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Semerci ZM, Toru HS, Çobankent Aytekin E, Tercanlı H, Chiorean DM, Albayrak Y, Cotoi OS. The Role of Artificial Intelligence in Early Diagnosis and Molecular Classification of Head and Neck Skin Cancers: A Multidisciplinary Approach. Diagnostics (Basel) 2024; 14:1477. [PMID: 39061614 PMCID: PMC11276319 DOI: 10.3390/diagnostics14141477] [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: 05/31/2024] [Revised: 07/01/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Cancer remains a significant global health concern, with increasing genetic and metabolic irregularities linked to its onset. Among various forms of cancer, skin cancer, including squamous cell carcinoma, basal cell carcinoma, and melanoma, is on the rise worldwide, often triggered by ultraviolet (UV) radiation. The propensity of skin cancer to metastasize highlights the importance of early detection for successful treatment. This narrative review explores the evolving role of artificial intelligence (AI) in diagnosing head and neck skin cancers from both radiological and pathological perspectives. In the past two decades, AI has made remarkable progress in skin cancer research, driven by advances in computational capabilities, digitalization of medical images, and radiomics data. AI has shown significant promise in image-based diagnosis across various medical domains. In dermatology, AI has played a pivotal role in refining diagnostic and treatment strategies, including genomic risk assessment. This technology offers substantial potential to aid primary clinicians in improving patient outcomes. Studies have demonstrated AI's effectiveness in identifying skin lesions, categorizing them, and assessing their malignancy, contributing to earlier interventions and better prognosis. The rising incidence and mortality rates of skin cancer, coupled with the high cost of treatment, emphasize the need for early diagnosis. Further research and integration of AI into clinical practice are warranted to maximize its benefits in skin cancer diagnosis and treatment.
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Affiliation(s)
- Zeliha Merve Semerci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, 07070 Antalya, Turkey; (Z.M.S.); (H.T.)
| | - Havva Serap Toru
- Department of Pathology, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey
| | | | - Hümeyra Tercanlı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, 07070 Antalya, Turkey; (Z.M.S.); (H.T.)
| | - Diana Maria Chiorean
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania; (D.M.C.); (O.S.C.)
- Department of Pathophysiology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
| | - Yalçın Albayrak
- Department of Electric and Electronic Engineering, Faculty of Engineering, Akdeniz University, 07010 Antalya, Turkey;
| | - Ovidiu Simion Cotoi
- Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania; (D.M.C.); (O.S.C.)
- Department of Pathophysiology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
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Tresserra F, Fabra G, Luque O, Castélla M, Gómez C, Fernández-Cid C, Rodríguez I. Validation of digital image slides for diagnosis in cervico-vaginal cytology. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:182-189. [PMID: 38971618 DOI: 10.1016/j.patol.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE To test the diagnostic concordance between microscopic (MI) and digital (DG) observation of cervico-vaginal (CV) cytology in a validation study of the technique. METHODS Five cytotechnologists (CT) reviewed 888 routine CV cytology cases from the Cervical Pathology Unit of our center over a 2-week period of time. The cases were first observed by MI and at the end of the day the cases were observed by DG. STATISTICAL ANALYSIS USED Agreement calculated using the Kappa index. RESULTS Most of the diagnoses corresponded to benign (64%) or inflammatory conditions (14%) and 24% corresponded to the intraepithelial lesion or malignancy (ILM) category. The overall kappa coefficient of concordance was strong (0.87). Among the different CTs it was almost perfect in two, strong in two and moderate in one. In 18 cases (10%) there were discrepancies between techniques in the category of ILM. In 10 (56%) cases there was an overdiagnosis in DG and in 8 (44%) an overdiagnosis in MI. Only in two cases, the diagnostic discrepancy exceeded one degree of difference between lesions, and they were ASCUS or AGUS for DG and CIN 2 for MI. CONCLUSIONS In this validation test in which routine cases during a two-week period have been used, observing the cases with both techniques on the same day, we have obtained a strong degree of concordance. The discordances obtained have not been considered relevant.
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Affiliation(s)
- Francisco Tresserra
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain.
| | - Gemma Fabra
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
| | - Olga Luque
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
| | - Miriam Castélla
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
| | - Carla Gómez
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
| | - Carmen Fernández-Cid
- Cytology Laboratory, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
| | - Ignacio Rodríguez
- Epidemiology Unit, Gynecology Service, Dexeus Women's Health, Dexeus University Hospital, Barcelona, Spain
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Shehabeldin A, Rohra P, Sellen LD, Zhao J, Alqaidy D, Aramin H, Hameed N, Perez YE, Lai Z, Tong YT, Milton DR, Edgerton ME, Fuller G, Hansel D, Prieto VG, Ballester LY, Aung PP. Utility of Whole Slide Imaging for Intraoperative Consultation: Experience of a Large Academic Center. Arch Pathol Lab Med 2024; 148:715-721. [PMID: 37756559 DOI: 10.5858/arpa.2023-0105-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 09/29/2023]
Abstract
CONTEXT.— In the United States, review of digital whole slide images (WSIs) using specific systems is approved for primary diagnosis but has not been implemented for intraoperative consultation. OBJECTIVE.— To evaluate the safety of review of WSIs and compare the efficiency of review of WSIs and glass slides (GSs) for intraoperative consultation. DESIGN.— Ninety-one cases previously submitted for frozen section evaluation were randomly selected from 8 different anatomic pathology subspecialties. GSs from these cases were scanned on a Leica Aperio AT2 scanner at ×20 magnification (0.25 μm/pixel). The slides were deidentified, and a short relevant clinical history was provided for each slide. Nine board-certified general pathologists who do not routinely establish primary diagnoses using WSIs reviewed the WSIs using Leica Aperio ImageScope viewing software. After a washout period of 2-3 weeks, the pathologists reviewed the corresponding GSs using a light microscope (Olympus BX43). The pathologists recorded the diagnosis and time to reach the diagnosis. Intraobserver concordance, time to diagnosis, and specificity and sensitivity compared to the original diagnosis were evaluated. RESULTS.— The rate of intraobserver concordance between GS results and WSI results was 93.7%. Mean time to diagnosis was 1.25 minutes for GSs and 1.76 minutes for WSIs (P < .001). Specificity was 91% for GSs and 90% for WSIs; sensitivity was 92% for GSs and 92% for WSIs. CONCLUSIONS.— Time to diagnosis was longer with WSIs than with GSs, and scanning GSs and uploading the data to whole slide imaging systems takes time. However, review of WSIs appears to be a safe alternative to review of GSs. Use of WSIs allows reporting from a remote site during a public health emergency such as the COVID-19 pandemic and facilitates subspecialty histopathology services.
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Affiliation(s)
- Ahmed Shehabeldin
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Prih Rohra
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Linton D Sellen
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Jianping Zhao
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Doaa Alqaidy
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Hermineh Aramin
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Nadia Hameed
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Ydamis Estrella Perez
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Zongshan Lai
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Yi Tat Tong
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Denái R Milton
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Mary E Edgerton
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Gregory Fuller
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Donna Hansel
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Victor G Prieto
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Leomar Y Ballester
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
| | - Phyu P Aung
- From the Departments of Pathology (Shehabeldin, Rohra, Sellen, Zhao, Alqaidy, Aramin, Hameed, Perez, Lai, Tong, Edgerton, Fuller, Hansel, Prieto, Ballester, Aung) and Biostatistics (Milton), The University of Texas MD Anderson Cancer Center, Houston
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Sajithkumar A, Thomas J, Saji AM, Ali F, E K HH, Adampulan HAG, Sarathchand S. Artificial Intelligence in pathology: current applications, limitations, and future directions. Ir J Med Sci 2024; 193:1117-1121. [PMID: 37542634 DOI: 10.1007/s11845-023-03479-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/26/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Given AI's recent success in computer vision applications, majority of pathologists anticipate that it will be able to assist them with a variety of digital pathology activities. Massive improvements in deep learning have enabled a synergy between Artificial Intelligence (AI) and deep learning, enabling image-based diagnosis against the backdrop of digital pathology. AI-based solutions are being developed to eliminate errors and save pathologists time. AIMS In this paper, we will discuss the components that went into the use of Artificial Intelligence in Pathology, its use in the medical profession, the obstacles and constraints that it encounters, and the future possibilities of AI in the medical field. CONCLUSIONS Based on these factors, we elaborate upon the use of AI in medical pathology and provide future recommendations for its successful implementation in this field.
