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Hsu YHR, Ahmed I, Phlamon J, Carment-Baker C, Chan JYT, Prassas I, Weiser K, Zeidan S, Clarke B, Yousef GM. An adapted & improved validation protocol for digital pathology implementation. Semin Diagn Pathol 2025; 42:150905. [PMID: 40273530 DOI: 10.1016/j.semdp.2025.150905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2025] [Accepted: 04/14/2025] [Indexed: 04/26/2025]
Abstract
Digital Pathology (DP) is transforming disease diagnosis by providing rapid and efficient analysis of tissue samples. However, ensuring the accuracy and reliability of diagnoses is crucial. This manuscript outlines University Health Network (UHN)'s journey towards the development of a customized validation protocol for implementing a digital workflow for primary clinical assessment. Drawing on guidelines from the Royal College of Pathologists (RCPath) UK and the College of American Pathologists (CAP), UHN has tailored its approach to accommodate the unique needs of its 14 subspecialty groups. Our protocol emphasizes pathologist-led self-validation, integration of diverse subspecialty cases, and a phased rollout with continuous monitoring. Additionally, the use of change management principles inspired by Leeds University (CCP) played a critical role in guiding the process, ensuring pathologists' comfort with digital workflows, and addressing subspecialty-specific challenges. This comprehensive validation protocol supports UHN's broader goals of leveraging DP for clinical practice while ensuring patient safety and data integrity.
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Affiliation(s)
- Ying-Han R Hsu
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Iman Ahmed
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Office of Strategy Management, University Health Network, Toronto, ON Canada
| | - Juliana Phlamon
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Charlotte Carment-Baker
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Office of Strategy Management, University Health Network, Toronto, ON Canada
| | - Joyce Yin Tung Chan
- Office of Strategy Management, University Health Network, Toronto, ON Canada
| | - Ioannis Prassas
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Karen Weiser
- Office of Strategy Management, University Health Network, Toronto, ON Canada
| | - Shaza Zeidan
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada
| | - Blaise Clarke
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - George M Yousef
- Laboratory Medicine Program, University Health Network, Toronto, ON Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada.
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Salido J, Vallez N, González-López L, Deniz O, Bueno G. Comparison of deep learning models for digital H&E staining from unpaired label-free multispectral microscopy images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 235:107528. [PMID: 37040684 DOI: 10.1016/j.cmpb.2023.107528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND AND OBJECTIVE This paper presents the quantitative comparison of three generative models of digital staining, also known as virtual staining, in H&E modality (i.e., Hematoxylin and Eosin) that are applied to 5 types of breast tissue. Moreover, a qualitative evaluation of the results achieved with the best model was carried out. This process is based on images of samples without staining captured by a multispectral microscope with previous dimensional reduction to three channels in the RGB range. METHODS The models compared are based on conditional GAN (pix2pix) which uses images aligned with/without staining, and two models that do not require image alignment, Cycle GAN (cycleGAN) and contrastive learning-based model (CUT). These models are compared based on the structural similarity and chromatic discrepancy between samples with chemical staining and their corresponding ones with digital staining. The correspondence between images is achieved after the chemical staining images are subjected to digital unstaining by means of a model obtained to guarantee the cyclic consistency of the generative models. RESULTS The comparison of the three models corroborates the visual evaluation of the results showing the superiority of cycleGAN both for its larger structural similarity with respect to chemical staining (mean value of SSIM ∼ 0.95) and lower chromatic discrepancy (10%). To this end, quantization and calculation of EMD (Earth Mover's Distance) between clusters is used. In addition, quality evaluation through subjective psychophysical tests with three experts was carried out to evaluate quality of the results with the best model (cycleGAN). CONCLUSIONS The results can be satisfactorily evaluated by metrics that use as reference image a chemically stained sample and the digital staining images of the reference sample with prior digital unstaining. These metrics demonstrate that generative staining models that guarantee cyclic consistency provide the closest results to chemical H&E staining that also is consistent with the result of qualitative evaluation by experts.
