Complete Workflow for ER-IHC Pathology Database Revalidation

Computer-aided systems can assist doctors in detecting cancer at an early stage using medical image analysis. In estrogen receptor immunohistochemistry (ER-IHC)-stained whole-slide images, automated cell identification and segmentation are helpful in the prediction scoring of hormone receptor status, which aids pathologists in determining whether to recommend hormonal therapy or other therapies for a patient. Accurate scoring can be achieved with accurate segmentation and classification of the nuclei. This paper presents two main objectives: first is to identify the top three models for this classification task and establish an ensemble model, all using 10-fold cross-validation strategy; second is to detect recurring misclassifications within the dataset to identify “misclassified nuclei” or “incorrectly labeled nuclei” for the nuclei class ground truth. The classification task is carried out using 32 pre-trained deep learning models from Keras Applications, focusing on their effectiveness in classifying negative, weak, moderate, and strong nuclei in the ER-IHC histopathology images. An ensemble learning with logistic regression approach is employed for the three best models. The analysis reveals that the top three performing models are EfficientNetB0, EfficientNetV2B2, and EfficientNetB4 with an accuracy of 94.37%, 94.36%, and 94.29%, respectively, and the ensemble model’s accuracy is 95%. We also developed a web-based platform for the pathologists to rectify the “faulty-class” nuclei in the dataset. The complete flow of this work can benefit the field of medical image analysis especially when dealing with intra-observer variability with a large number of images for ground truth validation.