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Affiliation(s)
- Akhil Sajithkumar
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India.
| | - Jubin Thomas
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India
| | - Ajish Meprathumalil Saji
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India
| | - Fousiya Ali
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India
| | - Haneena Hasin E K
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India
| | - Hannan Abdul Gafoor Adampulan
- Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre, Manoor Chekanoor Road, Mudur PO, Edappal, Malappuram Dist, 679578, India
| | - Swathy Sarathchand
- Sree Narayana Institute of Medical Sciences, Chalakka - Kuthiathode Rd, North Kuthiathode, Kunnukara, Kerala, 683594, India
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5
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Sanyal AJ, Loomba R, Anstee QM, Ratziu V, Kowdley KV, Rinella ME, Harrison SA, Resnick MB, Capozza T, Sawhney S, Shelat N, Younossi ZM. Utility of pathologist panels for achieving consensus in NASH histologic scoring in clinical trials: Data from a phase 3 study. Hepatol Commun 2024; 8:e0325. [PMID: 38126958 PMCID: PMC10749704 DOI: 10.1097/hc9.0000000000000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/21/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Liver histopathologic assessment is the accepted surrogate endpoint in NASH trials; however, the scoring of NASH Clinical Research Network (CRN) histologic parameters is limited by intraobserver and interobserver variability. We designed a consensus panel approach to minimize variability when using this scoring system. We assessed agreement between readers, estimated linear weighted kappas between 2 panels, compared them with published pairwise kappa estimates, and addressed how agreement or disagreement might impact the precision and validity of the surrogate efficacy endpoint in NASH trials. METHODS Two panels, each comprising 3 liver fellowship-trained pathologists who underwent NASH histology training, independently evaluated scanned whole slide images, scoring fibrosis, inflammation, hepatocyte ballooning, and steatosis from baseline and month 18 biopsies for 100 patients from the precirrhotic NASH study REGENERATE. The consensus score for each parameter was defined as agreement by ≥2 pathologists. If consensus was not reached, all 3 pathologists read the slide jointly to achieve a consensus score. RESULTS Between the 2 panels, the consensus was 97%-99% for steatosis, 91%-93% for fibrosis, 88%-92% for hepatocyte ballooning, and 84%-91% for inflammation. Linear weighted kappa scores between panels were similar to published NASH CRN values. CONCLUSIONS A panel of 3 trained pathologists independently scoring 4 NASH CRN histology parameters produced high consensus rates. Interpanel kappa values were comparable to NASH CRN metrics, supporting the accuracy and reproducibility of this method. The high concordance for fibrosis scoring was reassuring, as fibrosis is predictive of liver-specific outcomes and all-cause mortality.
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Affiliation(s)
- Arun J. Sanyal
- Department of Internal Medicine, Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rohit Loomba
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Quentin M. Anstee
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vlad Ratziu
- Sorbonne Université, Institute of Cardiometabolism and Nutrition, Pitié Salpêtriére University Hospital, Paris, France
| | | | - Mary E. Rinella
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - Murray B. Resnick
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, USA
| | - Thomas Capozza
- Intercept Pharmaceuticals, Inc., Morristown, New Jersey, USA
| | | | - Nirav Shelat
- Intercept Pharmaceuticals, Inc., Morristown, New Jersey, USA
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Schwen LO, Kiehl TR, Carvalho R, Zerbe N, Homeyer A. Digitization of Pathology Labs: A Review of Lessons Learned. J Transl Med 2023; 103:100244. [PMID: 37657651 DOI: 10.1016/j.labinv.2023.100244] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/18/2023] [Accepted: 08/23/2023] [Indexed: 09/03/2023] Open
Abstract
Pathology laboratories are increasingly using digital workflows. This has the potential of increasing laboratory efficiency, but the digitization process also involves major challenges. Several reports have been published describing the individual experiences of specific laboratories with the digitization process. However, a comprehensive overview of the lessons learned is still lacking. We provide an overview of the lessons learned for different aspects of the digitization process, including digital case management, digital slide reading, and computer-aided slide reading. We also cover metrics used for monitoring performance and pitfalls and corresponding values observed in practice. The overview is intended to help pathologists, information technology decision makers, and administrators to benefit from the experiences of others and to implement the digitization process in an optimal way to make their own laboratory future-proof.
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Affiliation(s)
- Lars Ole Schwen
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany.
| | - Tim-Rasmus Kiehl
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Rita Carvalho
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Norman Zerbe
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - André Homeyer
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
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Yang Y, Sun K, Gao Y, Wang K, Yu G. Preparing Data for Artificial Intelligence in Pathology with Clinical-Grade Performance. Diagnostics (Basel) 2023; 13:3115. [PMID: 37835858 PMCID: PMC10572440 DOI: 10.3390/diagnostics13193115] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The pathology is decisive for disease diagnosis but relies heavily on experienced pathologists. In recent years, there has been growing interest in the use of artificial intelligence in pathology (AIP) to enhance diagnostic accuracy and efficiency. However, the impressive performance of deep learning-based AIP in laboratory settings often proves challenging to replicate in clinical practice. As the data preparation is important for AIP, the paper has reviewed AIP-related studies in the PubMed database published from January 2017 to February 2022, and 118 studies were included. An in-depth analysis of data preparation methods is conducted, encompassing the acquisition of pathological tissue slides, data cleaning, screening, and subsequent digitization. Expert review, image annotation, dataset division for model training and validation are also discussed. Furthermore, we delve into the reasons behind the challenges in reproducing the high performance of AIP in clinical settings and present effective strategies to enhance AIP's clinical performance. The robustness of AIP depends on a randomized collection of representative disease slides, incorporating rigorous quality control and screening, correction of digital discrepancies, reasonable annotation, and sufficient data volume. Digital pathology is fundamental in clinical-grade AIP, and the techniques of data standardization and weakly supervised learning methods based on whole slide image (WSI) are effective ways to overcome obstacles of performance reproduction. The key to performance reproducibility lies in having representative data, an adequate amount of labeling, and ensuring consistency across multiple centers. Digital pathology for clinical diagnosis, data standardization and the technique of WSI-based weakly supervised learning will hopefully build clinical-grade AIP.
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Affiliation(s)
- Yuanqing Yang
- Department of Biomedical Engineering, School of Basic Medical Sciences, Central South University, Changsha 410013, China; (Y.Y.); (K.S.)
- Department of Biomedical Engineering, School of Medical, Tsinghua University, Beijing 100084, China
| | - Kai Sun
- Department of Biomedical Engineering, School of Basic Medical Sciences, Central South University, Changsha 410013, China; (Y.Y.); (K.S.)
- Furong Laboratory, Changsha 410013, China
| | - Yanhua Gao
- Department of Ultrasound, Shaanxi Provincial People’s Hospital, Xi’an 710068, China;
| | - Kuansong Wang
- Department of Pathology, School of Basic Medical Sciences, Central South University, Changsha 410013, China;
- Department of Pathology, Xiangya Hospital, Central South University, Changsha 410013, China
| | - Gang Yu
- Department of Biomedical Engineering, School of Basic Medical Sciences, Central South University, Changsha 410013, China; (Y.Y.); (K.S.)
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8
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Liu Y, Lai F, Lin B, Gu Y, Chen L, Chen G, Xiao H, Luo S, Pang Y, Xiong D, Li B, Peng S, Lv W, Alexander EK, Xiao H. Deep learning to predict cervical lymph node metastasis from intraoperative frozen section of tumour in papillary thyroid carcinoma: a multicentre diagnostic study. EClinicalMedicine 2023; 60:102007. [PMID: 37251623 PMCID: PMC10209138 DOI: 10.1016/j.eclinm.2023.102007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background Lymph node metastasis (LNM) assessment in patients with papillary thyroid carcinoma (PTC) is of great value. This study aimed to develop a deep learning model applied to intraoperative frozen section for prediction of LNM in PTC patients. Methods We established a deep-learning model (ThyNet-LNM) with the multiple-instance learning framework to predict LNM using whole slide images (WSIs) from intraoperative frozen sections of PTC. Data for the development and validation of ThyNet-LNM were retrospectively derived from four hospitals from January 2018 to December 2021. The ThyNet-LNM was trained using 1987 WSIs from 1120 patients obtained at the First Affiliated Hospital of Sun Yat-sen University. The ThyNet-LNM was then validated in the independent internal test set (479 WSIs from 280 patients) as well as three external test sets (1335 WSIs from 692 patients). The performance of ThyNet-LNM was further compared with preoperative ultrasound and computed tomography (CT). Findings The area under the receiver operating characteristic curves (AUCs) of ThyNet-LNM were 0.80 (95% CI 0.74-0.84), 0.81 (95% CI 0.77-0.86), 0.76 (95% CI 0.68-0.83), and 0.81 (95% CI 0.75-0.85) in internal test set and three external test sets, respectively. The AUCs of ThyNet-LNM were significantly higher than those of ultrasound and CT or their combination in all four test sets (all P < 0.01). Of 397 clinically node-negative (cN0) patients, the rate of unnecessary lymph node dissection decreased from 56.4% to 14.9% by ThyNet-LNM. Interpretation The ThyNet-LNM showed promising efficacy as a potential novel method in evaluating intraoperative LNM status, providing real-time guidance for decision. Furthermore, this led to a reduction of unnecessary lymph node dissection in cN0 patients. Funding National Natural Science Foundation of China, Guangzhou Science and Technology Project, and Guangxi Medical High-level Key Talents Training "139" Program.
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Affiliation(s)
- Yihao Liu
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bo Lin
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yunquan Gu
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lili Chen
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumour Images, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Han Xiao
- Division of Interventional Ultrasound, Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuli Luo
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuyan Pang
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumour Images, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dandan Xiong
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumour Images, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Erik K. Alexander
- Thyroid Section, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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9
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Jiang P, Liu J, Luo Q, Pang B, Xiao D, Cao D. Development of Automatic Portable Pathology Scanner and Its Evaluation for Clinical Practice. J Digit Imaging 2023; 36:1110-1122. [PMID: 36604365 PMCID: PMC10287606 DOI: 10.1007/s10278-022-00761-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/01/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Digital pathological scanners transform traditional glass slides into whole slide images (WSIs), which significantly improve the efficiency of pathological diagnosis and promote the development of digital pathology. However, the huge economic burden limits the spread and application of general WSI scanners in relatively remote and backward regions. In this paper, we develop an automatic portable cytopathology scanner based on mobile internet, Landing-Smart, to avert the above problems. Landing-Smart is a tiny device with a size of 208 mm × 107 mm × 104 mm and a weight of 1.8 kg, which integrates four main components including a smartphone, a glass slide carrier, an electric controller, and an optical imaging unit. By leveraging a simple optical imaging unit to substitute the sophisticated but complex conventional light microscope, the cost of Landing-Smart is less than $3000, much cheaper than general WSI scanners. On the one hand, Landing-Smart utilizes the built-in camera of the smartphone to acquire field of views (FoVs) in the section one by one. On the other hand, it uploads the images to the cloud server in real time via mobile internet, where the image processing and stitching method is implemented to generate the WSI of the cytological sample. The practical assessment of 209 cervical cytological specimens has demonstrated that Landing-Smart is comparable to general digital scanners in cytopathology diagnosis. Landing-Smart provides an effective tool for preliminary cytological screening in underdeveloped areas.
