LAUSR

Tumour budding in colorectal cancer, defined as single tumour cells or small clusters containing four tumour cells or less, is a robust and independent biomarker of aggressive tumour biology. Based on published data in the literature, evidence is certainly in favour of reporting tumour budding in routine practice. One important aspect of implementing tumour budding has been to establish a standardized and evidence-based scoring method as has been recommended by the International Tumour Budding Consensus Conference (ITBCC) in 2016. Further developments have aimed at establishing methods of automated tumour budding assessment. A digital approach to scoring tumour buds has great potential to assist in performing an objective budding count, but in analogy to the manual consensus method, must be validated and standardized. The aim of the present review is to present general considerations behind the ITBCC scoring method and a broad overview of the current status quo and challenges faced by automated tumour budding detection methods.