Digital Pathology Workflow Implementation at IPATIMUP

The advantages of the digital methodology are well known. In this paper, we provide a detailed description of the process for the digital transformation of the pathology laboratory at IPATIMUP, the major modifications that operate throughout the processing pipeline, and the advantages of its implementation. The model of digital workflow implementation at IPATIMUP demonstrates that careful planning and adoption of simple measures related to time, space, and sample management can be adopted by any pathology laboratory to achieve higher quality and easy digital transformation.

Download Full-text

A Survival Guide for the Rapid Transition to a Fully Digital Workflow: The “Caltagirone Example”

Diagnostics ◽

10.3390/diagnostics11101916 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1916

Author(s):

Filippo Fraggetta ◽

Alessandro Caputo ◽

Rosa Guglielmino ◽

Maria Giovanna Pellegrino ◽

Giampaolo Runza ◽

...

Keyword(s):

Digital Pathology ◽

Primary Diagnosis ◽

Pathology Laboratory ◽

Digital Workflow ◽

Pathology Department ◽

Health Level 7 ◽

2D Barcode ◽

Glass Slides ◽

Rapid Transition ◽

Routine Assessment

Digital pathology for the routine assessment of cases for primary diagnosis has been implemented by few laboratories worldwide. The Gravina Hospital in Caltagirone (Sicily, Italy), which collects cases from 7 different hospitals distributed in the Catania area, converted the entire workflow to digital starting from 2019. Before the transition, the Caltagirone pathology laboratory was characterized by a non-tracked workflow, based on paper requests, hand-written blocks and slides, as well as manual assembling and delivering of the cases and glass slides to the pathologists. Moreover, the arrangement of the spaces and offices in the department was illogical and under-productive for the linearity of the workflow. For these reasons, an adequate 2D barcode system for tracking purposes, the redistribution of the spaces inside the laboratory and the implementation of the whole-slide imaging (WSI) technology based on a laboratory information system (LIS)-centric approach were adopted as a needed prerequisite to switch to a digital workflow. The adoption of a dedicated connection for transfer of clinical and administrative data between different software and interfaces using an internationally recognised standard (Health Level 7, HL7) in the pathology department further facilitated the transition, helping in the integration of the LIS with WSI scanners. As per previous reports, the components and devices chosen for the pathologists’ workstations did not significantly impact on the WSI-based reporting phase in primary histological diagnosis. An analysis of all the steps of this transition has been made retrospectively to provide a useful “handy” guide to lead the digital transition of “analog”, non-tracked pathology laboratories following the experience of the Caltagirone pathology department. Following the step-by-step instructions, the implementation of a paperless routine with more standardized and safe processes, the possibility to manage the priority of the cases and to implement artificial intelligence (AI) tools are no more an utopia for every “analog” pathology department.

Download Full-text

Best Practice Recommendations for the Implementation of a Digital Pathology Workflow in the Anatomic Pathology Laboratory by the European Society of Digital and Integrative Pathology (ESDIP)

Diagnostics ◽

10.3390/diagnostics11112167 ◽

2021 ◽

Vol 11 (11) ◽

pp. 2167

Author(s):

Filippo Fraggetta ◽

Vincenzo L’Imperio ◽

David Ameisen ◽

Rita Carvalho ◽

Sabine Leh ◽

...

Keyword(s):