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Affiliation(s)
- Peng Jiang
- Institute of Artificial Intelligence, National Engineering Research Center for Multimedia Software, School of Computer Science, Wuhan University, Wuhan, 430072, China
| | - Juan Liu
- Institute of Artificial Intelligence, National Engineering Research Center for Multimedia Software, School of Computer Science, Wuhan University, Wuhan, 430072, China.
| | - Qiang Luo
- Landing Artificial Intelligence Center for Pathological Diagnosis, Wuhan, China
| | - Baochuan Pang
- Landing Artificial Intelligence Center for Pathological Diagnosis, Wuhan, China
| | - Di Xiao
- Landing Artificial Intelligence Center for Pathological Diagnosis, Wuhan, China
| | - Dehua Cao
- Landing Artificial Intelligence Center for Pathological Diagnosis, Wuhan, China
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10
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Wong CM, Kezlarian BE, Lin O. Current status of machine learning in thyroid cytopathology. J Pathol Inform 2023; 14:100309. [PMID: 37077698 PMCID: PMC10106504 DOI: 10.1016/j.jpi.2023.100309] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
The implementation of Digital Pathology has allowed the development of computational Pathology. Digital image-based applications that have received FDA Breakthrough Device Designation have been primarily focused on tissue specimens. The development of Artificial Intelligence-assisted algorithms using Cytology digital images has been much more limited due to technical challenges and a lack of optimized scanners for Cytology specimens. Despite the challenges in scanning whole slide images of cytology specimens, there have been many studies evaluating CP to create decision-support tools in Cytopathology. Among different Cytology specimens, thyroid fine needle aspiration biopsy (FNAB) specimens have one of the greatest potentials to benefit from machine learning algorithms (MLA) derived from digital images. Several authors have evaluated different machine learning algorithms focused on thyroid cytology in the past few years. The results are promising. The algorithms have mostly shown increased accuracy in the diagnosis and classification of thyroid cytology specimens. They have brought new insights and demonstrated the potential for improving future cytopathology workflow efficiency and accuracy. However, many issues still need to be addressed to further build on and improve current MLA models and their applications. To optimally train and validate MLA for thyroid cytology specimens, larger datasets obtained from multiple institutions are needed. MLAs hold great potential in improving thyroid cancer diagnostic speed and accuracy that will lead to improvements in patient management.
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Affiliation(s)
| | | | - Oscar Lin
- Corresponding author at: Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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11
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Parwani AV, Patel A, Zhou M, Cheville JC, Tizhoosh H, Humphrey P, Reuter VE, True LD. An update on computational pathology tools for genitourinary pathology practice: A review paper from the Genitourinary Pathology Society (GUPS). J Pathol Inform 2023; 14:100177. [PMID: 36654741 PMCID: PMC9841212 DOI: 10.1016/j.jpi.2022.100177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Machine learning has been leveraged for image analysis applications throughout a multitude of subspecialties. This position paper provides a perspective on the evolutionary trajectory of practical deep learning tools for genitourinary pathology through evaluating the most recent iterations of such algorithmic devices. Deep learning tools for genitourinary pathology demonstrate potential to enhance prognostic and predictive capacity for tumor assessment including grading, staging, and subtype identification, yet limitations in data availability, regulation, and standardization have stymied their implementation.
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Affiliation(s)
- Anil V. Parwani
- The Ohio State University, Columbus, Ohio, USA
- Corresponding author.
| | - Ankush Patel
- The Ohio State University, 2441 60th Ave SE, Mercer Island, Washington 98040, USA
| | - Ming Zhou
- Tufts University, Medford, Massachusetts, USA
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12
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Kim I, Kang K, Song Y, Kim TJ. Application of Artificial Intelligence in Pathology: Trends and Challenges. Diagnostics (Basel) 2022; 12:2794. [PMID: 36428854 PMCID: PMC9688959 DOI: 10.3390/diagnostics12112794] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/03/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Given the recent success of artificial intelligence (AI) in computer vision applications, many pathologists anticipate that AI will be able to assist them in a variety of digital pathology tasks. Simultaneously, tremendous advancements in deep learning have enabled a synergy with artificial intelligence (AI), allowing for image-based diagnosis on the background of digital pathology. There are efforts for developing AI-based tools to save pathologists time and eliminate errors. Here, we describe the elements in the development of computational pathology (CPATH), its applicability to AI development, and the challenges it faces, such as algorithm validation and interpretability, computing systems, reimbursement, ethics, and regulations. Furthermore, we present an overview of novel AI-based approaches that could be integrated into pathology laboratory workflows.
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Affiliation(s)
- Inho Kim
- College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Kyungmin Kang
- College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Youngjae Song
- College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Tae-Jung Kim
- Department of Hospital Pathology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Republic of Korea
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13
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Bertram CA, Stathonikos N, Donovan TA, Bartel A, Fuchs-Baumgartinger A, Lipnik K, van Diest PJ, Bonsembiante F, Klopfleisch R. Validation of digital microscopy: Review of validation methods and sources of bias. Vet Pathol 2022; 59:26-38. [PMID: 34433345 PMCID: PMC8761960 DOI: 10.1177/03009858211040476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Digital microscopy (DM) is increasingly replacing traditional light microscopy (LM) for performing routine diagnostic and research work in human and veterinary pathology. The DM workflow encompasses specimen preparation, whole-slide image acquisition, slide retrieval, and the workstation, each of which has the potential (depending on the technical parameters) to introduce limitations and artifacts into microscopic examination by pathologists. Performing validation studies according to guidelines established in human pathology ensures that the best-practice approaches for patient care are not deteriorated by implementing DM. Whereas current publications on validation studies suggest an overall high reliability of DM, each laboratory is encouraged to perform an individual validation study to ensure that the DM workflow performs as expected in the respective clinical or research environment. With the exception of validation guidelines developed by the College of American Pathologists in 2013 and its update in 2021, there is no current review of the application of methods fundamental to validation. We highlight that there is high methodological variation between published validation studies, each having advantages and limitations. The diagnostic concordance rate between DM and LM is the most relevant outcome measure, which is influenced (regardless of the viewing modality used) by different sources of bias including complexity of the cases examined, diagnostic experience of the study pathologists, and case recall. Here, we review 3 general study designs used for previous publications on DM validation as well as different approaches for avoiding bias.
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Affiliation(s)
- Christof A. Bertram
- University of Veterinary Medicine, Vienna, Austria
- Freie Universität Berlin, Berlin, Germany
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14
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Patel A, Balis UGJ, Cheng J, Li Z, Lujan G, McClintock DS, Pantanowitz L, Parwani A. Contemporary Whole Slide Imaging Devices and Their Applications within the Modern Pathology Department: A Selected Hardware Review. J Pathol Inform 2021; 12:50. [PMID: 35070479 PMCID: PMC8721869 DOI: 10.4103/jpi.jpi_66_21] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 12/21/2022] Open
Abstract
Digital pathology (DP) has disrupted the practice of traditional pathology, including applications in education, research, and clinical practice. Contemporary whole slide imaging (WSI) devices include technological advances that help address some of the challenges facing modern pathology, such as increasing workloads with fewer subspecialized pathologists, expanding integrated delivery networks with global reach, and greater customization when working up cases for precision medicine. This review focuses on integral hardware components of 43 market available and soon-to-be released digital WSI devices utilized throughout the world. Components such as objective lens type and magnification, scanning camera, illumination, and slide capacity were evaluated with respect to scan time, throughput, accuracy of scanning, and image quality. This analysis of assorted modern WSI devices offers essential, valuable information for successfully selecting and implementing a digital WSI solution for any given pathology practice.
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Affiliation(s)
- Ankush Patel
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | | | - Jerome Cheng
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Zaibo Li
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Giovanni Lujan
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | | | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Anil Parwani
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
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15
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White MJ, Birkness JE, Salimian KJ, Meiss AE, Butcher M, Davis K, Ware AD, Zarella MD, Lecksell K, Rooper LM, Cimino-Mathews A, VandenBussche CJ, Halushka MK, Thompson ED. Continuing Undergraduate Pathology Medical Education in the Coronavirus Disease 2019 (COVID-19) Global Pandemic: The Johns Hopkins Virtual Surgical Pathology Clinical Elective. Arch Pathol Lab Med 2021; 145:814-820. [PMID: 33740819 DOI: 10.5858/arpa.2020-0652-sa] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— In the early months of the response to the coronavirus disease 2019 (COVID-19) pandemic, the Johns Hopkins University School of Medicine (JHUSOM) (Baltimore, Maryland) leadership reached out to faculty to develop and implement virtual clinical clerkships after all in-person medical student clinical experiences were suspended. OBJECTIVE.— To develop and implement a digital slide-based virtual surgical pathology (VSP) clinical elective to meet the demand for meaningful and robust virtual clinical electives in response to the temporary suspension of in-person clinical rotations at JHUSOM. DESIGN.— The VSP elective was modeled after the in-person surgical pathology elective to include virtual previewing and sign-out with standardized cases supplemented by synchronous and asynchronous pathology educational content. RESULTS.— Validation of existing Web communications technology and slide-scanning systems was performed by feasibility testing. Curriculum development included drafting of course objectives and syllabus, Blackboard course site design, electronic-lecture creation, communications with JHUSOM leadership, scheduling, and slide curation. Subjectively, the weekly schedule averaged 35 to 40 hours of asynchronous, synchronous, and independent content, approximately 10 to 11 hours of which were synchronous. As of February 2021, VSP has hosted 35 JHUSOM and 8 non-JHUSOM students, who have provided positive subjective and objective course feedback. CONCLUSIONS.— The Johns Hopkins VSP elective provided meaningful clinical experience to 43 students in a time of immense online education need. Added benefits of implementing VSP included increased medical student exposure to pathology as a medical specialty and demonstration of how digital slides have the potential to improve standardization of the pathology clerkship curriculum.
