Domain Adaptation using Silver Standard Labels for Ki-67 Scoring in Digital Pathology: A Step Closer to Widescale Deployment

TL;DR

This paper introduces a domain adaptation pipeline using pseudo labels to improve Ki-67 scoring accuracy across different data domains, facilitating scalable clinical deployment of deep learning models in pathology.

Contribution

It proposes a novel unsupervised domain adaptation method employing silver standard labels to enhance model generalization without manual annotations.

Findings

SS+GS method achieved 95.9% PI accuracy on target data.

Features learned are more aligned across domains, improving generalization.

The pipeline enables scalable deployment without costly manual labeling.

Abstract

Deep learning systems have been proposed to improve the objectivity and efficiency of Ki- 67 PI scoring. The challenge is that while very accurate, deep learning techniques suffer from reduced performance when applied to out-of-domain data. This is a critical challenge for clinical translation, as models are typically trained using data available to the vendor, which is not from the target domain. To address this challenge, this study proposes a domain adaptation pipeline that employs an unsupervised framework to generate silver standard (pseudo) labels in the target domain, which is used to augment the gold standard (GS) source domain data. Five training regimes were tested on two validated Ki-67 scoring architectures (UV-Net and piNET), (1) SS Only: trained on target silver standard (SS) labels, (2) GS Only: trained on source GS labels, (3) Mixed: trained on target SS and source GS labels, (4) GS+SS: trained on source GS labels and fine-tuned on target SS labels, and our proposed method (5) SS+GS: trained on source SS labels and fine-tuned on source GS labels. The SS+GS method yielded significantly (p < 0.05) higher PI accuracy (95.9%) and more consistent results compared to the GS Only model on target data. Analysis of t-SNE plots showed features learned by the SS+GS models are more aligned for source and target data, resulting in improved generalization. The proposed pipeline provides an efficient method for learning the target distribution without manual annotations, which are time-consuming and costly to generate for medical images. This framework can be applied to any target site as a per-laboratory calibration method, for widescale deployment.