Dicom_wsi: A Python Implementation for Converting Whole-Slide Images to Digital Imaging and Communications in Medicine Compliant Files

Artificial intelligence in surgical pathology - Where do we stand, where do we go?

Surgical and neuropathologists continuously search for new and disease-specific features, such as independent predictors of tumor prognosis or determinants of tumor entities and sub-entities. This is a task where artificial intelligence (AI)/machine learning (ML) systems could significantly contribute to help with tumor outcome prediction and the search for new diagnostic or treatment stratification biomarkers. AI systems are increasingly integrated into routine pathology workflows to improve accuracy, reproducibility, productivity and to reveal difficult-to-see features in complicated histological slides, including the quantification of important markers for tumor grading and staging. In this article, we review the infrastructure needed to facilitate digital and computational pathology. We address the barriers for its full deployment in the clinical setting and describe the use of AI in intraoperative or postoperative settings were frozen or formalin-fixed, paraffin-embedded materials are used. We also summarize quality assessment issues of slide digitization, new spatial biology approaches, and the determination of specific gene-expression from whole slide images. Finally, we highlight new innovative and future technologies, such as large language models, optical biopsies, and mass spectrometry imaging.

The impact of digital transformation and earnings management on ESG performance: evidence from Chinese listed enterprises

The improvement of enterprise ESG performance is one of the key driving forces to achieve the goal of economic and social green development. There is a gap between knowledge and practice in the ESG performance of Chinese enterprises, and digital transformation (DT) provides new ideas for ESG development. The research purpose of this paper is to explore the impact mechanism of DT on ESG and the specific path of DT to drive ESG. It provides a reference for listed enterprises to rely on DT to empower their sustainable development capability. This paper takes the panel data of A-share listed enterprises from 2011 to 2021 as the sample and measures the core indicators using the text mining method, modified Jones model, and Roy-Chowdhury model. On this basis, using a combination of econometric models and qualitative comparative analysis, we empirically analyze the impact mechanisms of DT on ESG as well as the specific grouping paths that drive ESG performance. The main conclusions are shown as follows. First, DT can significantly reduce ESG, with an impact coefficient of - 0.013, which is significant at the 5% level. It reflects that the DT of enterprises at this stage has certain deficiencies. There is a matching lag in the enterprise's internal organizational resources. The entry of digital technology will have a certain impact on traditional operations, and the high uncertainty of DT adds some hidden costs to the enterprise. Secondly, there is an indirect suppression effect of accrued earnings management (AEM) in the transmission mechanism of DT affecting ESG. It is verified that DT can reduce information asymmetry and inhibit EM activities, thus reducing the impact on ESG. Finally, a total of six configurations achieved high ESG valuations. High technology practice-low performance manipulation; digital intelligence-low performance manipulation; digital intelligence-digital resources; digital resources-inadequate digital infrastructure.; high technology practice-bottom technology deficiency; digital intelligence-high performance manipulation. Through configuration analysis, the suppression effect of EM is further verified. The lack of AEM is usually the core condition of the high-valuation group. Meanwhile, digital intelligence, digital resources, and digital technology practice can drive the improvement of enterprise ESG. The instrumental variables approach and robustness tests support these findings.

Interoperable slide microscopy viewer and annotation tool for imaging data science and computational pathology

The exchange of large and complex slide microscopy imaging data in biomedical research and pathology practice is impeded by a lack of data standardization and interoperability, which is detrimental to the reproducibility of scientific findings and clinical integration of technological innovations. We introduce Slim, an open-source, web-based slide microscopy viewer that implements the internationally accepted Digital Imaging and Communications in Medicine (DICOM) standard to achieve interoperability with a multitude of existing medical imaging systems. We showcase the capabilities of Slim as the slide microscopy viewer of the NCI Imaging Data Commons and demonstrate how the viewer enables interactive visualization of traditional brightfield microscopy and highly-multiplexed immunofluorescence microscopy images from The Cancer Genome Atlas and Human Tissue Atlas Network, respectively, using standard DICOMweb services. We further show how Slim enables the collection of standardized image annotations for the development or validation of machine learning models and the visual interpretation of model inference results in the form of segmentation masks, spatial heat maps, or image-derived measurements.