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Affiliation(s)
- Marissa J White
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jacqueline E Birkness
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kevan J Salimian
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alice E Meiss
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Monica Butcher
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Katelynn Davis
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alisha D Ware
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark D Zarella
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristen Lecksell
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Rooper
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley Cimino-Mathews
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Marc K Halushka
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth D Thompson
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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16
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Vatchala Rani RM, Manjunath BC, Bajpai M, Sharma R, Gupta P, Bhargava A. Virtual microscopy: The future of pathological diagnostics, dental education, and telepathology. INDIAN JOURNAL OF DENTAL SCIENCES 2021. [DOI: 10.4103/ijds.ijds_194_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Azakpa AL, Priuli FF, Ndayake E, Ganhouingnon E, Gonzalez-Rodilla I, Tchaou MP, Zanin T. Telepathology Practice in Cancer Diagnosis in Saint Jean de Dieu Hospital - Tanguieta, Benin. Arch Pathol Lab Med 2020; 145:871-876. [PMID: 33091927 DOI: 10.5858/arpa.2019-0437-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2020] [Indexed: 12/24/2022]
Abstract
CONTEXT.— Both the incidence of cancer and cancer-related mortality rates are high in sub-Saharan Africa, while resources for diagnosis and management are inadequate. In Benin, there is an extreme shortage of pathology services. Because of this shortage we built a histopathology laboratory equipped with an automated immunohistochemistry and a whole-slide imaging and telepathology system. OBJECTIVE.— To report our experience of telepathology practice in the improvement of cancer diagnosis. DESIGN.— The study was performed in our histopathology laboratory from January 1, 2016, to December 31, 2018. Resident laboratory technicians were trained in the preparation of microscopic and virtual slides by European pathologists. Virtual slides were stored on a Web-accessible server area for reading by 21 telepathologists in Benin and Europe. All patients with a histologic diagnosis of cancer were included in this study. Demographic data of patients, anatomic site of cancer, its histologic type, and its histologic grade were recorded. RESULTS.— We registered 399 patients diagnosed with cancer of 1593 patients whose surgical specimens had been analyzed. There were 349 adults including 160 males and 189 females, and 50 children (both sexes) with a mean age of 53.40 years, 46.92 years, and 9.72 years, respectively. Eighty-three of 211 females (39.34%) had infiltrating breast carcinoma, and 34 of 188 males (18.09%) had prostatic carcinoma. Infiltrating carcinoma of no special type represented 51 (91.07%) of all infiltrating breast carcinomas. Prostatic carcinoma and infiltrating breast carcinoma were of high grade in 13 of 23 males (56.52%) and 34 of 56 females (60.71%), respectively. CONCLUSIONS.— Telepathology is enabling a great improvement in cancer diagnosis in our hospital.
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Affiliation(s)
- Assogba Léopold Azakpa
- From the Department of Pediatric Surgery (Azakpa), Saint Jean de Dieu Hospital, Tanguieta, Benin
| | - Friar Florent Priuli
- Medical and Scientific Director (Priuli), Saint Jean de Dieu Hospital, Tanguieta, Benin
| | - Essodina Ndayake
- Department of Laboratory (Ndayake, Ganhouingnon, Tchaou), Saint Jean de Dieu Hospital, Tanguieta, Benin
| | - Eric Ganhouingnon
- Department of Laboratory (Ndayake, Ganhouingnon, Tchaou), Saint Jean de Dieu Hospital, Tanguieta, Benin
| | | | - Meheza Parfait Tchaou
- Department of Laboratory (Ndayake, Ganhouingnon, Tchaou), Saint Jean de Dieu Hospital, Tanguieta, Benin
| | - Tiziano Zanin
- Human Genetic Laboratory, Galliera Hospital, Genova, Italy (Zanin)
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18
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Convergence of Digital Pathology and Artificial Intelligence Tools in Anatomic Pathology Practice: Current Landscape and Future Directions. Adv Anat Pathol 2020; 27:221-226. [PMID: 32541593 DOI: 10.1097/pap.0000000000000271] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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19
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Borowsky AD, Glassy EF, Wallace WD, Kallichanda NS, Behling CA, Miller DV, Oswal HN, Feddersen RM, Bakhtar OR, Mendoza AE, Molden DP, Saffer HL, Wixom CR, Albro JE, Cessna MH, Hall BJ, Lloyd IE, Bishop JW, Darrow MA, Gui D, Jen KY, Walby JAS, Bauer SM, Cortez DA, Gandhi P, Rodgers MM, Rodriguez RA, Martin DR, McConnell TG, Reynolds SJ, Spigel JH, Stepenaskie SA, Viktorova E, Magari R, Wharton KA, Qiu J, Bauer TW. Digital Whole Slide Imaging Compared With Light Microscopy for Primary Diagnosis in Surgical Pathology. Arch Pathol Lab Med 2020; 144:1245-1253. [DOI: 10.5858/arpa.2019-0569-oa] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2020] [Indexed: 12/28/2022]
Abstract
Context.—The adoption of digital capture of pathology slides as whole slide images (WSI) for educational and research applications has proven utility.Objective.—To compare pathologists' primary diagnoses derived from WSI versus the standard microscope. Because WSIs differ in format and method of observation compared with the current standard glass slide microscopy, this study is critical to potential clinical adoption of digital pathology.Design.—The study enrolled a total of 2045 cases enriched for more difficult diagnostic categories and represented as 5849 slides were curated and provided for diagnosis by a team of 19 reading pathologists separately as WSI or as glass slides viewed by light microscope. Cases were reviewed by each pathologist in both modalities in randomized order with a minimum 31-day washout between modality reads for each case. Each diagnosis was compared with the original clinical reference diagnosis by an independent central adjudication review.Results.—The overall major discrepancy rates were 3.64% for WSI review and 3.20% for manual slide review diagnosis methods, a difference of 0.44% (95% CI, −0.15 to 1.03). The time to review a case averaged 5.20 minutes for WSI and 4.95 minutes for glass slides. There was no specific subset of diagnostic category that showed higher rates of modality-specific discrepancy, though some categories showed greater discrepancy than others in both modalities.Conclusions.—WSIs are noninferior to traditional glass slides for primary diagnosis in anatomic pathology.
