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Informatics and digital imaging management
Conventional histopathology is rapidly shifting towards digital integration. The ability to digitize histopathology slides automatically, rapidly and a high resolution has been advanced by numerous investigators around the world over the past approximately fifteen years. We provide an overview of current digital pathology applications and research with emphasis on whole slide imaging (WSI) and beyond. Static or interactive digital pathology work stations already can be used for many purposes, e.g. telepathology expert consultations, frozen section diagnosis in remote areas, cytology screening, quality assurance, diagnostic validations for clinical trials, quantitation of hormone receptor in cancer, or three‐dimensional visualization of anatomical structures, among others. Changes of workflow in histology laboratories are beginning to enable digital image acquisition and WSI in a routine setting. WSI plays an increasingly important roles in pathology education, glass slide boxes in medical schools are being replaced by digital slide collections (virtual slide box); digital slide seminars and virtual microscopy are used for postgraduate and continuing medical education in pathology. Research to improve WSI in many ways and efforts to validate WSI systems for diagnostic settings are ongoing. The advanced versions of Optical Coherence Tomography (OCT) for in–vivo biopsy, Microtomography (Micro CT) for the frozen sections, and Light CT have joined in Digital Pathology world. It may bring new era in Pathology.
Applications and Tools
Digital Pathology is a relatively new field in medicine and still developing stage for clinical use. However, conventional pathology is rapidly shifting towards digital integration. After the Whole Slide Imaging Robot became available to produce virtual slides automatically, rapidly and a high resolution, many issues and limitations we had with telepathology and pathology imaging seemed to be solved. The combination of the WSI and Image Analysis can be very helpful for pathologists if it works right. We have been developing the algorithm and protocol to improve the image quality and reliability to make images useful in practice. To promote imaging, we have developed several applications and tools including 1) an automated, image analysis algorithm that is trainable for various purposes and 2) histology 3D imaging, 3) a ultra fast WSI viewing system. Advanced imaging research such as multispectral imaging for digital staining is moving to the validation study. Research and efforts to validate WSI systems for diagnostic settings are ongoing.
Multimodality Imaging Research
To date, a variety of WSI has been used widely in pathology research and imaging research. Because of the availability of digital pathology data, the relationship between other modalities is now closer than ever. High resolution, reliable, and high quality histology 3D imaging are becoming more important in multimodality studies. We have started a number of multimodality imaging research projects.
The Pathology Imaging Research Core provides professional and technical imaging services to researchers at MGH, academic researchers outside the Harvard system, and investigators in Industry. The Core is equipped with whole slide scanning systems for capturing high-resolution whole-slide images of bright-field and Fluorescence slides; powerful computational and storage systems for images and image based pathology research; and automated sectioning machine for slicing hundreds of tissue sections from paraffin embedded tissue blocks at consistent thickness.
Assistant Pathologist, Pathology ServiceMassachusetts General Hospital
Assistant Professor, Harvard Medical School
Director, Pathology Imaging and Communication Technology (PICT) Center and core lab
Yukako Yagi, PhD, started her career as an electrical engineer in Japan to develop robotic microscopes and their applications such as Telepathology. In 1995 she won a Nikon Fellowship for two research years for the International Consortium for Internet Telepathology at Georgetown University, Washington, D.C. She was Director of Technologies Management at the University of Pittsburgh Medical Center where she developed and implemented telepathology systems for organ transplantation, frozen section and second opinion consultations. She established clinical and technical standards for whole slide imaging systems. Dr. Yagi came to Massachusetts General Hospital, Boston, in 2007 and is now Director of the Pathology Imaging and Communication Technology Center at Massachusetts General Hospital. She is Assistant Professor of Pathology at Harvard Medical School and the first President of the International Academy of Digital Pathology.
Pinky Bautista, PhDNoriaki Hashimoto, PhDVeronica Klepeis, MDLuigi Kuo Feng Rao ,MDRiedlinger, Gregory,MDGabor Valcz, PhDAkiko Pizzimenti
John Gilbertson, MD
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