Automatic Ki-67 counting using robust cell detection and online dictionary learning.

Ki-67 proliferation index is a valid and important biomarker to gauge neuroendocrine tumor (NET) cell progression within the gastrointestinal tract and pancreas. Automatic Ki-67 assessment is very challenging due to complex variations of cell characteristics. In this paper, we propose an integrated learning-based framework for accurate automatic Ki-67 counting for NET. The main contributions of our method are: 1) A robust cell counting and boundary delineation algorithm that is designed to localize both tumor and nontumor cells. 2) A novel online sparse dictionary learning method to select a set of representative training samples. 3) An automated framework that is used to differentiate tumor from nontumor cells (such as lymphocytes) and immunopositive from immunonegative tumor cells for the assessment of Ki-67 proliferation index. The proposed method has been extensively tested using 46 NET cases. The performance is compared with pathologists' manual annotations. The automatic Ki-67 counting is quite accurate compared with pathologists' manual annotations. This is much more accurate than existing methods.