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Affiliation(s)
- Jesus Salido
- IEEAC Dept. (ESI-UCLM), P de la Universidad 4, Ciudad Real, 13071, Spain.
| | - Noelia Vallez
- IEEAC Dept. (ETSII-UCLM), Avda. Camilo José Cela s/n, Ciudad Real, 13071, Spain
| | - Lucía González-López
- Hospital Gral. Universitario de C.Real (HGUCR), C. Obispo Rafael Torija s/n, Ciudad Real, 13005, Spain
| | - Oscar Deniz
- IEEAC Dept. (ETSII-UCLM), Avda. Camilo José Cela s/n, Ciudad Real, 13071, Spain
| | - Gloria Bueno
- IEEAC Dept. (ETSII-UCLM), Avda. Camilo José Cela s/n, Ciudad Real, 13071, Spain
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Ruiz-Santaquiteria J, Espinosa-Aranda JL, Deniz O, Sanchez C, Borrego-Ramos M, Blanco S, Cristobal G, Bueno G. Low-cost oblique illumination: an image quality assessment. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-14. [PMID: 29297212 DOI: 10.1117/1.jbo.23.1.016001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/04/2017] [Indexed: 06/07/2023]
Abstract
We study the effectiveness of several low-cost oblique illumination filters to improve overall image quality, in comparison with standard bright field imaging. For this purpose, a dataset composed of 3360 diatom images belonging to 21 taxa was acquired. Subjective and objective image quality assessments were done. The subjective evaluation was performed by a group of diatom experts by psychophysical test where resolution, focus, and contrast were assessed. Moreover, some objective nonreference image quality metrics were applied to the same image dataset to complete the study, together with the calculation of several texture features to analyze the effect of these filters in terms of textural properties. Both image quality evaluation methods, subjective and objective, showed better results for images acquired using these illumination filters in comparison with the no filtered image. These promising results confirm that this kind of illumination filters can be a practical way to improve the image quality, thanks to the simple and low cost of the design and manufacturing process.
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Affiliation(s)
| | | | - Oscar Deniz
- University of Castilla-La Mancha, ETSI Industriales, Visilab, Ciudad Real, Spain
| | - Carlos Sanchez
- Institute of Optics "Daza de Valdés", Spanish National Research Council (CSIC), Madrid, Spain
| | | | - Saul Blanco
- University of León, Institute of Environment, León, Spain
| | - Gabriel Cristobal
- Institute of Optics "Daza de Valdés", Spanish National Research Council (CSIC), Madrid, Spain
| | - Gloria Bueno
- University of Castilla-La Mancha, ETSI Industriales, Visilab, Ciudad Real, Spain
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Stanciu SG, Ávila FJ, Hristu R, Bueno JM. A Study on Image Quality in Polarization-Resolved Second Harmonic Generation Microscopy. Sci Rep 2017; 7:15476. [PMID: 29133836 PMCID: PMC5684207 DOI: 10.1038/s41598-017-15257-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/24/2017] [Indexed: 01/21/2023] Open
Abstract
Second harmonic generation (SHG) microscopy represents a very powerful tool for tissue characterization. Polarization-resolved SHG (PSHG) microscopy extends the potential of SHG, by exploiting the dependence of SHG signals on the polarization state of the excitation beam. Among others, this dependence translates to the fact that SHG images collected under different polarization configurations exhibit distinct characteristics in terms of content and appearance. These characteristics hold deep implications over image quality, as perceived by human observers or by image analysis methods custom designed to automatically extract a quality factor from digital images. Our work addresses this subject, by investigating how basic image properties and the outputs of no-reference image quality assessment methods correlate to human expert opinion in the case of PSHG micrographs. Our evaluation framework is based on SHG imaging of collagen-based ocular tissues under different linear and elliptical polarization states of the incident light.
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Affiliation(s)
- Stefan G Stanciu
- Center for Microscopy-Microanalysis and Information Processing, University Politehnica of Bucharest, Bucharest, Romania.
| | | | - Radu Hristu
- Center for Microscopy-Microanalysis and Information Processing, University Politehnica of Bucharest, Bucharest, Romania
| | - Juan M Bueno
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain.