The Role of Pathology-Based Methods in Qualitative and Quantitative Approaches to Cancer Immunotherapy

Simple Summary

Immunotherapy has become the filar of modern oncological treatment, and programmed death-ligand 1 expression is one of the primary immune markers assessed by pathologists. However, there are still some issues concerning the evaluation of the marker and limited information about the interaction between the tumour and associated immune cells. Recent studies have focused on cancer immunology to try to understand the complex tumour microenvironment, and multiplex imaging methods are more widely used for this purpose. The presented article aims to provide an overall review of a different multiplex in situ method using spectral imaging, supported by automated image-acquisition and software-assisted marker visualisation and interpretation. Multiplex imaging methods could improve the current understanding of complex tumour-microenvironment immunology and could probably help to better match patients to appropriate treatment regimens.

Abstract

Immune checkpoint inhibitors, including those concerning programmed cell death 1 (PD-1) and its ligand (PD-L1), have revolutionised the cancer therapy approach in the past decade. However, not all patients benefit from immunotherapy equally. The prediction of patient response to this type of therapy is mainly based on conventional immunohistochemistry, which is limited by intraobserver variability, semiquantitative assessment, or single-marker-per-slide evaluation. Multiplex imaging techniques and digital image analysis are powerful tools that could overcome some issues concerning tumour-microenvironment studies. This novel approach to biomarker assessment offers a better understanding of the complicated interactions between tumour cells and their environment. Multiplex labelling enables the detection of multiple markers simultaneously and the exploration of their spatial organisation. Evaluating a variety of immune cell phenotypes and differentiating their subpopulations is possible while preserving tissue histology in most cases. Multiplexing supported by digital pathology could allow pathologists to visualise and understand every cell in a single tissue slide and provide meaning in a complex tumour-microenvironment contexture. This review aims to provide an overview of the different multiplex imaging methods and their application in PD-L1 biomarker assessment. Moreover, we discuss digital imaging techniques, with a focus on slide scanners and software.

Changes in Patellar Morphology Following Soft Tissue Surgical Correction of Recurrent Patellar Dislocation in Children with Low-Grade Trochlear Dysplasia

Objective

To investigate the changes in patellar morphology following soft tissue surgical correction of recurrent patellar dislocation in children with low‐grade trochlear dysplasia.

Methods

The prospective cohort study was performed between November 2007 and December 2012. Finally, 25 cases, with the mean age of 8.4 years (range from 7 to 10 years), were admitted to the study. All patients were diagnosed as bilateral recurrent patellar dislocation associated with femoral trochlear dysplasia. The knee that suffered injury or was dislocated was treated with medial patellar retinacular plasty (surgery group). The contralateral knee, which served as a control, was treated conservatively (conservative group). Axial CT scans were undertaken in all patients to assess the patellar morphological characteristics.

Results

The mean follow‐up time was 60.8 months (range 48 to 75 months). Preoperatively, there were no statistically significant differences between the patellar morphology in the two groups (P > 0.05). Many radiological parameters of patellar morphology were significantly different between the two groups at the final follow‐up, including well‐known parameters, such as the mean patellar width (surgery group, 40.58 mm [SD 1.26]; conservative group, 36.41 mm [SD 1.17]; P < 0.05), the mean patellar thickness (surgery group, 11.59 mm [SD 0.74]; conservative group, 9.38 mm [SD 0.56]; P < 0.05) and the mean Wiberg index (surgery group, 0.54 [SD 0.06]; conservative group, 0.72 [SD 0.08]; P < 0.05). There are also little‐known parameters, such as the ratio of length of lateral patella to medial patella (surgery group, 1.26 [SD 0.17]; conservative group, 1.69 [SD 0.21]; P < 0.05), which was a measurement of facet asymmetry. However, the Wiberg angle was not significantly different between the two groups (surgery group, 128.63° [SD 9.05]; conservative group, 125.47° [SD 13.96°]; P > 0.05) at the final follow‐up. No complications were found.

Conclusions

The patellar morphology can be significantly improved by early soft tissue surgical correction in children with patellar instability associated with low‐grade femoral trochlear dysplasia.