Potential quality pitfalls of digitalized whole slide image of breast pathology in routine practice

AbstractUsing digitalized whole slide images (WSI) in routine histopathology practice is a revolutionary technology. This study aims to assess the clinical impacts of WSI quality and representation of the corresponding glass slides. 40,160 breast WSIs were examined and compared with their corresponding glass slides. The presence, frequency, location, tissue type, and the clinical impacts of missing tissue were assessed. Scanning time, type of the specimens, time to WSIs implementation, and quality control (QC) measures were also considered. The frequency of missing tissue ranged from 2% to 19%. The area size of the missed tissue ranged from 1–70%. In most cases (>75%), the missing tissue area size was <10% and peripherally located. In all cases the missed tissue was fat with or without small entrapped normal breast parenchyma. No missing tissue was identified in WSIs of the core biopsy specimens. QC measures improved images quality and reduced WSI failure rates by seven-fold. A negative linear correlation between the frequency of missing tissue and both the scanning time and the image file size was observed (p < 0.05). None of the WSI with missing tissues resulted in a change in the final diagnosis. Missing tissue on breast WSI is observed but with variable frequency and little diagnostic consequence. Balancing between WSI quality and scanning time/image file size should be considered and pathology laboratories should undertake their own assessments of risk and provide the relevant mitigations with the appropriate level of caution.

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Standardized Method for Defining a 1-mm2 Region of Interest for Calculation of Mitotic Rate on Melanoma Whole Slide Images

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2020-0137-oa ◽

2021 ◽

Author(s):

Minhua Wang ◽

Phyu P. Aung ◽

Victor G. Prieto

Keyword(s):

Hot Spot ◽

Standard Procedure ◽

Region Of Interest ◽

Mitotic Rate ◽

Routine Practice ◽

Glass Slides ◽

Slide Image ◽

Standardized Method ◽

Mitotic Figures ◽

Whole Slide Images

Context.— Mitotic rate counting is essential in pathologic evaluations in melanoma. The American Joint Committee on Cancer recommends reporting the number of mitotic figures (MFs) in a 1-mm2 area encompassing the “hot spot.” There is currently no standard procedure for delineating a 1-mm2 region of interest for MF counting on a digital whole slide image (WSI) of melanoma. Objective.— To establish a standardized method to enclose a 1-mm2 region of interest for MF counting in melanoma based on WSIs and assess the method's effectiveness. Design.— Whole slide images were visualized using the ImageScope viewer (Aperio). Different monitors and viewing magnifications were explored and the annotation tools provided by ImageScope were evaluated. For validation, we compared mitotic rates obtained from WSIs with our method and those from glass slides with traditional microscopy with 30 melanoma cases. Results.— Of the monitors we examined, a 32-inch monitor with 3840 × 2160 resolution was optimal for counting MFs within a 1-mm2 region of interest in melanoma. When WSIs were viewed in the ImageScope viewer, ×10 to ×20 magnification during screening could efficiently locate a hot spot and ×20 to ×40 magnification during counting could accurately identify MFs. Fixed-shape annotations with 500 × 500-μm squares or circles can precisely and efficiently enclose a 1-mm2 region of interest. Our method on WSIs was able to produce a higher mitotic rate than with glass slides. Conclusions.— Whole slide images may be used to efficiently count MFs. We recommend fixed-shape annotation with 500 × 500-μm squares or circles for routine practice in counting MFs for melanoma.

