Challenges and Lessons from MIDOG 2025: A Two-Stage Approach to Domain-Robust Mitotic Figure Detection

Abstract: Mitotic figure detection remains a challenging task in computational pathology due to domain variability and morphological complexity. This paper describes our participation in the MIDOG 2025 challenge, focusing on robust mitotic figure detection across diverse tissue domains. We developed a two-stage pipeline combining Faster R-CNN for candidate detection with an ensemble of three classifiers (DenseNet-121, EfficientNet-v2, InceptionResNet-v2) for false positive reduction. Our best submission achieved F1-score 0.2237 (Recall: 0.9528, Precision: 0.1267) using a Faster R-CNN trained solely on MIDOG++ dataset. While our high recall demonstrates effective mitotic figure detection, the critically low precision (12.67%) reveals fundamental challenges in distinguishing true mitoses from morphologically similar imposters across diverse domains. Analysis of six submission variants showed that subsequent optimization attempts were counterproductive, highlighting the omplexity of domain generalization in histopathology. This work provides valuable insights into the practical challenges of developing robust mitotic figure detection algorithms and emphasizes the importance of effective false positive suppression strategies.