I find this very interesting, and really appreciate the detailed and systematic approach.
As mentioned on the other thread, I think manual counts may tend to underestimate (I would presume it is more likely to miss a cell than it is to add one that isn't there), while automatic methods could go either way depending upon how they are set up (low/high thresholds etc.). So I think that getting more cells by automatic detection when compared to manual counts isn't too bad; although many more cells would be a bit concerning. In the end, it comes down to checking what was/wasn't detected in the image, and looking for any systematic biases.
Anyway, the settings that were modified are the ones I would also choose to modify.
The background radius should be either larger than the radius of your largest cell, or this setting should be turned off (i.e. <= 0). If it is set, then at a basic level QuPath looks around each cell to try to find a background value, and then subtracts this prior to detection; the truth is somewhat more complicated, since background values then propagate throughout the image to try to give a better estimate. Sometimes this helps if there is problematic background staining, sometimes (e.g. with very large cells, or dense clusters) it doesn't because there is no sensible radius that works.
I think the default setting isn't good for your image; so I'd also either go with 0 or ~15.
(Note that the background values in this case are only for detection, not measurement.)
The
sigma value controls how much Gaussian smoothing is applied (
here's the relevant bit of the aforementioned GitBook). Larger values tend to decrease the number of detected cells; they reduce the chances of breaking up one nucleus into multiple detections, at a cost of increasing the risk of blurring nuclei together. Currently, QuPath doesn't do any substantial 'multiresolution' processing for cell detection, so I'm afraid it's a matter of trying to find a suitable balance for all nuclei.
Again, I agree that the default is probably too low for this image; I tried sigma = 2 when I was exploring it last time.
The median filter reduces texture slightly - thereby decreasing spurious peaks that might appear inside large nuclei. If you increase this value, you may find that you can keep the sigma value a bit lower.
The max background intensity only really matters if you have a background radius > 0. It then uses the background image as a sanity check. This can be useful if there is a large dark artefact present, which might otherwise produce a lot of false cell detections. But it tends to only matter in more extreme cases.
And of course the main threshold value is key in deciding when the staining is dark enough to be a potential nucleus.
When I looked at this again, I realised that the standard Cell detection command (as opposed to Positive cell detection) gives red outlines by default - which are hard to see. It might help to go to Edit -> Preferences and change the Default annotation color (and optionally Detection line thickness). This is the color that is applied in the absence of any classification, even for cells as well.
It might also help to use View -> Cell display -> Nuclei only to avoid being distracted by cell boundaries; this option (where relevant) is also available by right-clicking on the image.