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Applying MRI Intensity Normalization on Non-Bone Tissues to Facilitate Pseudo-CT Synthesis from MRI

Diagnostics ◽

10.3390/diagnostics11050816 ◽

2021 ◽

Vol 11 (5) ◽

pp. 816

Author(s):

Kuei-Yuan Hou ◽

Hao-Yuan Lu ◽

Ching-Ching Yang

Keyword(s):

Mean Value ◽

Tissue Type ◽

Routine Practice ◽

Intensity Level ◽

Mean Values ◽

Conversion Model ◽

Ratio Image ◽

Abdominal Mri ◽

High Level ◽

Intensity Normalization

This study aimed to facilitate pseudo-CT synthesis from MRI by normalizing MRI intensity of the same tissue type to a similar intensity level. MRI intensity normalization was conducted through dividing MRI by a shading map, which is a smoothed ratio image between MRI and a three-intensity mask. Regarding pseudo-CT synthesis from MRI, a conversion model based on a three-layer convolutional neural network was trained and validated. Before MRI intensity normalization, the mean value ± standard deviation of fat tissue in 0.35 T chest MRI was 297 ± 73 (coefficient of variation (CV) = 24.58%), which was 533 ± 91 (CV = 17.07%) in 1.5 T abdominal MRI. The corresponding results were 149 ± 32 (CV = 21.48%) and 148 ± 28 (CV = 18.92%) after intensity normalization. With regards to pseudo-CT synthesis from MRI, the differences in mean values between pseudo-CT and real CT were 3, 15, and 12 HU for soft tissue, fat, and lung/air in 0.35 T chest imaging, respectively, while the corresponding results were 3, 14, and 15 HU in 1.5 T abdominal imaging. Overall, the proposed workflow is reliable in pseudo-CT synthesis from MRI and is more practicable in clinical routine practice compared with deep learning methods, which demand a high level of resources for building a conversion model.

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F-18 Fluorodeoxyglucose PET/CT as a Diagnostic Tool in Orbital Inflammatory Disorders

10.21203/rs.3.rs-145990/v1 ◽

2021 ◽

Author(s):

Ghassan Elourimi ◽

Michael Soussan ◽

Matthieu Groh ◽

Antoine Martin ◽

Françoise Héran ◽

...

Keyword(s):

Autoimmune Diseases ◽

Diagnostic Tool ◽

Fdg Pet ◽

Final Diagnosis ◽

Diagnostic Workup ◽

Routine Practice ◽

Inflammatory Disorders ◽

Tertiary Referral Center ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background: In the last decade, FDG-PET/CT has become routine practice in the management of lymphoma or autoimmune diseases. In the current study, we aimed to assess the usefulness of FDG-PET/CT as a potential diagnostic tool for detecting underlying systemic diseases (SD) in patients with orbital inflammatory disorders (OID).Methods: All consecutive patients managed for new-onset OID between 2011 and 2018 in a tertiary referral center for OID, who underwent FDG-PET/CT as part as the etiological diagnostic workup were enrolled. PET-FDG/CT scans were reviewed blindly and were considered as positive for SD detection if they showed lymphadenopathy and/or other visceral lesions with an uptake above blood pool background. We used the standard diagnostic workup (performed in all patients at presentation) as relevant comparator. To quantify the incremental value of FDG-PET/CT over the standard diagnostic workup, the Net Reclassification Index (NRI) and Integrated Discrimination Index (IDI) were used. The final diagnosis was based on international criteria for autoimmune diseases, or histological confirmation for lymphoma, xanthogranuloma, crystal storing histiocytosis (CSH), or idiopathic orbital inflammation syndrome (IOIS). Results: Among the 22 patients enrolled, 14 (63%) had underlying SD (granulomatosis with polyangiitis (GPA), n=1; IgG4-related disease (IgG4-RD), n=5; CSH, n=1; adult onset asthma and periocular xanthogranuloma (AAPOX), n=3; lymphoma, n=4) while the remaining 8 (37%) patients were diagnosed with IOIS. Eleven (50%) patients had a positive FDG-PET/CT. After clinicobiological evaluation, FDG-PET/CT correctly reclassified 29% of patients with SD (p=0.04) and 13% with IOIS (p=0.3), corresponding to an elevated NRI of 0.41±0.17 (p=0.03). The IDI test used to evaluate the improvement of FDG-PET/CT for SD detection was 0.38±0.08 (p<0.001). After FDG-PET/CT, probability changes for SD and IOIS were measured at 0.14 and -0.24, respectively (relative gain of 3.04 for IDI). FDG-PET/CT successfully detected asymptomatic lesions in all patients with a final diagnosis of lymphoma. Conclusion: FDG-PET/CT enabled accurate reclassification of more than one quarter of patients with SD, suggesting its potential value for detecting SD (especially extraorbital lymphoma).