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Affiliation(s)
- Alexander D. Borowsky
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Eric F. Glassy
- The Affiliated Pathologists Medical Group, Rancho Dominguez, California (Glassy, Kallichanda)
| | | | - Nathash S. Kallichanda
- The Affiliated Pathologists Medical Group, Rancho Dominguez, California (Glassy, Kallichanda)
| | - Cynthia A. Behling
- The Pacific Rim Pathology Lab and Sharp Healthcare, San Diego, California (Behling, Mendoza, Molden, Saffer, Wixom)
| | - Dylan V. Miller
- Intermountain Central Laboratory, Salt Lake City, Utah (Miller, Albro, Cessna, Hall, Lloyd)
| | - Hemlata N. Oswal
- The Pathology Department, Lucent Pathology Partners Mercy San Juan Hospital, Carmichael, California (Oswal, SM Bauer, Cortez, Rodgers, Rodriguez)
| | - Richard M. Feddersen
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | - Omid R. Bakhtar
- Scripps Clinic Torrey Pines, La Jolla, California (Bakhtar, Ghandi)
| | - Arturo E. Mendoza
- The Pacific Rim Pathology Lab and Sharp Healthcare, San Diego, California (Behling, Mendoza, Molden, Saffer, Wixom)
| | - Daniel P. Molden
- The Pacific Rim Pathology Lab and Sharp Healthcare, San Diego, California (Behling, Mendoza, Molden, Saffer, Wixom)
| | - Helene L. Saffer
- The Pacific Rim Pathology Lab and Sharp Healthcare, San Diego, California (Behling, Mendoza, Molden, Saffer, Wixom)
| | - Christopher R. Wixom
- The Pacific Rim Pathology Lab and Sharp Healthcare, San Diego, California (Behling, Mendoza, Molden, Saffer, Wixom)
| | - James E. Albro
- Intermountain Central Laboratory, Salt Lake City, Utah (Miller, Albro, Cessna, Hall, Lloyd)
| | - Melissa H. Cessna
- Intermountain Central Laboratory, Salt Lake City, Utah (Miller, Albro, Cessna, Hall, Lloyd)
| | - Brian J. Hall
- Intermountain Central Laboratory, Salt Lake City, Utah (Miller, Albro, Cessna, Hall, Lloyd)
| | - Isaac E. Lloyd
- Intermountain Central Laboratory, Salt Lake City, Utah (Miller, Albro, Cessna, Hall, Lloyd)
| | - John W. Bishop
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Morgan A. Darrow
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Dorina Gui
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Kuang-Yu Jen
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Julie Ann S. Walby
- From the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Borowsky, Bishop, Darrow, Gui, Jen, Walby)
| | - Stephen M. Bauer
- The Pathology Department, Lucent Pathology Partners Mercy San Juan Hospital, Carmichael, California (Oswal, SM Bauer, Cortez, Rodgers, Rodriguez)
| | - Daniel A. Cortez
- The Pathology Department, Lucent Pathology Partners Mercy San Juan Hospital, Carmichael, California (Oswal, SM Bauer, Cortez, Rodgers, Rodriguez)
| | - Pranav Gandhi
- Scripps Clinic Torrey Pines, La Jolla, California (Bakhtar, Ghandi)
| | - Melissa M. Rodgers
- The Pathology Department, Lucent Pathology Partners Mercy San Juan Hospital, Carmichael, California (Oswal, SM Bauer, Cortez, Rodgers, Rodriguez)
| | - Rafael A. Rodriguez
- The Pathology Department, Lucent Pathology Partners Mercy San Juan Hospital, Carmichael, California (Oswal, SM Bauer, Cortez, Rodgers, Rodriguez)
| | - David R. Martin
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | - Thomas G. McConnell
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | - Samuel J. Reynolds
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | - James H. Spigel
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | - Shelly A. Stepenaskie
- The Histology Lab, TriCore Reference Laboratories, Albuquerque, New Mexico (Feddersen, Martin, McConnell, Reynolds, Spigel, Stepenaskie)
| | | | - Robert Magari
- Beckman Coulter, Inc., Miami, Florida (Viktorova, Magari)
| | - Keith A. Wharton
- Leica Biosystems Imaging, Inc., Danvers, Massachusetts (Wharton)
| | | | - Thomas W. Bauer
- The Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York (TW Bauer)
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20
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Lähnemann D, Köster J, Szczurek E, McCarthy DJ, Hicks SC, Robinson MD, Vallejos CA, Campbell KR, Beerenwinkel N, Mahfouz A, Pinello L, Skums P, Stamatakis A, Attolini CSO, Aparicio S, Baaijens J, Balvert M, Barbanson BD, Cappuccio A, Corleone G, Dutilh BE, Florescu M, Guryev V, Holmer R, Jahn K, Lobo TJ, Keizer EM, Khatri I, Kielbasa SM, Korbel JO, Kozlov AM, Kuo TH, Lelieveldt BP, Mandoiu II, Marioni JC, Marschall T, Mölder F, Niknejad A, Rączkowska A, Reinders M, Ridder JD, Saliba AE, Somarakis A, Stegle O, Theis FJ, Yang H, Zelikovsky A, McHardy AC, Raphael BJ, Shah SP, Schönhuth A. Eleven grand challenges in single-cell data science. Genome Biol 2020; 21:31. [PMID: 32033589 PMCID: PMC7007675 DOI: 10.1186/s13059-020-1926-6] [Citation(s) in RCA: 575] [Impact Index Per Article: 143.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/02/2020] [Indexed: 02/08/2023] Open
Abstract
The recent boom in microfluidics and combinatorial indexing strategies, combined with low sequencing costs, has empowered single-cell sequencing technology. Thousands-or even millions-of cells analyzed in a single experiment amount to a data revolution in single-cell biology and pose unique data science problems. Here, we outline eleven challenges that will be central to bringing this emerging field of single-cell data science forward. For each challenge, we highlight motivating research questions, review prior work, and formulate open problems. This compendium is for established researchers, newcomers, and students alike, highlighting interesting and rewarding problems for the coming years.
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Affiliation(s)
- David Lähnemann
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich Heine University, University Hospital, Düsseldorf, Germany
- Computational Biology of Infection Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Johannes Köster
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - Ewa Szczurek
- Institute of Informatics, Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warszawa, Poland
| | - Davis J. McCarthy
- Bioinformatics and Cellular Genomics, St Vincent’s Institute of Medical Research, Fitzroy, Australia
- Melbourne Integrative Genomics, School of BioSciences–School of Mathematics & Statistics, Faculty of Science, University of Melbourne, Melbourne, Australia
| | - Stephanie C. Hicks
- Department of Biostatistics, Johns Hopkins University, Baltimore, MD USA
| | - Mark D. Robinson
- Institute of Molecular Life Sciences and SIB Swiss Institute of Bioinformatics, University of Zürich, Zürich, Switzerland
| | - Catalina A. Vallejos
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- The Alan Turing Institute, British Library, London, UK
| | - Kieran R. Campbell
- Department of Statistics, University of British Columbia, Vancouver, Canada
- Department of Molecular Oncology, BC Cancer Agency, Vancouver, Canada
- Data Science Institute, University of British Columbia, Vancouver, Canada
| | - Niko Beerenwinkel
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Ahmed Mahfouz
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
- Delft Bioinformatics Lab, Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, The Netherlands
| | - Luca Pinello
- Molecular Pathology Unit and Center for Cancer Research, Massachusetts General Hospital Research Institute, Charlestown, USA
- Department of Pathology, Harvard Medical School, Boston, USA
- Broad Institute of Harvard and MIT, Cambridge, MA USA
| | - Pavel Skums
- Department of Computer Science, Georgia State University, Atlanta, USA
| | - Alexandros Stamatakis
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
- Institute for Theoretical Informatics, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - Samuel Aparicio
- Department of Molecular Oncology, BC Cancer Agency, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Jasmijn Baaijens
- Life Sciences and Health, Centrum Wiskunde & Informatica, Amsterdam, The Netherlands
| | - Marleen Balvert
- Life Sciences and Health, Centrum Wiskunde & Informatica, Amsterdam, The Netherlands
- Theoretical Biology and Bioinformatics, Science for Life, Utrecht University, Utrecht, The Netherlands
| | - Buys de Barbanson
- Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
- Quantitative biology, Hubrecht Institute, Utrecht, The Netherlands
| | - Antonio Cappuccio
- Institute for Advanced Study, University of Amsterdam, Amsterdam, The Netherlands
| | - Giacomo Corleone
- Department of Surgery and Cancer, The Imperial Centre for Translational and Experimental Medicine, Imperial College London, London, UK
| | - Bas E. Dutilh
- Theoretical Biology and Bioinformatics, Science for Life, Utrecht University, Utrecht, The Netherlands
- Centre for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria Florescu
- Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
- Quantitative biology, Hubrecht Institute, Utrecht, The Netherlands
| | - Victor Guryev
- European Research Institute for the Biology of Ageing, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rens Holmer
- Bioinformatics Group, Wageningen University, Wageningen, The Netherlands
| | - Katharina Jahn
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Thamar Jessurun Lobo
- European Research Institute for the Biology of Ageing, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Emma M. Keizer
- Biometris, Wageningen University & Research, Wageningen, The Netherlands
| | - Indu Khatri
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - Szymon M. Kielbasa
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan O. Korbel
- Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Alexey M. Kozlov
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Tzu-Hao Kuo
- Computational Biology of Infection Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Boudewijn P.F. Lelieveldt
- PRB lab, Delft University of Technology, Delft, The Netherlands
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ion I. Mandoiu
- Computer Science & Engineering Department, University of Connecticut, Storrs, USA
| | - John C. Marioni
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
| | - Tobias Marschall
- Center for Bioinformatics, Saarland University, Saarbrücken, Germany
- Max Planck Institute for Informatics, Saarbrücken, Germany
| | - Felix Mölder
- Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Amir Niknejad
- Computation molecular design, Zuse Institute Berlin, Berlin, Germany
- Mathematics Department, Mount Saint Vincent, New York, USA
| | - Alicja Rączkowska
- Institute of Informatics, Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warszawa, Poland
| | - Marcel Reinders
- Leiden Computational Biology Center, Leiden University Medical Center, Leiden, The Netherlands
- Delft Bioinformatics Lab, Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, The Netherlands
| | - Jeroen de Ridder
- Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | - Antoine-Emmanuel Saliba
- Helmholtz Institute for RNA-based Infection Research, Helmholtz-Center for Infection Research, Würzburg, Germany
| | - Antonios Somarakis
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Oliver Stegle
- Genome Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, UK
- Division of Computational Genomics and Systems Genetics, German Cancer Research Center–DKFZ, Heidelberg, Germany
| | - Fabian J. Theis
- Institute of Computational Biology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
| | - Huan Yang
- Division of Drug Discovery and Safety, Leiden Academic Center for Drug Research–LACDR–Leiden University, Leiden, The Netherlands
| | - Alex Zelikovsky
- Department of Computer Science, Georgia State University, Atlanta, USA
- The Laboratory of Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alice C. McHardy
- Computational Biology of Infection Research Group, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Sohrab P. Shah
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Alexander Schönhuth
- Life Sciences and Health, Centrum Wiskunde & Informatica, Amsterdam, The Netherlands
- Theoretical Biology and Bioinformatics, Science for Life, Utrecht University, Utrecht, The Netherlands
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21
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Melo RCN, Raas MWD, Palazzi C, Neves VH, Malta KK, Silva TP. Whole Slide Imaging and Its Applications to Histopathological Studies of Liver Disorders. Front Med (Lausanne) 2020; 6:310. [PMID: 31970160 PMCID: PMC6960181 DOI: 10.3389/fmed.2019.00310] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022] Open
Abstract
Histological analysis of hepatic tissue specimens is essential for evaluating the pathology of several liver disorders such as chronic liver diseases, hepatocellular carcinomas, liver steatosis, and infectious liver diseases. Manual examination of histological slides on the microscope is a classically used method to study these disorders. However, it is considered time-consuming, limited, and associated with intra- and inter-observer variability. Emerging technologies such as whole slide imaging (WSI), also termed virtual microscopy, have increasingly been used to improve the assessment of histological features with applications in both clinical and research laboratories. WSI enables the acquisition of the tissue morphology/pathology from glass slides and translates it into a digital form comparable to a conventional microscope, but with several advantages such as easy image accessibility and storage, portability, sharing, annotation, qualitative and quantitative image analysis, and use for educational purposes. WSI-generated images simultaneously provide high resolution and a wide field of observation that can cover the entire section, extending any single field of view. In this review, we summarize current knowledge on the application of WSI to histopathological analyses of liver disorders as well as to understand liver biology. We address how WSI may improve the assessment and quantification of multiple histological parameters in the liver, and help diagnose several hepatic conditions with important clinical implications. The WSI technical limitations are also discussed.
