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In Vivo (Athens, Greece) 1993The basic principles, technical objectives and future aspects of telecommunication in pathology (telepathology) are discussed. Visual information, which is the usually...
The basic principles, technical objectives and future aspects of telecommunication in pathology (telepathology) are discussed. Visual information, which is the usually the basic source of medical disease classification, and its transfer have to be distinguished from acoustic information, which is commonly of secondary, i.e. abstract nature. Visual telecommunication in pathology can be applied in five different aspects, namely: a) to create visual data bases, b) to be used in expert consultation, c) to combine morphological and clinical data, d) to quantitate morphological findings (DNA- measurements, etc.), and e) to install remote control microscopes. Depending upon the application, different technical prerequisites and constraints have to be taken into account: queries of visual data bases and expert consultations can be performed by use of "normal" telephone lines; combination of morphological and clinical data and quantitation of morphological data may need a digitized telephone network (ISDN), and the transfer of live images needed for application of remote control microscopes can only be performed by use of ISDN or broadband networks (optical fiber transmission systems, satellite communication, etc.). The experiences of various groups working in different aspects of telepathology are described.
Topics: Forecasting; Microscopy; Pathology; Telecommunications
PubMed: 8218975
DOI: No ID Found -
Archives of Pathology & Laboratory... Jul 2017- There is growing interest in the use of digital pathology, especially whole slide imaging, for diagnostic purposes. Many issues need to be considered when... (Review)
Review
CONTEXT
- There is growing interest in the use of digital pathology, especially whole slide imaging, for diagnostic purposes. Many issues need to be considered when incorporating this technology into a clinical laboratory. The College of American Pathologists (CAP) established a Digital Pathology Committee to support the development of CAP programs related to digital pathology. One of its many initiatives was a panel discussion entitled "Implementing Whole-Slide Imaging for Clinical Use: What to Do and What to Avoid," given for 3 years at the CAP annual meetings starting in 2014.
OBJECTIVES
- To review major issues to consider when implementing whole slide imaging for clinical purposes as covered during the panel discussion.
DESIGN
- The views expressed and recommendations given are based primarily on the personal experience of the authors as early adopters of this technology. It is not intended to be an exhaustive review of digital pathology.
RESULTS
- Implementation is best approached in phases. Early efforts are directed toward identifying initial clinical applications and assembling an implementation team. Scanner selection should be based on intended use and budget. Recognizing pathologist concerns over the use of digital pathology for diagnostic purposes, ensuring adequate training, and performing appropriate validation studies will enhance adoption. Once implemented, the transition period from glass slide to image-based diagnostics will be associated with challenges, especially those related to a hybrid glass slide-digital slide workflow.
CONCLUSIONS
- With appropriate preparation, planning, and stepwise implementation, whole slide imaging can be used safely and reliably for frozen sections, consultation, quality assurance, and primary diagnosis.
Topics: Humans; Image Interpretation, Computer-Assisted; Pathology, Clinical
PubMed: 28440660
DOI: 10.5858/arpa.2016-0074-OA -
International Journal of Surgical... Aug 2016Turnaround time (TAT) is the benchmark to assess the performance of a laboratory, pathologists, and pathology services, but there are few articles on TAT of surgical...
BACKGROUND
Turnaround time (TAT) is the benchmark to assess the performance of a laboratory, pathologists, and pathology services, but there are few articles on TAT of surgical pathology, particularly in relation to oral or head and neck specimens. This study investigates the TAT for oral histopathology reporting in an academic institution's training laboratory and offers recommendations to achieve better overall quality of diagnostic services.
METHODS
This study examined data obtained from biopsy request forms for specimens received from the Oro-Maxillofacial Surgery Department of Hospital Tengku Ampuan Rahimah Klang in the Oral Pathology Diagnostic Laboratory of the Faculty of Dentistry, University of Malaya, over a period of 3 years between January 2012 and October 2014.
RESULTS
TAT for surgical and decalcified specimens were increased significantly compared to biopsies. Additional special handling did not influence TAT, but increased specimen volume resulted in greater TAT. Slide interpretation was the most time-consuming stage during histopathology reporting. Overall, mean TAT was acceptable for most specimens, but the TAT goals were less than satisfactory.
CONCLUSION
A TAT goal appropriate for this laboratory may hence be established based on this study. Collective efforts to improve the TAT for various specimens are essential for better laboratory performance in the future.
Topics: Biopsy; Humans; Laboratories; Malaysia; Mouth Diseases; Pathology, Surgical; Time Factors
PubMed: 27006298
DOI: 10.1177/1066896916639372 -
Surgery Jun 2010Research studies frequently perform reviews of archived pathology material mainly for purposes of diagnostic accuracy. Accuracy is subject to temporal changes in...
Research studies frequently perform reviews of archived pathology material mainly for purposes of diagnostic accuracy. Accuracy is subject to temporal changes in diagnostic criteria and reproducibility error, which limits the applicability of any revision of the original diagnosis to patient care. Currently, such revisions are not disclosed to the patient or their physician unless there is patient consent. Recent expert opinion advocated full disclosure irrespective of the consent status and suggested procedures by which it could occur. We suggest guidelines for conducting unbiased pathology reviews are also needed as part of that process.