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IMPLEMENTASI ALGORITMA SUBEXPONENTIAL CODE UNTUK KOMPRESI FILE GAMBAR

KOMIK (Konferensi Nasional Teknologi Informasi dan Komputer) ◽

10.30865/komik.v3i1.1611 ◽

2019 ◽

Vol 3 (1) ◽

Author(s):

Amir Maniur Silitonga ◽

Surya Darma Nasution ◽

Putri Ramadhani

Keyword(s):

Transfer Process ◽

Storage Space ◽

File Size ◽

K Value ◽

Image File ◽

Code Algorithm ◽

And Storage

Image file size is sometimes relatively large where the better the quality of the image produced, the pixel shape needed to record the image is bigger. With a very large image file size, at the time of the transfer process the transfer process could fail because the storage space media exceeds its limit. As for the Solution in this problem is how the image file can be compressed in order to accelerate the transfer and storage of image files. compression on image files is done by reducing the shape of the image file by reducing the bit in the image file, but does not eliminate the information data in it. By running compression, large files will shrink in size so that it can save storage space. In this study, the algorithm used is Subexponential Code, by using this method, the compression results from the k value have different results from each value, and the compression results will be advantageous in sending, and transferring image files will be easier.Keywords: image file compression, subexponential code algorithm

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The Effectiveness of cloud-based telepathology system in China：Large-Sample Observational Study (Preprint)

10.2196/preprints.23799 ◽

2020 ◽

Author(s):

Xianying He ◽

Linlin Wang ◽

Li Wang ◽

Jinghong Gao ◽

Fangfang Cui ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Final Diagnosis ◽

Turnaround Time ◽

Economic Benefits ◽

The Novel ◽

Benign Lesions ◽

Glass Slides ◽

System P ◽

Malignant Lesions ◽

Telepathology System

BACKGROUND Telepathology is a potent strategy to overcome the shortage of senior pathologists, whole slid imaging (WSI) is the most advanced means and has been widely used in telepathology owning to its complete scanning of glass slides, but WSI occupies large storage space and computing resource, and the WSI retrieval is time-consuming. To compensate for these shortcomings of WSI, we have established a cloud-based telepathology system and conducted detailed evaluation of its implementation effects. OBJECTIVE The cloud-based telepathology system in China has been running for more than four years, and a large number of cases were submitted. The main purpose of this study is to evaluate the operation effect of this system based on a large sample, including the overview of the submitted cases, timeliness of telepathology reports, diagnostic accuracy, and economic benefits. METHODS A total of 23,167 cases submitted to the cloud-based telepathology system of the National Telemedicine Center of China from January 2016 to December 2019 were collected as subjects. The variation tendency of the report-timeliness from the system were analyzed for years. 564 patients who also directly visited the First Affiliated Hospital of Zhengzhou University and obtained final diagnoses were followed up to analyze the diagnostic accuracy of the system. RESULTS The amounts of participated hospitals and submitted cases rose year by year. Most samples were captured from uterus, gastrointestinal tract, bone or soft tissue, breast, and esophagus. 17,495 cases were confirmed, including 12,088 benign lesions, 5217 malignant lesions, and 190 borderline lesions, the proportion of malignant lesions in esophagus, lung/mediastinum, urinary and thoracic cavity/pleura was higher than that in benign lesions, which was different from other 22 anatomic sites. The median turnaround time was 16.93 hours and shortened yearly (between 2018 and 2019 adjusted P= .012, other groups adjusted P＜ .001), 82.88% cases were diagnosed in 48 hours. The telepathological diagnosis of 11 cases were discrepant with the final diagnosis, and the diagnostic accuracy of the system was 98.05%, with no statistical difference from the final diagnosis in hospital(P= .549). 300,000 dollars were saved for patients every year with this system. CONCLUSIONS The novel cloud-based telepathology system has the potential to relieve the shortage of pathologists in primary hospitals and simultaneously reduced the high medical costs for patients in China. It should be therefore promoted further to enhance the efficiency, quantity and quality of telepathological diagnoses.