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Affiliation(s)
- Rossana C N Melo
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Maximilian W D Raas
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil.,Faculty of Medical Sciences, Radboud University, Nijmegen, Netherlands
| | - Cinthia Palazzi
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Vitor H Neves
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Kássia K Malta
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Thiago P Silva
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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22
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Alassiri A, Almutrafi A, Alsufiani F, Al Nehkilan A, Al Salim A, Musleh H, Aziz M, Khalbuss W. Whole slide imaging compared with light microscopy for primary diagnosis in surgical neuropathology: a validation study. Ann Saudi Med 2020; 40:36-41. [PMID: 32026707 PMCID: PMC7012027 DOI: 10.5144/0256-4947.2020.36] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Digital pathology practice is rapidly gaining popularity among practicing anatomic pathologists. Acceptance is higher among the newer generation of pathologists who are willing to adapt to this new diagnostic method due to the advantages offered by whole slide imaging (WSI) compared to traditional light microscopy (TLM). We performed this validation study because we plan to implement the WSI system for diagnostic services. OBJECTIVES Determine the feasibility of using digital pathology for diagnostic services by assessing the equivalency of WSI and TLM. DESIGN A laboratory-based cross-sectional study. SETTING Central laboratory at a tertiary health care center. MATERIALS AND METHODS Four practicing surgical pathologists participated in this study. Each pathologist blindly reviewed 60 surgical neuropathology cases with a minimum 8-week washout-period between the two diagnostic modalities (WSI vs. TLM). Intraobserver concordance rates between WSI and TLM diagnoses as compared to the original diagnosis were calculated. MAIN OUTCOME MEASURES Overall intraobserver concordance rates between each diagnostic method (WSI and TLM) and original diagnosis. SAMPLE SIZE 60 in-house surgical neuropathology cases. RESULTS The overall intraobserver concordance rate between TLM and original diagnosis was 86.3% (range 76.7%-91.7%) versus 80.8% for WSI (range 68.3%-88.3%). These findings are suggestive of the superiority of TLM, but the Fleiss' Kappa statistic indicated that the two methods are equivalent, despite the low level of the K value. CONCLUSION WSI is not inferior to the light microscopy and is feasible for primary diagnosis in surgical neuropathology. However, to ensure the best results, only formally trained neuropathologists should handle the digital neuropathology service. LIMITATIONS Only one diagnostic slide per case rather than the whole set of slides, sample size was relatively small, and there was an insufficient number of participating neuropathologists. CONFLICT OF INTEREST None.
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Affiliation(s)
- Ali Alassiri
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,From the King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Amna Almutrafi
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Fahd Alsufiani
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Atheer Al Nehkilan
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alaa Al Salim
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hesham Musleh
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammad Aziz
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Walid Khalbuss
- From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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23
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Urbano N, Scimeca M, Bonfiglio R, Bonanno E, Schillaci O. New advance in breast cancer pathology and imaging. Future Oncol 2019; 15:2707-2722. [DOI: 10.2217/fon-2019-0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The improvement of knowledge concerning the pathology of breast cancer could provide the rationale for the development of new imaging diagnostic protocols. Indeed, as for the microcalcifications, new histopathological markers can be used as target for in vivo early detection of breast cancer lesions by using molecular imaging techniques such as positron emission tomography. Specifically, the mutual contribution of these medical specialties can ‘nourish’ the dream of a personalized medicine that takes into account the intrinsic variability of breast cancer. In this review, we report the main discoveries concerning breast cancer pathology highlighting the possible cooperation between the departments of anatomic pathology and imaging diagnostics.
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Affiliation(s)
- Nicoletta Urbano
- Nuclear Medicine, Policlinico ‘Tor Vergata,’ viale Oxford, 81, Rome, 00133, Italy
| | - Manuel Scimeca
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS San Raffaele, Via di Val Cannuta 247, 00166, Rome, Italy
- Fondazione Umberto Veronesi (FUV), Piazza Velasca 5, 20122 Milano (Mi), Italy
| | - Rita Bonfiglio
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
| | - Elena Bonanno
- Department of Experimental Medicine, University ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- Neuromed Group, ‘Diagnostica Medica’ & ‘Villa dei Platani', Via Errico Carmelo, 2, 83100 Avellino AV, Italy
| | - Orazio Schillaci
- Department of Biomedicine & Prevention, University of Rome ‘Tor Vergata’, Via Montpellier 1, Rome 00133, Italy
- IRCCS Neuromed, Pozzilli, Italy
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24
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Advancing diagnostic hematopathology: pigeons or pixels? J Hematop 2019. [DOI: 10.1007/s12308-019-00358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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25
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Paradis V, Quaglia A. Digital pathology, what is the future? J Hepatol 2019; 70:1016-1018. [PMID: 30857782 DOI: 10.1016/j.jhep.2018.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 12/04/2022]
Affiliation(s)
- V Paradis
- Pathology Department, Beaujon Hospital, Clichy, France.
| | - A Quaglia
- Institute of Liver Studies, King's College Hospital, United Kingdom
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26
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The performance of digital microscopy for primary diagnosis in human pathology: a systematic review. Virchows Arch 2019; 474:269-287. [DOI: 10.1007/s00428-018-02519-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/25/2018] [Accepted: 12/28/2018] [Indexed: 02/06/2023]
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27
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Hon JD, Chen W, Minerowicz C, Thomas S, Barnard N, Gilbert N, Fyfe B. Analysis and Comparison of Tissue-Marking Dye Detection via Light Microscopy, Telemicroscopy, and Virtual Microscopy. Am J Clin Pathol 2019; 151:95-99. [PMID: 30239594 DOI: 10.1093/ajcp/aqy117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objectives To examine the fidelity of ink color identification using light microscopy (LM), telemicroscopy (TM), and virtual microscopy (VM). Methods Twenty H&E-stained frozen section slides, prepared after tissue inking with five stain combinations, were assessed by three pathologists using LM, TM, and VM. TM was performed using Mikroscan D2 slide scanner/LiveQ software with various objectives. VM was performed using Mikroscan D2 scanner/Qumulus software, specimens digitized at20×. Results Sensitivity/specificity by LM was 100%/100% for all colors. TM showed high overall specificity but poor sensitivity, particularly red (54%). VM showed high specificity for all colors except black (69%) and, consequently, poor sensitivity for all colors except black (96%). Conclusions TMD identification via telepathology showed loss of sensitivity/specificity vs LM and highlighted the need for caution when interpreting TMDs with digital technologies and the need for validation protocols.
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Affiliation(s)
- Jane Date Hon
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Wenjin Chen
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
- Rutgers Cancer Institute of New Jersey, New Brunswick
| | | | - Sumi Thomas
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Nicola Barnard
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - Billie Fyfe
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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28
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David L, Martins I, Ismail MR, Fernandes F, Sidat M, Seixas M, Fonseca E, Carrilho C. Interactive Digital Microscopy at the Center for a Cross-Continent Undergraduate Pathology Course in Mozambique. J Pathol Inform 2018; 9:42. [PMID: 30607309 PMCID: PMC6289002 DOI: 10.4103/jpi.jpi_63_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/01/2018] [Indexed: 11/04/2022] Open
Abstract
Background Recent medical education trends encourage the use of teaching strategies that emphasize student centeredness and self-learning. In this context, the use of new educative technologies is stimulated at the Faculty of Medicine of Eduardo Mondlane University (FMUEM) in Mozambique. The Faculty of Medicine of University of Porto (FMUP) and FMUEM have a long-lasting record of collaborative work. Within this framework, both institutions embarked in a partnership, aimed to develop a blended learning course of pathology for undergraduates, shared between the two faculties and incorporating interactive digital microscopy as a central learning tool. Methods A core team of faculty members from both institutions identified the existing resources and previous experiences in the two faculties. The Moodle course for students from the University of Porto was the basis to implement the current project. The objective was to develop educational modules of mutual interest, designed for e-learning, followed by a voluntary student's survey conducted in FMUEM to get their perception about the process. Results We selected contents from the pathology curricula of FMUP and FMUEM that were of mutual interest. We next identified and produced new contents for the shared curricula. The implementation involved joint collaboration and training to prepare the new contents, together with building quizzes for self-evaluation. All the practical sessions were based on the use of interactive digital microscopy. The students have reacted enthusiastically to the incorporation of the online component that increased their performance and motivation for pathology learning. For the students in Porto, the major acquisition was the access to slides from infectious diseases as well as autopsy videos. Conclusions Our study indicates that students benefited from high-quality educational contents, with emphasis on digital microscopy, in a platform generated in a win-win situation for FMUP and FMUEM.