Topics: Humans; Laboratories; Pathology; Practice Guidelines as Topic; Research; Surgical Procedures, Operative; Thyroid Diseases; Thyroid Gland
PubMed: 20494214
DOI: 10.1016/j.surg.2009.12.012 -
Medical Image Analysis Jan 2023Machine learning model deployment in clinical practice demands real-time risk assessment to identify situations in which the model is uncertain. Once deployed, models...
Machine learning model deployment in clinical practice demands real-time risk assessment to identify situations in which the model is uncertain. Once deployed, models should be accurate for classes seen during training while providing informative estimates of uncertainty to flag abnormalities and unseen classes for further analysis. Although recent developments in uncertainty estimation have resulted in an increasing number of methods, a rigorous empirical evaluation of their performance on large-scale digital pathology datasets is lacking. This work provides a benchmark for evaluating prevalent methods on multiple datasets by comparing the uncertainty estimates on both in-distribution and realistic near and far out-of-distribution (OOD) data on a whole-slide level. To this end, we aggregate uncertainty values from patch-based classifiers to whole-slide level uncertainty scores. We show that results found in classical computer vision benchmarks do not always translate to the medical imaging setting. Specifically, we demonstrate that deep ensembles perform best at detecting far-OOD data but can be outperformed on a more challenging near-OOD detection task by multi-head ensembles trained for optimal ensemble diversity. Furthermore, we demonstrate the harmful impact OOD data can have on the performance of deployed machine learning models. Overall, we show that uncertainty estimates can be used to discriminate in-distribution from OOD data with high AUC scores. Still, model deployment might require careful tuning based on prior knowledge of prospective OOD data.
Topics: Humans; Prospective Studies; Machine Learning; Pathology
PubMed: 36306568
DOI: 10.1016/j.media.2022.102655 -
Virchows Archiv : An International... 1995Telepathology may be used to provide a frozen section service to hospitals without a department or institute of pathology. We have developed a telepathology system using... (Review)
Review
Telepathology may be used to provide a frozen section service to hospitals without a department or institute of pathology. We have developed a telepathology system using the commercially available Integrated Services Digital Network (ISDN). The main software and hardware elements of our system are: Apple Macintosh workstations, a program for simultaneous transfer of image, voice and data, and a data bank for storage of patients' data and microscopic images. A picture instrument manager (PIM) makes remote control of microscopes or other instruments possible. The system connects the Department of Pathology of the University of Basel with the Regional Hospital of Samedan, 250 km away, and the Regional Hospital of Burgdorf, 100 km away. During a period of 20 months, frozen sections with the hospitals in Samedan and Burgdorf were performed in 53 patients. Between 54 and 58 s were required for the transfer of a diagnostic 8-bit grey level image containing 341 +/- 26.1 (standard error) kbytes (n = 13) or a diagnostic 24-bit colour image containing 165 +/- 16.9 kbytes (n = 40). Frozen section diagnosis was completed in 20-40 min. True-positive diagnoses of malignant tumours were achieved in 85.7% of cases (sensitivity = 0.857). No false-positive diagnosis was made. In 3 of the 53 cases telepathological diagnosis was not possible for technical reasons.
Topics: Frozen Sections; Humans; Neoplasms; Pathology; Telecommunications
PubMed: 7704321
DOI: 10.1007/BF00194692 -
Ultrastructural Pathology 2003Rapid advances have been made in recent years in understanding the genetic makeup of mankind. The human genome project has identified approximately 32,000 genes that... (Review)
Review
Rapid advances have been made in recent years in understanding the genetic makeup of mankind. The human genome project has identified approximately 32,000 genes that occur in humans. It is now possible to perform genetic profiling with many of the genes to understand embryogenesis, growth and development, the normal state, senescence, diseases, and tumorogenesis. Techniques in molecular diagnostics are becoming available that will expand the ability to provide more precise diagnoses, predict response to treatment, evaluate treatment, and predict prognosis and outcome. Genetic profiling will, in the future, direct therapy by providing specific targets for development of medications, antibodies, and gene therapy. More recently, the attention of the scientific community has turned toward the gene products within the cell and tissue matrix, namely proteins. The field of proteomics is an evolving area, which may shed light on the proteins associated with diseases and tumors. This will again provide a mechanism for creating personalized, designer therapies for individual patients or groups of patients with similar diseases based on expression profiling. The final avenue of exploration in understanding cell function is the metabolites that occur as the end products of cellular function (metabolome). These metabolites, or improper degradation of cellular proteins, may lead to disease and neoplasia. The role of the pathologist in expression profiling for diseases and tumorigenesis is of considerable importance in providing diagnostic information and predicting outcome based on pathobiologic features of diseases and tumors.