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Use of whole slide imaging (WSI) for distance teaching

Journal of Clinical Pathology ◽

10.1136/jclinpath-2020-206763 ◽

2020 ◽

pp. jclinpath-2020-206763

Author(s):

Andrew John Evans ◽

Nadia Depeiza ◽

Shara-Gaye Allen ◽

Kimone Fraser ◽

Suzanne Shirley ◽

...

Keyword(s):

Distance Education ◽

Digital Pathology ◽

Daily Practice ◽

Distance Teaching ◽

Whole Slide Imaging ◽

Glass Slides ◽

Slide Image ◽

Technical Issues ◽

Initial Sessions ◽

The University

BackgroundTime, travel and financial constraints have meant that traditional visiting teaching engagements are more difficult to accomplish. This has been exacerbated with the advent of the COVID-19 pandemic. The use of digital pathology and whole slide imaging (WSI) as an educational tool for distance teaching is underutilised and not fully exploited. This paper highlights the utility and feedback on the use of WSI for distance education/teaching.Materials and methodsBuilding on an existing relationship with the University of the West Indies (UWI), pathologists at University Health Network, Toronto, provided distance education using WSI, a digitised slide image hosting repository and videoconferencing facilities to provide case-based teaching to 15 UWI pathology trainees. Feedback was obtained from residents via a questionnaire and from teachers via a discussion.ResultsThere was uniform support from teachers who felt that teaching was not hampered by the ‘virtual’ engagement. Comfort levels grew with each engagement and technical issues with sound diminished with the use of a portable speaker. The residents were very supportive and enthusiastic in embracing this mode of teaching. While technical glitches marred initial sessions, the process evened out especially when the slide hosting facility, teleconferencing and sound issues were changed.ConclusionsThere was unanimous endorsement that use of WSI was the future, especially for distance teaching. However, it was not meant to supplant the use of glass slides in their current routine, daily practice.

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Adequacy of Tissue Sampling in Breast Specimen

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.010 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S41-S41

Author(s):

Sidrah Khawar ◽

Ameer Hamza ◽

Ahmed Alrajjal ◽

Sajad Salehi ◽

Hong Qu

Keyword(s):

Neoadjuvant Therapy ◽

Lymphovascular Invasion ◽

Final Diagnosis ◽

Tumor Stage ◽

Positive Lymph Node ◽

Margin Status ◽

Tissue Sampling ◽

Tissue Sections ◽

Glass Slides ◽

Pathology Reports

Abstract Objectives Due to inadequate sampling concerns, pathologists frequently request additional tissue sections (ie, more tissue sections in addition to initial representative sections) in breast specimens. This study explores the effectiveness of the additional tissue sections in the breast specimens. Methods Breast specimens received in our institution on which additional tissue sections were requested were included in the study. Pathology reports and glass slides for these specimens were reviewed. Additional tissue sections were considered effective if they changed the final diagnosis altogether, changed a benign entity to borderline or malignant category, changed pathologic tumor stage, changed margin status, changed tumor focality, or if lymphovascular invasion was identified. Results A total of 325 specimens were identified. Of these, 98 (30.1%) were benign while 224 (68.9%) were malignant. Among malignant cases, 53 (23.7%) had neoadjuvant therapy. Overall mean initial representative sections submitted were 15.1 ± 8.7 while additional tissue sections were 10.7 ± 8.0. There was no difference in additional sections submitted for benign versus malignant cases (9.8 ± 7.7 vs 11.2 ± 8.0; P = .96). Also there was no difference in additional sections submitted for cases with neoadjuvant therapy versus those without any therapy (10.4 ± 6.9 vs 11.6 ± 8.4; P = .36). Twenty-five (7.7%) specimens benefited from submission of additional tissue sections. All 25 cases were malignant; 7 had neoadjuvant therapy while 18 did not. No tumor was identified in initial representative sections in 6 cases, pathologic tumor stage was changed in 12 cases, margin status changed in 2 cases, tumor focality changed in 4 cases, and an extra positive lymph node was identified in 1 case. Conclusion Additional tissue sections contributed to final diagnosis in 7.7% cases. Surgical pathology breast specimens require specialized handling and thorough sampling for accurate diagnosis and staging.