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Affiliation(s)
- Leonor David
- Differentiation and Cancer, Institute of Pathology and Molecular Immunology of the University of Porto, Portugal.,Department of Pathology, Faculty of Medicine, The University of Porto, Porto, Portugal
| | - Isabel Martins
- Unit of Educational Technologies, University of Porto, Porto, Portugal
| | - Mamudo Rafik Ismail
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Fabíola Fernandes
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Mohsin Sidat
- Department of Community Health, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Mário Seixas
- Department of Surgery and Physiology, Faculty of Medicine, The University of Porto, Porto, Portugal
| | - Elsa Fonseca
- Department of Pathology, Faculty of Medicine, The University of Porto, Porto, Portugal
| | - Carla Carrilho
- Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Department of Pathology, Maputo Central Hospital, Maputo, Mozambique
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29
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Pantanowitz L, Sharma A, Carter AB, Kurc T, Sussman A, Saltz J. Twenty Years of Digital Pathology: An Overview of the Road Travelled, What is on the Horizon, and the Emergence of Vendor-Neutral Archives. J Pathol Inform 2018; 9:40. [PMID: 30607307 PMCID: PMC6289005 DOI: 10.4103/jpi.jpi_69_18] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/28/2018] [Indexed: 12/13/2022] Open
Abstract
Almost 20 years have passed since the commercial introduction of whole-slide imaging (WSI) scanners. During this time, the creation of various WSI devices with the ability to digitize an entire glass slide has transformed the field of pathology. Parallel advances in computational technology and storage have permitted rapid processing of large-scale WSI datasets. This article provides an overview of important past and present efforts related to WSI. An account of how the virtual microscope evolved from the need to visualize and manage satellite data for earth science applications is provided. The article also discusses important milestones beginning from the first WSI scanner designed by Bacus to the Food and Drug Administration approval of the first digital pathology system for primary diagnosis in surgical pathology. As pathology laboratories commit to going fully digitalize, the need has emerged to include WSIs into an enterprise-level vendor-neutral archive (VNA). The different types of VNAs available are reviewed as well as how best to implement them and how pathology can benefit from participating in this effort. Differences between traditional image algorithms that extract pixel-, object-, and semantic-level features versus deep learning methods are highlighted. The need for large-scale data management, analysis, and visualization in computational pathology is also addressed.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ashish Sharma
- Department of Biomedical Informatics, Emory University, GA, USA
| | - Alexis B. Carter
- Department of Pathology and Laboratory Medicine, Children's Healthcare of Atlanta, GA, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Alan Sussman
- Department of Computer Science, University of Maryland, College Park, MD, USA
| | - Joel Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
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30
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Validation of digital microscopy in the histopathological diagnoses of oral diseases. Virchows Arch 2018; 473:321-327. [DOI: 10.1007/s00428-018-2382-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 05/21/2018] [Indexed: 01/17/2023]
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31
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Jafarian AH, Tasbandi A, Mohamadian Roshan N. Evaluation of photoshop based image analysis in cytologic diagnosis of pleural fluid in comparison with conventional modalities. Diagn Cytopathol 2018; 46:578-583. [PMID: 29673113 DOI: 10.1002/dc.23952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND The aim of this study is to investigate and compare the results of digital image analysis in pleural effusion cytology samples with conventional modalities. MATERIALS AND METHODS In this cross-sectional study, 53 pleural fluid cytology smears from Qaem hospital pathology department, located in Mashhad, Iran were investigated. Prior to digital analysis, all specimens were evaluated by two pathologists and categorized into three groups as: benign, suspicious, and malignant. Using an Olympus microscope and Olympus DP3 digital camera, digital images from cytology slides were captured. Appropriate images (n = 130) were separately imported to Adobe Photoshop CS5 and parameters including area and perimeter, circularity, Gray Value mean, integrated density, and nucleus to cytoplasm area ratio were analyzed. RESULTS Gray Value mean, nucleus to cytoplasm area ratio, and circularity showed the best sensitivity and specificity rates as well as significant differences between all groups. Also, nucleus area and perimeter showed a significant relation between suspicious and malignant groups with benign group. Whereas, there was no such difference between suspicious and malignant groups. CONCLUSION We concluded that digital image analysis is welcomed in the field of research on pleural fluid smears as it can provide quantitative data to apply various comparisons and reduce interobserver variation which could assist pathologists to achieve a more accurate diagnosis.
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Affiliation(s)
- Amir Hossein Jafarian
- Department of Pathology, Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences Medical Sciences, Mashhad, Iran
| | - Aida Tasbandi
- Department of Pathology, Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences Medical Sciences, Mashhad, Iran
| | - Nema Mohamadian Roshan
- Department of Pathology, Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences Medical Sciences, Mashhad, Iran
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Scimeca M, Urbano N, Bonfiglio R, Schillaci O, Bonanno E. Management of oncological patients in the digital era: anatomic pathology and nuclear medicine teamwork. Future Oncol 2018; 14:1013-1015. [PMID: 29623724 DOI: 10.2217/fon-2017-0698] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Manuel Scimeca
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCCS San Raffaele, Via di Val Cannuta 247, Rome 00166, Italy.,OrchideaLab S.r.l., Via del Grecale 6, Morlupo, Rome (RM) 000674, Italy
| | | | - Rita Bonfiglio
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy
| | - Orazio Schillaci
- Department of Biomedicine & Prevention, University of Rome 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCCS Neuromed, Pozzilli 860777, Italy
| | - Elena Bonanno
- Department of Experimental Medicine & Surgery, University 'Tor Vergata', Via Montpellier 1, Rome 00133, Italy.,IRCSS Neuromed Lab. 'Diagnostica Medica' & 'Villa dei Platani', Avellino 83100, Italy
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Huang YN, Peng XC, Ma S, Yu H, Jin YB, Zheng J, Fu GH. Development of Whole Slide Imaging on Smartphones and Evaluation With ThinPrep Cytology Test Samples: Follow-Up Study. JMIR Mhealth Uhealth 2018; 6:e82. [PMID: 29618454 PMCID: PMC5906711 DOI: 10.2196/mhealth.9518] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/01/2018] [Accepted: 02/01/2018] [Indexed: 12/24/2022] Open
Abstract
Background The smartphone-based whole slide imaging (WSI) system represents a low-cost and effective alternative to automatic scanners for telepathology. In a previous study, the development of one such solution, named scalable whole slide imaging (sWSI), was presented and analyzed. A clinical evaluation of its iOS version with 100 frozen section samples verified the diagnosis-readiness of the produced virtual slides. Objective The first aim of this study was to delve into the quantifying issues encountered in the development of an Android version. It should also provide insights into future high-resolution real-time feedback medical imaging apps on Android and invoke the awareness of smartphone manufacturers for collaboration. The second aim of this study was to further verify the clinical value of sWSI with cytology samples. This type is different from the frozen section samples in that they require finer detail on the cellular level. Methods During sWSI development on Android, it was discovered that many models do not support uncompressed camera pixel data with sufficient resolution and full field of view. The proportion of models supporting the optimal format was estimated in a test on 200 mainstream Android models. Other factors, including slower processing speed and camera preview freezing, also led to inferior performance of sWSI on Android compared with the iOS version. The processing speed was mostly determined by the central processing unit frequency in theory, and the relationship was investigated in the 200-model simulation experiment with physical devices. The camera preview freezing was caused by the lag between triggering photo capture and resuming preview. In the clinical evaluation, 100 ThinPrep cytology test samples covering 6 diseases were scanned with sWSI and compared against the ground truth of optical microscopy. Results Among the tested Android models, only 3.0% (6/200) provided an optimal data format, meeting all criteria of quality and efficiency. The image-processing speed demonstrated a positive relationship with the central processing unit frequency but to a smaller degree than expected and was highly model-dependent. The virtual slides produced by sWSI on Android and iOS of ThinPrep cytology test samples achieved similar high quality. Using optical microscopy as the ground truth, pathologists made a correct diagnosis on 87.5% (175/200) of the cases with sWSI virtual slides. Depending on the sWSI version and the pathologist in charge, the kappa value varied between .70 and .82. All participating pathologists considered the quality of the sWSI virtual slides in the experiment to be adequate for routine usage. Conclusions Limited by hardware and operating system support, the performance of sWSI on mainstream Android smartphones did not fully match the iOS version. However, in practice, this difference was not significant, and both were adequate for digitizing most of the sample types for telepathology consultation.
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Affiliation(s)
- Yu-Ning Huang
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Faculty of Basic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xing-Chun Peng
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Faculty of Basic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuoxin Ma
- TerryDr Info Technology Co, Ltd, Nanjing, China
| | - Hong Yu
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Biao Jin
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zheng
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guo-Hui Fu
- Department of Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Faculty of Basic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bertram CA, Gurtner C, Dettwiler M, Kershaw O, Dietert K, Pieper L, Pischon H, Gruber AD, Klopfleisch R. Validation of Digital Microscopy Compared With Light Microscopy for the Diagnosis of Canine Cutaneous Tumors. Vet Pathol 2018; 55:490-500. [PMID: 29402206 DOI: 10.1177/0300985818755254] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Integration of new technologies, such as digital microscopy, into a highly standardized laboratory routine requires the validation of its performance in terms of reliability, specificity, and sensitivity. However, a validation study of digital microscopy is currently lacking in veterinary pathology. The aim of the current study was to validate the usability of digital microscopy in terms of diagnostic accuracy, speed, and confidence for diagnosing and differentiating common canine cutaneous tumor types and to compare it to classical light microscopy. Therefore, 80 histologic sections including 17 different skin tumor types were examined twice as glass slides and twice as digital whole-slide images by 6 pathologists with different levels of experience at 4 time points. Comparison of both methods found digital microscopy to be noninferior for differentiating individual tumor types within the category epithelial and mesenchymal tumors, but diagnostic concordance was slightly lower for differentiating individual round cell tumor types by digital microscopy. In addition, digital microscopy was associated with significantly shorter diagnostic time, but diagnostic confidence was lower and technical quality was considered inferior for whole-slide images compared with glass slides. Of note, diagnostic performance for whole-slide images scanned at 200× magnification was noninferior in diagnostic performance for slides scanned at 400×. In conclusion, digital microscopy differs only minimally from light microscopy in few aspects of diagnostic performance and overall appears adequate for the diagnosis of individual canine cutaneous tumors with minor limitations for differentiating individual round cell tumor types and grading of mast cell tumors.