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Bueno G, Fernández-Carrobles MM, Deniz O, García-Rojo M. New Trends of Emerging Technologies in Digital Pathology. Pathobiology 2017; 83:61-9. [PMID: 27100343 DOI: 10.1159/000443482] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The future paradigm of pathology will be digital. Instead of conventional microscopy, a pathologist will perform a diagnosis through interacting with images on computer screens and performing quantitative analysis. The fourth generation of virtual slide telepathology systems, so-called virtual microscopy and whole-slide imaging (WSI), has allowed for the storage and fast dissemination of image data in pathology and other biomedical areas. These novel digital imaging modalities encompass high-resolution scanning of tissue slides and derived technologies, including automatic digitization and computational processing of whole microscopic slides. Moreover, automated image analysis with WSI can extract specific diagnostic features of diseases and quantify individual components of these features to support diagnoses and provide informative clinical measures of disease. Therefore, the challenge is to apply information technology and image analysis methods to exploit the new and emerging digital pathology technologies effectively in order to process and model all the data and information contained in WSI. The final objective is to support the complex workflow from specimen receipt to anatomic pathology report transmission, that is, to improve diagnosis both in terms of pathologists' efficiency and with new information. This article reviews the main concerns about and novel methods of digital pathology discussed at the latest workshop in the field carried out within the European project AIDPATH (Academia and Industry Collaboration for Digital Pathology).
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Roszkowiak L, Lopez C. PATMA: parser of archival tissue microarray. PeerJ 2016; 4:e2741. [PMID: 27920955 PMCID: PMC5136132 DOI: 10.7717/peerj.2741] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/31/2016] [Indexed: 02/04/2023] Open
Abstract
Tissue microarrays are commonly used in modern pathology for cancer tissue evaluation, as it is a very potent technique. Tissue microarray slides are often scanned to perform computer-aided histopathological analysis of the tissue cores. For processing the image, splitting the whole virtual slide into images of individual cores is required. The only way to distinguish cores corresponding to specimens in the tissue microarray is through their arrangement. Unfortunately, distinguishing the correct order of cores is not a trivial task as they are not labelled directly on the slide. The main aim of this study was to create a procedure capable of automatically finding and extracting cores from archival images of the tissue microarrays. This software supports the work of scientists who want to perform further image processing on single cores. The proposed method is an efficient and fast procedure, working in fully automatic or semi-automatic mode. A total of 89% of punches were correctly extracted with automatic selection. With an addition of manual correction, it is possible to fully prepare the whole slide image for extraction in 2 min per tissue microarray. The proposed technique requires minimum skill and time to parse big array of cores from tissue microarray whole slide image into individual core images.
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Affiliation(s)
- Lukasz Roszkowiak
- Laboratory of Processing Systems of Microscopic Image Information, Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Carlos Lopez
- Molecular Biology & Research Laboratory (IISPV, URV), Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
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Abstract
Automated analysis of microscope images is necessitated by the increased need for high-resolution follow up of events in time. Manually finding the right images to be analyzed, or eliminated from data analysis are common day-to-day problems in microscopy research today, and the constantly growing size of image datasets does not help the matter. We propose a simple method and a software tool for sorting images within a dataset, according to their relative quality. We demonstrate the applicability of our method in finding good quality images in a STED microscope sample preparation optimization image dataset. The results are validated by comparisons to subjective opinion scores, as well as five state-of-the-art blind image quality assessment methods. We also show how our method can be applied to eliminate useless out-of-focus images in a High-Content-Screening experiment. We further evaluate the ability of our image quality ranking method to detect out-of-focus images, by extensive simulations, and by comparing its performance against previously published, well-established microscopy autofocus metrics.
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Indu M, Rathy R, Binu MP. "Slide less pathology": Fairy tale or reality? J Oral Maxillofac Pathol 2016; 20:284-8. [PMID: 27601824 PMCID: PMC4989562 DOI: 10.4103/0973-029x.185921] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 05/22/2016] [Indexed: 11/24/2022] Open
Abstract
Pathology practice is significantly advanced in various frontiers. Therefore, "slide less digital" pathology will not be a mere imagination in near future. Digitalization of histopathological slides (whole slide imaging [WSI]) is possible with the help of whole slide scanner. The WSI has a positive impact not only in routine practice but also in research field, medical education and bioindustry. Even if digital pathology has definitive advantages, its widespread use is not yet possible. As it is an upcoming technology in our field, this article is aimed to discussessential aspects of WSI.