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Colon Tissues Classification and Localization in Whole Slide Images Using Deep Learning

Diagnostics ◽

10.3390/diagnostics11081398 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1398

Author(s):

Pushpanjali Gupta ◽

Yenlin Huang ◽

Prasan Kumar Sahoo ◽

Jeng-Fu You ◽

Sum-Fu Chiang ◽

...

Keyword(s):

Interobserver Variability ◽

Tissue Sample ◽

Treatment Strategies ◽

Region Of Interest ◽

Final Diagnosis ◽

Colon Tissue ◽

Automated Method ◽

Slide Image ◽

Colon Tissue Sample ◽

Whole Slide Images

Colorectal cancer is one of the leading causes of cancer-related death worldwide. The early diagnosis of colon cancer not only reduces mortality but also reduces the burden related to the treatment strategies such as chemotherapy and/or radiotherapy. However, when the microscopic examination of the suspected colon tissue sample is carried out, it becomes a tedious and time-consuming job for the pathologists to find the abnormality in the tissue. In addition, there may be interobserver variability that might lead to conflict in the final diagnosis. As a result, there is a crucial need of developing an intelligent automated method that can learn from the patterns themselves and assist the pathologist in making a faster, accurate, and consistent decision for determining the normal and abnormal region in the colorectal tissues. Moreover, the intelligent method should be able to localize the abnormal region in the whole slide image (WSI), which will make it easier for the pathologists to focus on only the region of interest making the task of tissue examination faster and lesser time-consuming. As a result, artificial intelligence (AI)-based classification and localization models are proposed for determining and localizing the abnormal regions in WSI. The proposed models achieved F-score of 0.97, area under curve (AUC) 0.97 with pretrained Inception-v3 model, and F-score of 0.99 and AUC 0.99 with customized Inception-ResNet-v2 Type 5 (IR-v2 Type 5) model.

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Watermarking Using LSB Shifting to Document Protection

INTERNATIONAL JOURNAL OF COMPUTERS & TECHNOLOGY ◽

10.24297/ijct.v15i12.3968 ◽

2016 ◽

Vol 15 (12) ◽

pp. 7322-7328

Author(s):

Wasilah Wasilah ◽

Suhendro Y. Irianto ◽

Dona Yuliawati

Keyword(s):

Daily Life ◽

The State ◽

New Technique ◽

File Size ◽

The Public ◽

Image File

The original signature or document. The application demonstrates that it can be used to protect a document or signature from fraud by an authorize person. Criminal can be considered as Harmful act or omission against the public which the State wishes to prevent and which, upon con eviction, is punishable by fine, imprisonment, and/or death. No conduct constitutes a crime unless it is declared criminal in the laws of the country. Some crimes (such as theft or criminal damage) may also be civil wrongs (torts) for which the victim(s) may claim damages in compensation. Criminals may be happened in every sector and in daily life. Criminal acts may be in the form of copy right fraud and signature forgery. In this work we try to solve or prevent those criminals. By using watermarking technique, the work proposed to introduce new technique to protect document originality quickly and accurately. Watermarking was carried out by inserting an image or text into signature image in order to protect. The work shows that file size produced by integrating the two same files but on different file stored and also produce different file size. Moreover Testing shows that steganography of image file with JPEG format and file image hidden with JPEG format which produced other small size of file from file steganography storage such as BMP and PNG formats.

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