplement or correct an otherwise highly automated process.</title>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>ACKNOWLEDGEMENTS</title>
      <sec id="sec-2-1">
        <title>This work is supported by EPSRC grant EP/M023869/1 “Novel context-based segmentation algorithms for intelligent microscopy”.</title>
      </sec>
    </sec>
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