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El Jiar M, Eliahiai I, Chaib S, Elmorabit K, Mouatakid M, Kharmoum J, Chraibi M. The State of Telepathology in Africa in the Age of Digital Pathology Advancements: A Bibliometric Analysis and Literature Review. Cureus 2024; 16:e63835. [PMID: 39099907 PMCID: PMC11297393 DOI: 10.7759/cureus.63835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2024] [Indexed: 08/06/2024] Open
Abstract
Telepathology emerges as a vital tool, offering significant promise for enhancing pathology services in Africa, a region historically challenged by healthcare access and resource limitations. This review explores the development, adoption, and impacts of telepathology in Africa through a comprehensive bibliometric analysis and literature review. A methodical search in PubMed for publications up to 2024 revealed 119 pertinent studies, out of which 47 met the inclusion criteria for a focused review on telepathology's role in African healthcare settings. This research has charted a clear trajectory of growing interest in telepathology, as evidenced by the annual increase in related publications and robust international collaboration. It underscores the expanding utility of telepathology in diagnostics, education, and research within Africa, particularly in domains like dermatopathology, neuropathology, and, notably, oncology. The integration of artificial intelligence into telepathology presents new frontiers for enhancing diagnostic accuracy and efficiency. However, the review also identifies persistent challenges such as infrastructural inadequacies, a shortage of skilled professionals, and regulatory hurdles. The study highlights the indispensable role of international partnerships in advancing telepathology in the region. This review proposes a strategic pivot toward "leapfrogging," an approach that allows Africa to skip traditional developmental hurdles by directly adopting cutting-edge technologies and practices.
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Affiliation(s)
- Mohammed El Jiar
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Imane Eliahiai
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Sanae Chaib
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Khalid Elmorabit
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Mohamed Mouatakid
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Jinane Kharmoum
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
| | - Mariame Chraibi
- Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, MAR
- Department of Pathology, University Hospital Mohammed VI of Tangier, Tangier, MAR
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Pantanowitz J, Manko CD, Pantanowitz L, Rashidi HH. Synthetic Data and its Utility in Pathology and Laboratory Medicine. J Transl Med 2024; 104:102095. [PMID: 38925488 DOI: 10.1016/j.labinv.2024.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
In our rapidly expanding landscape of artificial intelligence, synthetic data have become a topic of great promise and also some concern. This review aimed to provide pathologists and laboratory professionals with a primer on the role of synthetic data and how it may soon shape the landscape within our field. Using synthetic data presents many advantages but also introduces a milieu of new obstacles and limitations. This review aimed to provide pathologists and laboratory professionals with a primer on the general concept of synthetic data and its potential to transform our field. By leveraging synthetic data, we can help accelerate the development of various machine learning models and enhance our medical education and research/quality study needs. This review explored the methods for generating synthetic data, including rule-based, machine learning model-based and hybrid approaches, as they apply to applications within pathology and laboratory medicine. We also discussed the limitations and challenges associated with such synthetic data, including data quality, malicious use, and ethical bias/concerns and challenges. By understanding the potential benefits (ie, medical education, training artificial intelligence programs, and proficiency testing, etc) and limitations of this new data realm, we can not only harness its power to improve patient outcomes, advance research, and enhance the practice of pathology but also become readily aware of their intrinsic limitations.
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Affiliation(s)
- Joshua Pantanowitz
- Computational Pathology and AI Center of Excellence (CPACE), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Christopher D Manko
- Guthrie Clinic Robert Packer Hospital; Geisinger Commonwealth School of Medicine, Guthrie, Pennsylvania
| | - Liron Pantanowitz
- Computational Pathology and AI Center of Excellence (CPACE), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Hooman H Rashidi
- Computational Pathology and AI Center of Excellence (CPACE), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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Furtado LV. In Silico Options for Assay Validation. J Appl Lab Med 2024; 9:180-182. [PMID: 38167772 DOI: 10.1093/jalm/jfad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Larissa V Furtado
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, United States
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Dolezal JM, Wolk R, Hieromnimon HM, Howard FM, Srisuwananukorn A, Karpeyev D, Ramesh S, Kochanny S, Kwon JW, Agni M, Simon RC, Desai C, Kherallah R, Nguyen TD, Schulte JJ, Cole K, Khramtsova G, Garassino MC, Husain AN, Li H, Grossman R, Cipriani NA, Pearson AT. Deep learning generates synthetic cancer histology for explainability and education. NPJ Precis Oncol 2023; 7:49. [PMID: 37248379 PMCID: PMC10227067 DOI: 10.1038/s41698-023-00399-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
Artificial intelligence methods including deep neural networks (DNN) can provide rapid molecular classification of tumors from routine histology with accuracy that matches or exceeds human pathologists. Discerning how neural networks make their predictions remains a significant challenge, but explainability tools help provide insights into what models have learned when corresponding histologic features are poorly defined. Here, we present a method for improving explainability of DNN models using synthetic histology generated by a conditional generative adversarial network (cGAN). We show that cGANs generate high-quality synthetic histology images that can be leveraged for explaining DNN models trained to classify molecularly-subtyped tumors, exposing histologic features associated with molecular state. Fine-tuning synthetic histology through class and layer blending illustrates nuanced morphologic differences between tumor subtypes. Finally, we demonstrate the use of synthetic histology for augmenting pathologist-in-training education, showing that these intuitive visualizations can reinforce and improve understanding of histologic manifestations of tumor biology.