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Affiliation(s)
- Christof A Bertram
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Corinne Gurtner
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.,2 Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Martina Dettwiler
- 2 Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Olivia Kershaw
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Kristina Dietert
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Laura Pieper
- 3 Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany
| | - Hannah Pischon
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Achim D Gruber
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
| | - Robert Klopfleisch
- 1 Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany
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Bongaerts O, Clevers C, Debets M, Paffen D, Senden L, Rijks K, Ruiten L, Sie-Go D, van Diest PJ, Nap M. Conventional Microscopical versus Digital Whole-Slide Imaging-Based Diagnosis of Thin-Layer Cervical Specimens: A Validation Study. J Pathol Inform 2018; 9:29. [PMID: 30197818 PMCID: PMC6120269 DOI: 10.4103/jpi.jpi_28_18] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 06/29/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Whole-slide imaging (WSI) has been implemented in many areas of pathology, but primary diagnostics of cytological specimens are lagging behind. One of the objectives of viewing scanned whole-slide images from histological or cytological specimens is remote exchange of knowledge and expertise of professionals to increase diagnostic accuracy. We compared the scoring results of our team obtained in double readings of two different data sets: conventional light microscopy (CLM) versus CLM and CLM versus WSI. We hypothesized that WSI is noninferior to CLM for primary diagnostics of thin-layer cervical slides. MATERIALS AND METHODS First, we determined the concordance rate at different thresholds of the participating cytotechnicians by double reading with CLM of 500 thin-layer cervical slides (Cohort 1). Next, CLM was compared with WSI examination of another 505 thin-layer cervical slides (Cohort 2) scanned at ×20 in single focus plane. Finally, all major discordant cases of Cohort 1 were evaluated by an external expert in the field of gynecological cytology and of Cohort 2 in the weekly case meetings. RESULTS The overall concordance rate of Cohort 1 (CLM vs. CLM) was 97.8% (95% confidence interval [CI]: 96.0%-98.7%) and of Cohort 2 was 95.3% (95% CI: 93.0%-96.9%). CONCLUSION Concordance rates of WSI versus CLM were comparable with those of CLM versus CLM. We have made a step forward paving the road to implementation of WSI also in routine diagnostic cytology.
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Affiliation(s)
- Odille Bongaerts
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
- Address for correspondence: Mrs. Odille Bongaerts, Department of Pathology, Zuyderland Hospital, PO Box 6446, 6401 CX Heerlen, The Netherlands. E-mail:
| | - Carla Clevers
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Marij Debets
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Daniëlle Paffen
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Lisanne Senden
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Kim Rijks
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Linda Ruiten
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Daisy Sie-Go
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul J van Diest
- Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
- Department of Oncology, Johns Hopkins Oncology Center, Baltimore, MD, USA
| | - Marius Nap
- Nap Pathology Consultance bv, Numansdorp, The Netherlands
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Elasbali AM, Al-Onzi Z, Hamza A, Khalafalla E, Ahmed HG. Morphological Patterns of Elastic and Reticulum Fibers in Breast Lesions. Health (London) 2018. [DOI: 10.4236/health.2018.1012122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Saco A, Diaz A, Hernandez M, Martinez D, Montironi C, Castillo P, Rakislova N, Del Pino M, Martinez A, Ordi J. Validation of whole-slide imaging in the primary diagnosis of liver biopsies in a University Hospital. Dig Liver Dis 2017; 49:1240-1246. [PMID: 28780052 DOI: 10.1016/j.dld.2017.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/11/2017] [Accepted: 07/11/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Experience in the use of whole slide imaging (WSI) for primary diagnosis is limited and there are no comprehensive reports evaluating this technology in liver biopsy specimens. AIMS To determine the accuracy of interpretation of WSI compared with conventional light microscopy (CLM) in the diagnosis of needle liver biopsies. METHODS Two experienced liver pathologists blindly analyzed 176 consecutive biopsies from the Pathology Department at the Hospital Clinic of Barcelona. One of the observers performed the initial evaluation with CLM, and the second evaluation with WSI, whereas the second observer performed the first evaluation with WSI and the second with CLM. All slides were digitized in a Ventana iScan HT at 400× and evaluated with the Virtuoso viewer (Roche diagnostics). We used kappa statistics (κ) for two observations. RESULTS Intra-observer agreement between WSI and CLM evaluations was almost perfect (96.6%, κ=0.9; 95% confidence interval [95% CI]: 0.9-1 for observer 1, and 90.3%, κ=0.9; 95%CI: 0.8-0.9 for observer 2). Both native and transplantation biopsies showed an almost perfect concordance in the diagnosis. CONCLUSION Diagnosis of needle liver biopsy specimens using WSI is accurate. This technology can reliably be introduced in routine diagnosis.
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Affiliation(s)
- Adela Saco
- Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Alba Diaz
- Department of Pathology, Hospital Clínic, Barcelona, Spain
| | | | | | | | - Paola Castillo
- Department of Pathology, Hospital Clínic, Barcelona, Spain; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Marta Del Pino
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic - Institut d́Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Spain
| | - Antonio Martinez
- Department of Pathology, Hospital Clínic, Barcelona, Spain; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Jaume Ordi
- Department of Pathology, Hospital Clínic, Barcelona, Spain; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; University of Barcelona, School of Medicine, Barcelona, Spain.
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Callea F. Microscopic and telescopic pathology. Dig Liver Dis 2017; 49:1247-1248. [PMID: 28927708 DOI: 10.1016/j.dld.2017.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/10/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Francesco Callea
- Department of Pathology, Bambino Gesú Children Hospital I.R.C.C.S., Rome, Italy
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39
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Bertram CA, Klopfleisch R. The Pathologist 2.0: An Update on Digital Pathology in Veterinary Medicine. Vet Pathol 2017; 54:756-766. [DOI: 10.1177/0300985817709888] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Christof A. Bertram
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany
| | - Robert Klopfleisch
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany
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40
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Christensen PA, Lee NE, Thrall MJ, Powell SZ, Chevez-Barrios P, Long SW. RecutClub.com: An Open Source, Whole Slide Image-based Pathology Education System. J Pathol Inform 2017; 8:10. [PMID: 28382224 PMCID: PMC5364738 DOI: 10.4103/jpi.jpi_72_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/18/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Our institution's pathology unknown conferences provide educational cases for our residents. However, the cases have not been previously available digitally, have not been collated for postconference review, and were not accessible to a wider audience. Our objective was to create an inexpensive whole slide image (WSI) education suite to address these limitations and improve the education of pathology trainees. MATERIALS AND METHODS We surveyed residents regarding their preference between four unique WSI systems. We then scanned weekly unknown conference cases and study set cases and uploaded them to our custom built WSI viewer located at RecutClub.com. We measured site utilization and conference participation. RESULTS Residents preferred our OpenLayers WSI implementation to Ventana Virtuoso, Google Maps API, and OpenSlide. Over 16 months, we uploaded 1366 cases from 77 conferences and ten study sets, occupying 793.5 GB of cloud storage. Based on resident evaluations, the interface was easy to use and demonstrated minimal latency. Residents are able to review cases from home and from their mobile devices. Worldwide, 955 unique IP addresses from 52 countries have viewed cases in our site. CONCLUSIONS We implemented a low-cost, publicly available repository of WSI slides for resident education. Our trainees are very satisfied with the freedom to preview either the glass slides or WSI and review the WSI postconference. Both local users and worldwide users actively and repeatedly view cases in our study set.
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Affiliation(s)
- Paul A Christensen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
| | - Nathan E Lee
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
| | - Michael J Thrall
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
| | - Suzanne Z Powell
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
| | - Patricia Chevez-Barrios
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
| | - S Wesley Long
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Cornell Medical College of Cornell University, Houston, TX 77030, USA
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Prajapati S, Madrigal E, Friedman MT. Acquisition, Visualization and Potential Applications of 3D Data in Anatomic Pathology. Discoveries (Craiova) 2016; 4:e68. [PMID: 32309587 PMCID: PMC6941555 DOI: 10.15190/d.2016.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Although human anatomy and histology are naturally three-dimensional (3D), commonly used diagnostic and educational tools are technologically restricted to providing two-dimensional representations (e.g. gross photography and glass slides). This limitation may be overcome by employing techniques to acquire and display 3D data, which refers to the digital information used to describe a 3D object mathematically. There are several established and experimental strategies to capture macroscopic and microscopic 3D data. In addition, recent hardware and software innovations have propelled the visualization of 3D models, including virtual and augmented reality. Accompanying these advances are novel clinical and non-clinical applications of 3D data in pathology. Medical education and research stand to benefit a great deal from utilizing 3D data as it can change our understanding of complex anatomical and histological structures. Although these technologies are yet to be adopted in routine surgical pathology, forensic pathology has embraced 3D scanning and model reconstruction. In this review, we intend to provide a general overview of the technologies and emerging applications involved with 3D data.
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Affiliation(s)
- Shyam Prajapati
- Mount Sinai Health System, Department of Diagnostic Pathology and Laboratory Medicine, New York, NY, USA
| | - Emilio Madrigal
- Mount Sinai Health System, Department of Diagnostic Pathology and Laboratory Medicine, New York, NY, USA
| | - Mark T Friedman
- Mount Sinai Health System, Department of Diagnostic Pathology and Laboratory Medicine, New York, NY, USA
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García-Rojo M, Ordi J. Trying to Understand Digital Pathology before We Move to Computational Pathology. Pathobiology 2016; 83:57-60. [PMID: 27100520 DOI: 10.1159/000443904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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