Robust Nuclei Segmentation using Statistical Level Set Method with Topology Preserving Constraint
Ayman El-Baz, Jasjit S. Suri in Level Set Method in Medical Imaging Segmentation, 2019
Pathology is a medical specialty which concerns laboratory examination of cells and tissue samples with the purpose of diagnosis and characterization of diseases. More specifically, cytopathological and histopathological examinations of a biopsy or surgical specimen are two main branches of anatomical pathology that are commonly applied to diagnose various diseases, including cancer. Cytopathology (or cytology) refers to the microscopic investigation of samples at the cellular level and is mainly advantageous when quick preparation, staining, and interpretation procedures are needed. Despite the fact that cytopathological imagery are highly beneficial as they provide great cellular detail at low cost, cytopathological examinations alone are not sufficient for accurate diagnosis purposes. For instance, they cannot indicate whether the cancer cells are spreading into and damaging surrounding tissues. Therefore, to obtain higher diagnostic accuracy, the preliminary cytopathological tests must be confirmed by the so-called histopathological (or histological) assessments for which the overall tissue architecture is evaluated. Pathologists usually make diagnostic interferences by visual inspection of cells based on their morphological features and architecture, such as shape, position, size, number, etc. Although still being considered as the gold standard, manual examination of biological images is tedious work which requires many hours of human labor. This highlights the requirement for an automatic system that accurately measures these features in a few seconds.
Pathology and its role in medical science and practice
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Unlike histopathology, where assessment of the tissue architecture is of prime importance, in cytopathology the characteristics of the individual cells are of most value. Essentially, in diagnostic practice the cytopathologist looks for the cytological features of malignancy (see Figure 6.3D). Admittedly, the relationships between adjacent cells can be appreciated to some extent: e.g. in an aspirate from a breast lump, loss of cohesion between cells is suggestive of malignancy, as is a high cellular nucleus:cytoplasm ratio (Figure 1.7). In screening practice, e.g. in cervical cancer programmes, the cytopathologist seeks to identify the same changes but at an earlier, pre-invasive stage, and thus give a warning of incipient cancerous changes. The biological basis and efficacy of screening programmes continue to be hotly debated.
Imaging of the Salivary Glands
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in Head & Neck Surgery Plastic Surgery, 2018
Articles concerning USgFNAC yields34–37 have reported sensitivities ranging from 62% to 98% and specificity ranges from 94% to 100%. For 191 salivary tumours, Howlett et al.38 conducted a 1-year audit within a rapid-access clinic setting and found a diagnostic sensitivity of 64% and specificity of 100%. Zhang et al. in 200939 published data showing that overall accuracy in distinguishing benign from malignant lesions was 79.1% and the sensitivity for salivary neoplasia was 89.4%. In 2011, a retrospective study40 looked at USgFNAC for 245 parotid and submandibular salivary aspirates without immediate adequacy assessments. A cytological diagnosis was possible in 215 aspirates (87.8%). The sensitivity, specificity and diagnostic accuracy of the test in separating benign from malignant lesions were 75.7%, 100% and 95.8% respectively. In the recent pathology literature, it seems clear that the ideal FNAC is immediately prepared by skilled technicians trained in slide preparation with further on-site ‘live’ technical expertise available for prompt adequacy assessments; however, this model has significant increased service cost implications. With this model in place, the group quotes an overall accuracy rate for salivary FNAC of between 90% and 95%. The UK National Institute for Health and Care Excellence (NICE) guidelines recommend having a cytopathologist or biomedical scientist to assess the cytology sample adequacy when the procedure is carried out.
Comparison of 22-gauge standard fine needle versus core biopsy needle for endoscopic ultrasound-guided sampling of suspected pancreatic cancer: a randomized crossover trial
Published in Scandinavian Journal of Gastroenterology, 2018
Dong Hyo Noh, Kyu Choi, Seonhye Gu, Juhee Cho, Kee-Taek Jang, Young Sik Woo, Kyu Taek Lee, Jong Kyun Lee, Kwang Hyuck Lee
The secondary endpoints were cytological and histological quality of the specimen and the rate of complications as bleeding, perforation, infection and acute pancreatitis. Cytohistological quality indicators of specimen were composed of cellularity, degree of blood contamination, presence of stromal tissue and adequate specimen for analysis [15]. Cellularity was noted as no cells, sparsely cellular (less than 3 clusters or nests), moderately cellular (more than 3 but less than 10 clusters or nests) and a highly cellular (more than 10 clusters of nests) sample. Degree of blood contamination was classified as no blood, contamination with red blood cells but interpretable, and blood clots inhibiting diagnosis. Stromal tissue was divided into two categories such as absent or present (without or within invasive tumor). Adequate specimen meant that sample was sufficient to diagnose for the cytopathologist.
Factors influencing diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic and biliary tumors
Published in Scandinavian Journal of Gastroenterology, 2021
Giovanna Del Vecchio Blanco, Giampiero Palmieri, Diana Giannarelli, Vincenzo Formica, Ilaria Portarena, Antonella Nardecchia, Edoardo Troncone, Michela Benassi, Emilia Giudice, Alessandro Anselmo, Giuseppe Tisone, Mario Roselli, Giovanni Monteleone, Omero Alessandro Paoluzi
There is general agreement that the diagnostic accuracy of EUS-FNA increases with operator experience, as it is an operator-dependent technique with a long learning curve [11–21]. Based on expert opinion, the American Society for Gastrointestinal Endoscopy (ASGE) suggests that clinical competence in all aspects of EUS may be achieved following at least 150 supervised EUS procedures. As a part of formal training, at least 75 supervised EUS procedures with pancreatic–biliary indication and 60 FNAs, including 25 of the pancreas, should be performed during the learning period [20]. Guidelines released by the European Society of Gastrointestinal Endoscopy (ESGE) recommend a minimum of 20 to 30 supervised EUS-FNAs in the presence of rapid on-site cytopathological examination (ROSE) to reach sufficient competency in this technique and sensitivity for pathological diagnosis up to 80% [21]. The importance of ROSE in increasing EUS-FNA diagnostic accuracy and reducing the number of passes needed to obtain sufficient tissue specimens is largely debated [22]. However, the presence of a cytopathologist in the endoscopy room may be limited for a number of practical reasons, such as local availability and high costs.
Role of endoscopic ultrasound-guided liver biopsy: a meta-analysis
Published in Scandinavian Journal of Gastroenterology, 2022
Keyu Zeng, Zhenpeng Jiang, Jie Yang, Kefei Chen, Qiang Lu
The primary outcomes were diagnostic yield, specimen adequacy, and qualified specimens evaluated by ROSE. A liver specimen was deemed to have diagnostic yield if it allowed pathologists to make a successful pathological diagnosis. A liver specimen satisfying the following criterion was deemed adequate: TSL ≥ 15 mm and presence of CPTs ≥ 6. A specimen was deemed qualified when it was assured adequate for further evaluation by the on-site cytopathologist or cytotechnician when performing cytopathology. The secondary outcome was adverse events. An adverse event was defined as any incident deviating from the expectant postbiopsy clinical course. Adverse events were graded based on the Clavien-Dindo classification [23].
Related Knowledge Centers
- Cell Biology
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