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Peer-reviewedCC BYJournal of Pathology Informatics

Deploying YOLO for whole-slide mitosis detection: A transparent, auditable, and reproducible pipeline for pathology AI-assisted diagnosis and decision-support tool

10 affiliations
  1. 1Cellular Pathology Department, Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom; Corresponding author.
  2. 2Cellular Pathology Department, Barking, Havering & Redbridge University Hospitals NHS Trust, London, United Kingdom
  3. 3Department of Education, Medical Laboratory Science Council of Nigeria, Abuja, Nigeria
  4. 4Department of Cellular Pathology, St George's University of London NHS Hospital, London, United Kingdom
  5. 5Airedale Voluntary Drug and Alcohol Service, Sheffield, United Kingdom
  6. 6Global Health and Infectious Disease Institute, Nasarawa State University, Nasarawa State, Nigeria
  7. 7School of Health and Life Sciences, Teesside University, Middlesbrough City, United Kingdom
  8. 8Department of Medical Laboratory Science, Faculty of Basic Medical Science, Osun State University, Osogbo, Nigeria
  9. 9Department of Vet. Pathology, University of Ilorin, Ilorin, Nigeria
  10. 10Department of Medical Laboratory, Haematology and Blood Transfusion Science Unit, Obafemi Awolowo College of Health Sciences, Ago-Iwoye, Nigeria

Abstract

Background: Reliable mitotic identification in whole-slide images (WSIs) is essential for prognostic evaluation and tumor grading; yet, many commercial artificial intelligence (AI) pathology platforms function as opaque black boxes with little auditability and, frequently, little expert supervision throughout development. Methods: We developed a transparent and repeatable process for mitosis identification using YOLOv8, designed to scale from full slide inference to patch-level benchmarking. Global non-maximum suppression (NMS), GPU accelerated inference, region of interest-driven and adaptive tiling, and tissue gating are all integrated into the pipeline. In order to facilitate expert validation and traceability, audit-ready outputs include detection CSVs, tile manifests, positive and negative overlays, and heatmaps. Results: From small clinical slides (26 tiles, 4 detections) to huge benchmarks (TUPAC SP2 with 14,270 tiles, 1754 detections), six typical WSIs were processed. Whereas throughput averaged 78 tiles/s depending on the slide size and tissue dispersion, average confidence scores remained constant between 0.69 and 0.80. The successful generation of all audit outputs attested to its scalability and reproducibility. Discussion: Transparency and expert monitoring are given priority in this pipeline, in contrast to many industry systems that place an emphasis on end-to-end automation. Whereas audit outputs enable reviewers to track each detection, explicit recording of positive detection tiles avoid quiet false positives. Evaluation on a small number of WSIs and the lack of benchmarking against annotated entire slide datasets are among the limitations, highlighting the necessity for more extensive and thorough cohort validation. Another significant drawback of this work was the use of a single GPU for inferencing. Conclusion: This study develops a therapeutically focused, audit-ready process for mitotic figure detection, hotspot identification, and decision-support tool by fusing technical rigor, vetted by experts throughout the process. By demonstrating scalability, reproducibility, and transparency, this work is positioned as a proof-of concept for clinical mitosis detection, multi-GPU/cloud deployment, lab information systems/LIMS connectivity, and eventual use in digital pathology work processes. It also offers a trustworthy and marketable illustration of AI's potential in pathology.

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BibTeX
@article{obami2026deploying,
  title = {{Deploying YOLO for whole-slide mitosis detection: A transparent, auditable, and reproducible pipeline for pathology AI-assisted diagnosis and decision-support tool}},
  author = {Peter Omozokpia Obami and Aniruddha Ketkar and Samuel Ayobami Fasogbon and Kevin Odega and Iniobong Anselem Udo and Olumide Faith Ajani and Bob-Manuel Osuji and Akinpelu Moronkeji and Adiru Afolabi Adegboye and Ibukun Akinsola Omisakin},
  journal = {Journal of Pathology Informatics},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jpi.2026.100721},
  url = {https://doi.org/10.1016/j.jpi.2026.100721},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Deploying YOLO for whole-slide mitosis detection: A transparent, auditable, and reproducible pipeline for pathology AI-assisted diagnosis and decision-support tool
AU  - Peter Omozokpia Obami
AU  - Aniruddha Ketkar
AU  - Samuel Ayobami Fasogbon
AU  - Kevin Odega
AU  - Iniobong Anselem Udo
AU  - Olumide Faith Ajani
AU  - Bob-Manuel Osuji
AU  - Akinpelu Moronkeji
AU  - Adiru Afolabi Adegboye
AU  - Ibukun Akinsola Omisakin
PY  - 2026
DA  - 2026/09/21
JO  - Journal of Pathology Informatics
DO  - 10.1016/j.jpi.2026.100721
UR  - https://doi.org/10.1016/j.jpi.2026.100721
AB  - Background: Reliable mitotic identification in whole-slide images (WSIs) is essential for prognostic evaluation and tumor grading; yet, many commercial artificial intelligence (AI) pathology platforms function as opaque black boxes with little auditability and, frequently, little expert supervision throughout development. Methods: We developed a transparent and repeatable process for mitosis identification using YOLOv8, designed to scale from full slide inference to patch-level benchmarking. Global non-maximum suppression (NMS), GPU accelerated inference, region of interest-driven and adaptive tiling, and tissue gating are all integrated into the pipeline. In order to facilitate expert validation and traceability, audit-ready outputs include detection CSVs, tile manifests, positive and negative overlays, and heatmaps. Results: From small clinical slides (26 tiles, 4 detections) to huge benchmarks (TUPAC SP2 with 14,270 tiles, 1754 detections), six typical WSIs were processed. Whereas throughput averaged 78 tiles/s depending on the slide size and tissue dispersion, average confidence scores remained constant between 0.69 and 0.80. The successful generation of all audit outputs attested to its scalability and reproducibility. Discussion: Transparency and expert monitoring are given priority in this pipeline, in contrast to many industry systems that place an emphasis on end-to-end automation. Whereas audit outputs enable reviewers to track each detection, explicit recording of positive detection tiles avoid quiet false positives. Evaluation on a small number of WSIs and the lack of benchmarking against annotated entire slide datasets are among the limitations, highlighting the necessity for more extensive and thorough cohort validation. Another significant drawback of this work was the use of a single GPU for inferencing. Conclusion: This study develops a therapeutically focused, audit-ready process for mitotic figure detection, hotspot identification, and decision-support tool by fusing technical rigor, vetted by experts throughout the process. By demonstrating scalability, reproducibility, and transparency, this work is positioned as a proof-of concept for clinical mitosis detection, multi-GPU/cloud deployment, lab information systems/LIMS connectivity, and eventual use in digital pathology work processes. It also offers a trustworthy and marketable illustration of AI's potential in pathology.
SN  - 2153-3539
SN  - 2229-5089
ER  -