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Telepathology and telecytology in developing countries
Published in Richard Wootton, Nivritti G. Patil, Richard E. Scott, Kendall Ho, Telehealth in the Developing World, 2019
Telepathology can be performed using a static, or ‘store-and-forward’, approach; it can also be conducted using a dynamic, or real-time, approach; or it may employ a hybrid of the two.1,2 There are obvious disadvantages associated with static telepathology, the major one being sampling error, which reflects the passive nature of this exercise. In contrast, dynamic telepathology overcomes the basic drawback of static telepathology, although techniques such as ultra-rapid virtual slide processing6 are prohibitively expensive in a developing country setting. Sampling error in static telepathology consultation could be reduced by the referring pathologist sending a set of images covering both ambiguous and unambiguous areas. There is general agreement that a reasonably accurate histopathological diagnosis is possible on the basis of the examination of judiciously selected digital images. It has been our observation that mutual trust, rapport and close interaction between referring pathologist and telepathologist, and adequate training of the referring pathologist, are very important to achieve successful teleconsultations.2
Routine and Special Techniques in Toxicologic Pathology
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Daniel J. Patrick, Matthew L. Renninger, Peter C. Mann
Digital pathology has greatly advanced the current and potential status of “telepathology,” which is broadly defined as the practice of pathology at a distance. Telepathology allows a pathologist to evaluate microscopic images without being physically stationed at a microscope looking at tissue sections mounted on glass slides. This is especially promising for multisite institutions, including those that are international, and has the potential to improve cross-institutional communication, collaboration, consultation, and consistency. There are three major types of telepathology systems: static, dynamic (or real time), and virtual slide systems (McCullough et al. 2004). Static image systems involve the digital capture of microscopic image fields (photomicrographs) that are stored and then forwarded (usually by e-mail) for off-site access. Dynamic telepathology systems allow for online digital image exchange in real time. This can occur either by an off-site pathologist actively operating a robotically controlled motorized microscope or by viewing a live digital video feed controlled by a host pathologist. Static and dynamic telepathology systems are rapidly being replaced by virtual slides, which represent all of the information on an entire glass microscopic slide.
Image Analysis for Tissue Phenomics
Published in Gerd Binnig, Ralf Huss, Günter Schmidt, Tissue Phenomics, 2018
Johannes Zimmermann, Keith E. Steele, Brian Laffin, René Korn, Jan Lesniak, Tobias Wiestler, Martin Baatz
An image analysis methodology that gained considerable traction over the last years (from 33 publications in the realm of digital pathology during 2005-2010 to 133 in 2016 alone) is CNT. The CNT system perceives biological structures on all scales as objects, very much as a human observer would do, and allows a heuristic approach to complex biomedical questions (Binnig et al., 2002). Being object-oriented and context-driven, it is excellently suited for functional, morphological, and geographical phenotyping in histological sections (Baatz et al., 2009). When a virtual slide is analyzed, a fractal network of objects is generated, not only as final result, but already during an evolutionary process (Figs. 2.1 and 2.2) in which initial object primitives are semantically enriched until the final state of abstracted, correctly segmented, and classified objects of interest is reached (Fig. 2.3).
Automated Analysis of PD1 and PDL1 Expression in Lymph Nodes and the Microenvironment of Transmissible Tumors in Tasmanian Devils
Published in Immunological Investigations, 2023
Grace G. Russell, Chiara Palmieri, Jocelyn Darby, Gary P. Morris, Nicholas M. Fountain-Jones, Ruth J. Pye, Andrew S. Flies
Following immunohistochemical staining, slides were scanned using a VS120 Virtual Slide System (Olympus) at 40× magnification. Digitalized slides were saved in .vsi format. Digitalized slide images were imported into the open-source software QuPath, with the image type set to “Brightfield (H-DAB)” and the stain vectors automatically estimated. Each image was duplicated, to produce an image for nuclei detection/cell classification optimization, and final analysis. The analysis pipeline was modified from the QuPath online brightfield analysis tutorial v0.2.3 (Bankhead 2021). Custom scripts for QuPath were developed with the aid of IntelliJ ® Community Edition v2020.3.2 using Apache Groovy coding language. All scripts are available in Supplementary dataset 2.
Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model
Published in Critical Reviews in Clinical Laboratory Sciences, 2020
Deirdre L. Church, Christopher Naugler
Telepathology, a component of laboratory medicine practice, is being realized by the advancement in digital imaging technology that allows capture, transmission, and remote or automated analysis of slides [76–79]. The use of digitized microscopic slides or whole-slide images in diagnostic pathology is being implemented increasingly across large laboratory networks [80]. Although there remain barriers to its widespread adoption, a fully digitized pathology workflow has been recognized medically to increase efficiency and ergonomics for laboratory physicians as well to deliver higher quality of diagnostics and improved patient safety [77]. Among the limitations to the widespread use of digital pathology are the high costs of acquiring the infrastructure for scanning slides and storing digital images, which includes the implementation of information technology (IT) capacity and systems to handle the large scale introduction of a completely digitized workflow [80]. To date, digital pathology services have been validated and used primarily by single healthcare facilities [78]. However, because rapid consultation on cases with extramural experts is one of the most important uses for digital pathology networks, recent studies have focused on validating a whole-slide image-based teleconsultation network among a few institutions [81], and even amongst pathology laboratories within a nation [80]. The Dutch digital pathology project created and implemented a vendor-independent software platform for the exchange of high-quality images that would not lead to patient privacy breaches; this was subsequently validated and implemented in pathology laboratories throughout the Netherlands to facilitate efficient teleconsultation, telerevision, and virtual slide panels [80]. These technology advances will allow specialized pathologist support to be rapidly and routinely provided within large laboratory networks.
Development and evaluation of an online integrative histology module: simple design, low-cost, and improves pathology self-efficacy
Published in Medical Education Online, 2022
Daniel T. Schoenherr, Mary O. Dereski, Kurt D. Bernacki, Said Khayyata, Stefanie M. Attardi
The Respiratory course spans five weeks at the conclusion of the M1 year, covering normal and abnormal functions of the respiratory system. Class sessions for the study population included a respiratory histology lecture (1 hour) and laboratory session (1.5 hours) during the first week of the course. There were six pathology lectures (6 hours) delivered over the second through fourth weeks and an ungraded respiratory pathology laboratory session (1.5 hours) in the fourth week. The laboratory consisted of ten cases divided into four stations, each 20 minutes in length. Two faculty pathologists and two pathology residents served as facilitators for the four stations, and each station included 12–16 students. Case topics included pulmonary hamartoma, carcinoid tumor, small cell carcinoma, adenocarcinoma, sarcoidosis, granulomatosis with polyangiitis, Coccidioides immitis infection, Pneumocystis jirovecii infection, Cytomegalovirus infection, and tonsillar squamous cell carcinoma. Clinical histories and laboratory exercise questions were provided for each case on a paper worksheet. Students were asked to examine the virtual slide(s) for each case and determine whether the pathologic process was neoplastic or non-neoplastic. In developing a differential diagnosis, subsequent questions directed students to consider pertinent clinical details that would help refine the differential, such as symptoms, past medical history of immunosuppression, smoking history, or travel history. Students were then asked to determine what types of additional histologic stains (microbiologic or immunohistochemical) would help refine the differential diagnosis. In some cases of lung tumors, after the correct diagnosis was reached, questions relating to subsequent molecular testing or therapy were posed. Pathologist facilitators circulated amongst the students to help guide with location of diagnostic foci on the virtual slides and to assist with progression through the exercise questions.