Significant technologic gains have led to the adoption of innovative digital imaging solutions in pathology. Whole slide imaging (WSI), which refers to scanning of conventional glass slides in order to produce digital slides, is the most recent imaging modality being employed by pathology departments worldwide. WSI continues to gain traction among pathologists for diagnostic, educational, and research purposes. This article provides a technologic review of WSI platforms and covers clinical and nonclinical pathology applications of these imaging systems. Barriers to adoption of WSI include limiting technology, image quality, problems with scanning all materials (eg, cytology slides), cost, digital slide storage, inability to handle high-throughput routine work, regulatory barriers, ergonomics, and pathologists' reluctance. Emerging issues related to clinical validation, standardization, and forthcoming advances in the field are also addressed.

/pdf/whole-slide-imaging-in-pathology-advantages-limitations-and-7kahmwt9q6.pdf

whole slide imaging in pathology: advantages, limitations, and emerging perspectives

Eye-movement study and human performance using telepathology virtual slides: implications for medical education and differences with experience.

A method and apparatus are disclosed for constructing a virtual microscope slide comprised of digitally scanned images from a microscope specimen. The digitally scanned images are arranged in a tiled format convenient for viewing without a microscope, and for transferring the tiled images for viewing by another at a remote location. Several original microscope views at a low magnification are digitized and stored as digitized images coherently seamed together to provide an overall virtual, macro image of the specimen at a lower resolution. Several original microscope views at higher magnifications are digitized and stored as digitized images coherently seamed together to provide virtual micro images at higher resolution. A data structure is formed with these virtual macro and micro digitized images along with their mapping coordinates. Preferably, a generic viewing program is also provided in the data structure that allows remote users to manipulate and interpret the tiled images on the user's monitor. Also, the data structure is formed with significantly compressed data so as to be transmitted over low bandwidth channels, such as the Internet, without loss of resolution that would interfere with the analysis at a remotely-located pathologist receiving the data structure over the Internet. The preferred interactive program allows the pathologist to scroll and view neighboring image areas of interest. A marker on the macro image indicates to the user the location of the micro image and assists the user in selecting areas from the macro image to be viewed at higher resolution and magnification.

Method and apparatus for creating a virtual microscope slide

Advances in new technologies for complete slide digitization in pathology have allowed the appearance of a wide spectrum of technologic solutions for whole-slide scanning, which have been classified into motorized microscopes and scanners. This article describes technical aspects of 31 different digital microscopy systems. The most relevant characteristics of the scanning devices are described, including the cameras used, the speed of digitization, and the image quality. Other aspects, such as the file format, the compression techniques, and the solutions for visualization of digital slides, (including diagnosis-aided tools) are also considered. Most of the systems evaluated allow a high-resolution digitization of the whole slide within about 1 hour using a x40 objective. The image quality of the current virtual microscopy systems is suitable for clinical, educational, and research purposes. The efficient use of digital microscopy by means of image analysis systems can offer important benefits to pathology departments.

/pdf/critical-comparison-of-31-commercially-available-digital-17aejpi6lp.pdf

Critical comparison of 31 commercially available digital slide systems in pathology.

Automated image analysis of histopathology specimens could potentially provide support for early detection and improved characterization of breast cancer. Automated segmentation of the cells comprising imaged tissue microarrays (TMAs) is a prerequisite for any subsequent quantitative analysis. Unfortunately, crowding and overlapping of cells present significant challenges for most traditional segmentation algorithms. In this paper, we propose a novel algorithm that can reliably separate touching cells in hematoxylin-stained breast TMA specimens that have been acquired using a standard RGB camera. The algorithm is composed of two steps. It begins with a fast, reliable object center localization approach that utilizes single-path voting followed by mean-shift clustering. Next, the contour of each cell is obtained using a level set algorithm based on an interactive model. We compared the experimental results with those reported in the most current literature. Finally, performance was evaluated by comparing the pixel-wise accuracy provided by human experts with that produced by the new automated segmentation algorithm. The method was systematically tested on 234 image patches exhibiting dense overlap and containing more than 2200 cells. It was also tested on whole slide images including blood smears and TMAs containing thousands of cells. Since the voting step of the seed detection algorithm is well suited for parallelization, a parallel version of the algorithm was implemented using graphic processing units (GPU) that resulted in significant speedup over the C/C++ implementation.

Robust Segmentation of Overlapping Cells in Histopathology Specimens Using Parallel Seed Detection and Repulsive Level Set

We present the design of the Virtual Microscope, a software system employing a client/server architecture to provide a realistic emulation of a high power light microscope We discuss several technical challenges related to providing the performance necessary to achieve rapid response time, mainly in dealing with the enormous amounts of data (tens to hundreds of gigabytes per slide) that must be retrieved from secondary storage and processed To effectively implement the data server, the system design relies on the computational power and high I/O throughput available from an appropriately configured parallel computer

The Virtual Microscope.

The Virtual Microscope is being designed as an integrated computer hardware and software system that generates a highly realistic digital simulation of analog, mechanical light microscopy. We present our work over the past year in meeting the challenges in building such a system. The enhancements we made are discussed, as well as the planned future improvements. Performance results are provided showing the system scales well, so that many users can be adequately serviced by an appropriately configured data server.

/pdf/digital-dynamic-telepathology-the-virtual-microscope-58mfaw0wun.pdf

Digital dynamic telepathology--the Virtual Microscope.

Medical data are characterized by complex taxonomies and evolving terminology. Questions that clinicians, medical administrators, and researchers may wish to answer using medical databases are not easily formulated as SQL queries. In this paper we describe a graphical tool that facilitates formulation of ad hoc questions as SQL queries. This tool manages multiple attribute hierarchies and creates SQL query strings by navigating through the hierarchies. This interactive tool has been optimized using indexing to improve the overall speed of the query building and the data retrieval process. Indexed queries performed 5 to 100 times faster than query strings. However, query string generation time depends on the size of the taxonomies describing the hierarchies, while the index generation time depends on the size of the data warehouse.

/pdf/a-graphical-tool-for-ad-hoc-query-generation-4hgqpccs6p.pdf

A graphical tool for ad hoc query generation.

In this paper we describe indexing techniques based on domain knowledge made available in the form of ontologies. In high level interfaces like those used in many data warehousing applications, it is advantageous to use terminology familiar to the enduser of the system. This terminology is very often different from the one incorporated in the underlying database. Much of the terminology (i.e. concepts) in an end-user ontology will map to complex collections of data warehouse attribute value pairs. We create a mapping between the end-user terminology and attribute-value pairs in the data warehouse. We optimize performance by indexing the data warehouse using an ontology. We optimize performance by indexing the whole database using an ontology that represents the end-user’s terminology.

Semantic Indexing for Complex Patient Grouping

Aspects of Electronic Health Record Systems (Health Informatics)

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