European Society ◽

Best Practice ◽

Digital Pathology ◽

Primary Diagnosis ◽

Real World Data ◽

Pathology Laboratory ◽

Digital Workflow ◽

Anatomic Pathology ◽

Fda Approval ◽

Slide Image

The interest in implementing digital pathology (DP) workflows to obtain whole slide image (WSI) files for diagnostic purposes has increased in the last few years. The increasing performance of technical components and the Food and Drug Administration (FDA) approval of systems for primary diagnosis led to increased interest in applying DP workflows. However, despite this revolutionary transition, real world data suggest that a fully digital approach to the histological workflow has been implemented in only a minority of pathology laboratories. The objective of this study is to facilitate the implementation of DP workflows in pathology laboratories, helping those involved in this process of transformation to identify: a) the scope and the boundaries of the DP transformation; b) how to introduce automation to reduce errors; c) how to introduce appropriate quality control to guarantee the safety of the process and d) the hardware and software needed to implement DP systems inside the pathology laboratory. The European Society of Digital and Integrative Pathology (ESDIP) provided consensus-based recommendations developed through discussion among members of the Scientific Committee. The recommendations are thus based on the expertise of the panel members and on the agreement obtained after virtual meetings. Prior to publication, the recommendations were reviewed by members of the ESDIP Board. The recommendations comprehensively cover every step of the implementation of the digital workflow in the anatomic pathology department, emphasizing the importance of interoperability, automation and tracking of the entire process before the introduction of a scanning facility. Compared to the available national and international guidelines, the present document represents a practical, handy reference for the correct implementation of the digital workflow in Europe.

Download Full-text

Philip T. Cagle, MD—Editor-in-Chief of the Archives of Pathology & Laboratory Medicine, 2005–2019

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2019-0905-sa ◽

2020 ◽

Vol 144 (2) ◽

pp. 133-135

Author(s):

Timothy Craig Allen

Keyword(s):

Digital Pathology ◽

Medical Knowledge ◽

Laboratory Medicine ◽

Official Journal ◽

Pathology Laboratory ◽

Dynamic Leadership ◽

Specialty Journal ◽

General Pathology ◽

Whole Slide Images

• The Archives of Pathology & Laboratory Medicine was first published in 1926 as a specialty journal of the American Medical Association. It became the official journal of the College of American Pathologists in 1995. Under the dynamic leadership of its most recent editor-in-chief, Philip T. Cagle, MD, the Archives has dramatically increased its impact factor and become the most widely read general pathology journal. Dr. Cagle has consistently added leading pathologists to the editorial board, and the collective expertise of these individuals is clearly evident in new, cutting-edge journal masthead sections. The Archives has featured innovative content in the field of digital pathology, including articles on the utilization of smart phones in pathology and the incorporation of whole-slide images and videos into the content of articles. During the current editorial board's tenure, special sections were introduced and have proven immensely popular with the journal's readership. As the Archives celebrates its 94th anniversary, its editorial board remains committed to providing insightful and relevant medical knowledge. The journal's open access Web site (www.archivesofpathology.org) allows the dissemination of this information to every corner of the globe at no expense to those who wish to expand their knowledge or improve their medical practice. Dr. Cagle, with support from the editorial board and journal staff, has worked tirelessly during his tenure as Archives editor-in-chief to greatly enhance the content of the journal and its stature within pathology and laboratory medicine.

Download Full-text

Artificial intelligence technology applications in the pathologic diagnosis of the gastrointestinal tract

Future Oncology ◽

10.2217/fon-2020-0678 ◽

2020 ◽

Vol 16 (34) ◽

pp. 2845-2851

Author(s):

Leonardo S Lino-Silva ◽

Diana L Xinaxtle

Keyword(s):

Artificial Intelligence ◽

Gastrointestinal Tract ◽

Digital Pathology ◽

Pathology Laboratory ◽

Tissue Identification ◽

Technology Applications ◽

Artificial Intelligence Technology ◽

Complex Technology ◽

New Applications

Artificial intelligence (AI) is a complex technology with a steady flow of new applications, including in the pathology laboratory. Applications of AI in pathology are scarce but increasing; they are based on complex software-based machine learning with deep learning trained by pathologists. Their uses are based on tissue identification on histologic slides for classification into categories of normal, nonneoplastic and neoplastic conditions. Most AI applications are based on digital pathology. This commentary describes the role of AI in the pathological diagnosis of the gastrointestinal tract and provides insights into problems and future applications by answering four fundamental questions.

Download Full-text

The Use of Quantitative Digital Pathology to Measure Proteoglycan and Glycosaminoglycan Expression and Accumulation in Healthy and Diseased Tissues

Journal of Histochemistry & Cytochemistry ◽

10.1369/0022155420959146 ◽

2020 ◽

pp. 002215542095914

Author(s):

A. Sally Davis ◽

Mary Y. Chang ◽

Jourdan E. Brune ◽

Teal S. Hallstrand ◽

Brian Johnson ◽

...