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Affiliation(s)
- James M Dolezal
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Rachelle Wolk
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Hanna M Hieromnimon
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Frederick M Howard
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | | | | | - Siddhi Ramesh
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Sara Kochanny
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Jung Woo Kwon
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Meghana Agni
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Richard C Simon
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Chandni Desai
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Raghad Kherallah
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Tung D Nguyen
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Jefree J Schulte
- Department of Pathology and Laboratory Medicine, University of Wisconsin at Madison, Madison, WN, USA
| | - Kimberly Cole
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Galina Khramtsova
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Marina Chiara Garassino
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Aliya N Husain
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Huihua Li
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Robert Grossman
- University of Chicago, Center for Translational Data Science, Chicago, IL, USA
| | - Nicole A Cipriani
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA.
| | - Alexander T Pearson
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA.
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Ozer E, Bilecen AE, Ozer NB, Yanikoglu B. Intraoperative cytological diagnosis of brain tumours: A preliminary study using a deep learning model. Cytopathology 2023; 34:113-119. [PMID: 36458464 DOI: 10.1111/cyt.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Intraoperative pathological diagnosis of central nervous system (CNS) tumours is essential to planning patient management in neuro-oncology. Frozen section slides and cytological preparations provide architectural and cellular information that is analysed by pathologists to reach an intraoperative diagnosis. Progress in the fields of artificial intelligence and machine learning means that AI systems have significant potential for the provision of highly accurate real-time diagnosis in cytopathology. OBJECTIVE To investigate the efficiency of machine-learning models in the intraoperative cytological diagnosis of CNS tumours. MATERIALS AND METHODS We trained a deep neural network to classify biopsy material for intraoperative tissue diagnosis of four major brain lesions. Overall, 205 medical images were obtained from squash smear slides of histologically correlated cases, with 18 high-grade and 11 low-grade gliomas, 17 metastatic carcinomas, and 9 non-neoplastic pathological brain tissue samples. The neural network model was trained and evaluated using 5-fold cross-validation. RESULTS The model achieved 95% and 97% diagnostic accuracy in the patch-level classification and patient-level classification tasks, respectively. CONCLUSIONS We conclude that deep learning-based classification of cytological preparations may be a promising complementary method for the rapid and accurate intraoperative diagnosis of CNS tumours.
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Affiliation(s)
- Erdener Ozer
- Department of Pathology, Dokuz Eylul University School of Medicine, Izmir, Turkey.,Division of Anatomical Pathology, Sidra Medicine and Research Center, Doha, Qatar
| | - Ali Enver Bilecen
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Nur Basak Ozer
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Berrin Yanikoglu
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey.,Center of Excellence in Data Analytics (VERIM), Sabanci University, Istanbul, Turkey
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McAlpine E, Michelow P, Liebenberg E, Celik T. Are synthetic cytology images ready for prime time? A comparative assessment of real and synthetic urine cytology images. J Am Soc Cytopathol 2022; 12:126-135. [PMID: 37013344 DOI: 10.1016/j.jasc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/17/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The use of synthetic data in pathology has, to date, predominantly been augmenting existing pathology data to improve supervised machine learning algorithms. We present an alternative use case-using synthetic images to augment cytology training when the availability of real-world examples is limited. Moreover, we compare the assessment of real and synthetic urine cytology images by pathology personnel to explore the usefulness of this technology in a real-world setting. MATERIALS AND METHODS Synthetic urine cytology images were generated using a custom-trained conditional StyleGAN3 model. A morphologically balanced 60-image data set of real and synthetic urine cytology images was created for an online image survey system to allow for the assessment of the differences in visual perception between real and synthetic urine cytology images by pathology personnel. RESULTS A total of 12 participants were recruited to answer the 60-image survey. The study population had a median age of 36.5 years and a median of 5 years of pathology experience. There was no significant difference in diagnostic error rates between real and synthetic images, nor was there a significant difference between subjective image quality scores between real and synthetic images when assessed on an individual observer basis. CONCLUSIONS The ability of Generative Adversarial Networks technology to generate highly realistic urine cytology images was demonstrated. Furthermore, there was no difference in how pathology personnel perceived the subjective quality of synthetic images, nor was there a difference in diagnostic error rates between real and synthetic urine cytology images. This has important implications for the application of Generative Adversarial Networks technology to cytology teaching and learning.
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Affiliation(s)
- Ewen McAlpine
- Division of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; Ampath National Laboratories, Johannesburg, South Africa.
| | - Pamela Michelow
- Division of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; National Health Laboratory Services, Johannesburg, South Africa
| | - Eric Liebenberg
- Division of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Turgay Celik
- School of Electrical and Information Engineering and Wits Institute of Data Science, University of the Witwatersrand, Johannesburg, South Africa
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