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Affiliation(s)
- M Indu
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - R Rathy
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - MP Binu
- Private Dental Practitioner, Cherthala, Alappuzha, Kerala, India
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Korzynska A, Roszkowiak L, Pijanowska D, Kozlowski W, Markiewicz T. The influence of the microscope lamp filament colour temperature on the process of digital images of histological slides acquisition standardization. Diagn Pathol 2015; 9 Suppl 1:S13. [PMID: 25565329 PMCID: PMC4305971 DOI: 10.1186/1746-1596-9-s1-s13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The aim of this study is to compare the digital images of the tissue biopsy captured with optical microscope using bright field technique under various light conditions. The range of colour's variation in immunohistochemically stained with 3,3'-Diaminobenzidine and Haematoxylin tissue samples is immense and coming from various sources. One of them is inadequate setting of camera's white balance to microscope's light colour temperature. Although this type of error can be easily handled during the stage of image acquisition, it can be eliminated with use of colour adjustment algorithms. The examination of the dependence of colour variation from microscope's light temperature and settings of the camera is done as an introductory research to the process of automatic colour standardization. Methods Six fields of view with empty space among the tissue samples have been selected for analysis. Each field of view has been acquired 225 times with various microscope light temperature and camera white balance settings. The fourteen randomly chosen images have been corrected and compared, with the reference image, by the following methods: Mean Square Error, Structural SIMilarity and visual assessment of viewer. Results For two types of backgrounds and two types of objects, the statistical image descriptors: range, median, mean and its standard deviation of chromaticity on a and b channels from CIELab colour space, and luminance L, and local colour variability for objects' specific area have been calculated. The results have been averaged for 6 images acquired in the same light conditions and camera settings for each sample. Conclusions The analysis of the results leads to the following conclusions: (1) the images collected with white balance setting adjusted to light colour temperature clusters in certain area of chromatic space, (2) the process of white balance correction for images collected with white balance camera settings not matched to the light temperature moves image descriptors into proper chromatic space but simultaneously the value of luminance changes. So the process of the image unification in a sense of colour fidelity can be solved in separate introductory stage before the automatic image analysis.
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Shrestha P, Kneepkens R, van Elswijk G, Vrijnsen J, Ion R, Verhagen D, Abels E, Vossen D, Bas Hulsken A. Objective and Subjective Assessment of Digital Pathology Image Quality. AIMS MEDICAL SCIENCE 2015. [DOI: 10.3934/medsci.2015.1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bueno G, Déniz O, Fernández-Carrobles MDM, Vállez N, Salido J. An automated system for whole microscopic image acquisition and analysis. Microsc Res Tech 2014; 77:697-713. [PMID: 24916187 DOI: 10.1002/jemt.22391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 04/14/2014] [Accepted: 05/30/2014] [Indexed: 11/12/2022]
Abstract
The field of anatomic pathology has experienced major changes over the last decade. Virtual microscopy (VM) systems have allowed experts in pathology and other biomedical areas to work in a safer and more collaborative way. VMs are automated systems capable of digitizing microscopic samples that were traditionally examined one by one. The possibility of having digital copies reduces the risk of damaging original samples, and also makes it easier to distribute copies among other pathologists. This article describes the development of an automated high-resolution whole slide imaging (WSI) system tailored to the needs and problems encountered in digital imaging for pathology, from hardware control to the full digitization of samples. The system has been built with an additional digital monochromatic camera together with the color camera by default and LED transmitted illumination (RGB). Monochrome cameras are the preferred method of acquisition for fluorescence microscopy. The system is able to digitize correctly and form large high resolution microscope images for both brightfield and fluorescence. The quality of the digital images has been quantified using three metrics based on sharpness, contrast and focus. It has been proved on 150 tissue samples of brain autopsies, prostate biopsies and lung cytologies, at five magnifications: 2.5×, 10×, 20×, 40×, and 63×. The article is focused on the hardware set-up and the acquisition software, although results of the implemented image processing techniques included in the software and applied to the different tissue samples are also presented.
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Affiliation(s)
- Gloria Bueno
- VISILAB Research Group, E.T.S. Ingenieros Industriales, University of Castilla-La Mancha, Av. Camilo José Cela s/n, Ciudad Real, 13071, Spain
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Henricks WH. Evaluation of whole slide imaging for routine surgical pathology: Looking through a broader scope. J Pathol Inform 2012; 3:39. [PMID: 23248760 PMCID: PMC3519098 DOI: 10.4103/2153-3539.103009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 09/04/2012] [Indexed: 11/04/2022] Open
Affiliation(s)
- Walter H. Henricks
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
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Yagi Y, Pantanowitz L. Comment on “Quality evaluation of microscopy and scanned histological images for diagnostic purposes”: Are scanners better than microscopes? J Pathol Inform 2012. [DOI: 10.1016/s2153-3539(22)00588-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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