Keyword(s):

Artificial Intelligence ◽

Immune Cells ◽

Quantitative Data ◽

Digital Pathology ◽

Quality Data ◽

High Quality ◽

Pathology Laboratory ◽

High Quality Data ◽

Hidden Patterns

Advances in reagents, methodologies, analytic platforms, and tools have resulted in a dramatic transformation of the research pathology laboratory. These advances have increased our ability to efficiently generate substantial volumes of data on the expression and accumulation of mRNA, proteins, carbohydrates, signaling pathways, cells, and structures in healthy and diseased tissues that are objective, quantitative, reproducible, and suitable for statistical analysis. The goal of this review is to identify and present how to acquire the critical information required to measure changes in tissues. Included is a brief overview of two morphometric techniques, image analysis and stereology, and the use of artificial intelligence to classify cells and identify hidden patterns and relationships in digital images. In addition, we explore the importance of preanalytical factors in generating high-quality data. This review focuses on techniques we have used to measure proteoglycans, glycosaminoglycans, and immune cells in tissues using immunohistochemistry and in situ hybridization to demonstrate the various morphometric techniques. When performed correctly, quantitative digital pathology is a powerful tool that provides unbiased quantitative data that are difficult to obtain with other methods.

Download Full-text

IMI—Bigpicture: A Central Repository for Digital Pathology

Toxicologic Pathology ◽

10.1177/0192623321989644 ◽

2021 ◽

Vol 49 (4) ◽

pp. 711-713 ◽

Cited By ~ 1

Author(s):

Pierre Moulin ◽

Katrien Grünberg ◽

Erio Barale-Thomas ◽

Jeroen van der Laak

Keyword(s):

Large Scale ◽

Digital Pathology ◽

Digital Transformation ◽

Pharmaceutical Companies ◽

Small Enterprises ◽

Whole Slide Imaging ◽

Large Scale Data ◽

Community Model ◽

Central Repository ◽

Scale Data

To address the challenges posed by large-scale development, validation, and adoption of artificial intelligence (AI) in pathology, we have constituted a consortium of academics, small enterprises, and pharmaceutical companies and proposed the BIGPICTURE project to the Innovative Medicines Initiative. Our vision is to become the catalyst in the digital transformation of pathology by creating the first European, ethically compliant, and quality-controlled whole slide imaging platform, in which both large-scale data and AI algorithms will exist. Our mission is to develop this platform in a sustainable and inclusive way, by connecting the community of pathologists, researchers, AI developers, patients, and industry parties based on creating value and reciprocity in use based on a community model as the mechanism for ensuring sustainability of the platform.

Download Full-text

The Archives of Pathology & Laboratory Medicine: The Most Widely Read Pathology Journal Today

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2016-0090-sa ◽

2016 ◽

Vol 140 (9) ◽

pp. 953-955

Author(s):

Timothy Craig Allen

Keyword(s):

Digital Pathology ◽

Medical Knowledge ◽

Laboratory Medicine ◽

Official Journal ◽

Pathology Laboratory ◽

Dynamic Leadership ◽

General Pathology ◽

90Th Anniversary ◽

Whole Slide Images

The Archives of Pathology & Laboratory Medicine was first published in 1926 as a subspecialty journal of the American Medical Association. It became the official journal of the College of American Pathologists in 1995. Under the dynamic leadership of its most recent editor-in-chief, Philip T. Cagle, MD, and his vibrant editorial board, the Archives has nearly doubled its impact factor and become the most widely read general pathology journal today. Dr Cagle has consistently added leading pathologists to the editorial board, and the collective expertise of these individuals is clearly evident in new, cutting-edge journal masthead sections. The Archives has featured innovative content in the field of digital pathology, including articles on the utilization of smart phones in pathology and incorporation of whole-slide images and videos into the content of articles. Special sections have characterized the Archives during the current editorial board's tenure and have proven immensely popular with the journal's readership. As the Archives celebrates its 90th anniversary, its editorial board remains committed to providing insightful and relevant medical knowledge. The journal's open access Web site (www.archivesofpathology.org) allows the dissemination of this knowledge to every corner of the globe at no expense to those who wish to be educated or improve their medical practice.

Download Full-text