Topics: Genome; Humans; Molecular Biology; Pathology; Proteome; Transcription, Genetic
PubMed: 14708720
DOI: No ID Found -
Toxicologic Pathology 2002Historical control tumor data are useful in the interpretation of long-term rodent carcinogenicity bioassays, especially to assess the occurrence of rare tumors and... (Review)
Review
Historical control tumor data are useful in the interpretation of long-term rodent carcinogenicity bioassays, especially to assess the occurrence of rare tumors and marginally increased tumor incidences. The major prerequisites to compare historical control data with studies under evaluation are the validity and consistency of the respective databases. The RITA (Registry of Industrial Toxicology Animal-data) database for historical data of tumors and pre-neoplastic lesions collects data according to highly standardized procedures including tissue sampling and trimming, histopathology according to internationally harmonized nomenclature and diagnostic criteria, and peer review. All lesions that are entered are unanimously diagnosed according to IARC (Intermational Agency for Research on Cancer)/WHO criteria. The validity of data is additionally confirmed by a complete peer review performed by a database pathologist. Equivocal diagnoses and selected cases are additionally submitted to a panel of RITA pathologists. In the RITA database, there are currently 10,896 rats from 106 studies with more than 17,604 primary tumors and 16,551 pre-neoplastic lesions. The RITA database for historical control data for Wistar and Sprague Dawley rats as well as for different mouse strains is briefly described. Based upon RITA background data, the survival rate of Wistar rats has been consistent over a period of 10 years. The occurrence of tumor-bearing animals also shows a stable percentage over a decade. Additionally, examples of how historical control data may support carcinogenic risk assessment in cases of rare tumors or marginally increased incidences of tumors and pre-neoplastic lesions are given.
Topics: Animals; Animals, Laboratory; Carcinogens; Databases, Factual; Government Agencies; Industry; Information Systems; Neoplasms, Experimental; Pathology; Rats; Reference Standards; Survival Rate
PubMed: 11890480
DOI: 10.1080/01926230252824743 -
Stroke May 2005Carotid plaque instability is an important determinant of stroke risk. There are now a number of different imaging techniques that provide information on carotid plaque... (Comparative Study)
Comparative Study Review
BACKGROUND AND PURPOSE
Carotid plaque instability is an important determinant of stroke risk. There are now a number of different imaging techniques that provide information on carotid plaque morphology. However, it is unclear how they compare with one another or whether they can reliably assess plaque instability. Studies comparing imaging with pathology have shown highly variable results, even for similar imaging techniques. This may be because of variable pathology techniques rather than differences in imaging.
METHODS
We performed a systematic review of studies that compared carotid imaging with histology of the excised plaque published between January 1995 and September 2004. We assessed the quality and comparability of these studies. In particular, we determined which histology methods were used and whether observer reproducibility of the histology assessment was reported.
RESULTS
Among 73 eligible studies, histological methods were poorly reported and highly variable; 23% reported reproducibility data for imaging and only 12% reported reproducibility data for histology. Of 29 studies that reported quantitative results of blinded comparisons, there were methodological deficiencies and the results were highly variable. No study considered the extent to which the lack of reproducibility influenced the imaging-pathological correlations reported.
CONCLUSIONS
Pathological correlation in studies of carotid plaque imaging cannot be reliably interpreted or compared because of incomparable and poorly reported histology methods. We make recommendations for the performance, reporting, and interpretation of imaging-pathological correlation studies and highlight the need for consensus guidelines.
Topics: Carotid Arteries; Carotid Stenosis; Diagnostic Imaging; Humans; Observer Variation; Pathology, Clinical; Practice Guidelines as Topic; Reproducibility of Results
PubMed: 15774817
DOI: 10.1161/01.STR.0000160749.61763.95 -
Toxicologic Pathology 2003Ready or not, fish models are "here to stay." No longer are fish confined to a few specialized laboratories, nor are they exclusively the purview of zoologists or... (Review)
Review
Ready or not, fish models are "here to stay." No longer are fish confined to a few specialized laboratories, nor are they exclusively the purview of zoologists or environmental toxicologists. In fact, the institution that does not house at least 1 fish facility is probably not at the forefront of cutting edge research. In toxicologic pathology, fish models are increasingly being used to provide high animal numbers at relatively low cost in carcinogenicity testing and developmental research, and to provide mechanistic information on fundamental cellular processes. In this session, we attempt to provide some perspective for the pathologist that is faced with planning or performing experiments or testing protocols using fish models, or with reading or interpreting fish studies. First, we cover how to approach fish studies from the contract laboratory standpoint, including sectioning, quality control, and GLP considerations. Then, we discuss specifics on the use of the rainbow trout, zebrafish, and Japanese medaka models. The rainbow trout has a rich history in carcinogenicity and mechanistic cancer research. Similarly, the 2 workhorses in the small fish category, zebrafish and medaka, have found their way into many laboratories doing developmental biology and genomics research as well as carcinogenicity testing. Some fascinating genetically altered fish models have been developed with both of these species. This manuscript provides a session overview of the use of small fish models in toxicologic pathology, along with some historical perspective on how these models have played a role in the current state of the science.
Topics: Animals; Carcinogenicity Tests; Carcinogens; Drug Evaluation, Preclinical; Fishes; Models, Animal; Pathology; Toxicology
PubMed: 12597431
DOI: 10.1080/01926230390174922