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108: DigiPath Digest #14 (AI in Pathology: Case Prioritization, Kidney Biopsy Analysis and the Need for Consistent TIL Quantification).
In this 14th episode of DigiPath Digest, I introduce a new course on AI in pathology, designed to help pathologists understand and confidently navigate AI technologies.
The episode focuses on various research studies that highlight the integration and effectiveness of AI in pathology, particularly in colorectal biopsies and kidney transplant biopsies, emphasizing the importance of seamless workflow integration.
You will also learn about challenges in manual assessment of tumor-infiltrating lymphocytes and HER2 expression in breast cancer. I advocate for more consistent and precise AI-driven approaches.
And there an opportunity for a discounted beta test of the new AI course.
00:00 Welcome to DigiPath Digest #14
00:24 New AI Course Announcement
01:51 Deep Learning in Colorectal Biopsies
09:17 AI in Kidney Biopsy Evaluation
16:12 Automated Scoring of Tumor Infiltrating Lymphocytes
24:22 AI for HER2 Expression in Breast Cancer
31:13 Conclusion and Course Details
THIS EPISODE'S RESOURCES
📰 A deep learning approach to case prioritisation of colorectal biopsies 🔗 https://pubmed.ncbi.nlm.nih.gov/39360579/
📰 Automated scoring methods for quantitative interpretation of Tumour infiltrating lymphocytes (TILs) in breast cancer: a systematic review 🔗 https://pubmed.ncbi.nlm.nih.gov/39350098/
📰 Precision HER2: a comprehensive AI system for accurate and consistent evaluation of HER2 expression in invasive breast Cancer 🔗 https://pubmed.ncbi.nlm.nih.gov/39350085/
▶️ YouTube Version of this Episode: 🔗 https://www.youtube.com/live/jkT8dTxelt4?si=xT6MNH7O4HuUnAN6
📕 Digital Pathology 101 E-book 🔗https://digitalpathology.club/digital-pathology-beginners-guide-notification
Good morning, digital pathology trailblazers! Welcome to another exciting exploration of digital pathology and AI. I’m thrilled to have our global community here with us today from so many different time zones. Before we dive into today's content, a quick note: my equipment is being a bit finicky, but that’s life in the digital world!
Integrating Image Analysis with AI
Let's kick off with a recap of some recent updates. Yesterday, I had the privilege of presenting to a mixed group at Cincinnati Children’s Hospital. We discussed AI in image analysis, an essential tool bridging radiology and pathology as these fields rapidly evolve with new technologies like foundation models and large language models. A diverse audience—ranging from radiologists to pathologists—prompted me to adapt my presentation style on the spot. It was a dynamic discussion about the advancements in healthcare that shared perspectives from both sides.
Lymphovascular Invasion: A Case Study
Our first paper today focuses on a deep learning model for identifying lymphovascular invasion (LVI) in lung adenocarcinoma. This significant prognostic factor is crucial for advancing diagnostic consistency and reliability. Unlike broad foundation models, this work engages with dedicated image analysis applications targeting specific diagnostic challenges. The study demonstrated reduced pathologist evaluation time by nearly 17% and even more in complex cases, aligning with previous findings that AI enhances efficiency by around 21%.
AI Collaborations: Human and Veterinary Pathology
Next, we delve into a collaborative effort between human and veterinary pathologists, emphasizing the promise of AI integration in telepathology and digital pathology. These fields are converging to enhance information exchange, teaching, and research. I’m particularly excited about this paper due to my own veterinary pathology background and the potential it offers for both educational and clinical practices.
Spatial Profiling and Immuno-Oncology
We then journey into the intricate landscape of immuno-oncology with a study on PD-1 and PD-L1 in osteosarcoma microenvironments. Utilizing deep learning and multiplex fluorescence immunohistochemistry, researchers highlighted the spatial orchestration of these markers, providing insights into potential immunotherapeutic strategies. This work is an exemplar of how AI can illuminate complex biological landscapes, offering a path for future therapies.
Conclusion
Thank you all for joining this vibrant discussion. Whether you’re tuning in from early morning in Atlanta or late at night in Algeria, your engagement enriches our learning experience. Keep an eye out for more content and upcoming courses designed to unpack these groundbreaking developments in AI and digital pathology.
Until next time, keep blazing trails in digital pathology!
Exploring Foundation Models in Digital Pathology: Insights and Tools
In today's DigiPath Digest we talk about the foundation models in pathology. reviewing abstracts from two notable papers in Nature.
We discuss the high-level overview of these models, including Hamid Tizhoosh's insights on the vast data requirements for developing effective foundational models.
We also explore tools for literature research, comparing PubMed and Undermind.ai, and examine a useful children's book on artificial intelligence :)
The episode features audience interaction and offers updates on digital pathology trends, along with a personal anecdote on the nature of comparison based on a yoga class experience.
00:00 Introduction and Overview 00:16 Foundation Models in Pathology 00:33 Comparing Research Tools 01:03 Live Stream Interaction 01:12 Starting the Podcast 04:51 Foundation Models Explained 05:11 Research and Findings 06:34 Children's Book on AI 08:00 Deep Dive into Foundation Models 14:28 Case Studies and Examples 18:18 Discussion on Data and Models 21:00 Final Thoughts and Questions 26:24 Exploring ToxPath and Foundation Models 27:05 Introduction to Image Repositories 28:36 Using PubMed for Research 30:35 Exploring Undermined Tool 35:42 Comparing PubMed and Undermined 41:00 Final Thoughts and Recommendations
The tools to develop AI models for biomedical image analysis have recently become accessible also for non-computer scientists. With the accessibility to AI tools, the question arises whether the things we build are good enough?
How do we check the model?
How do we validate it and be sure that when deployed according to the intended use it will perform adequately and help us make the right decisions based on the correct premises?
In this episode, Thomas Westerling-Bui from Aiforia explains the validation principles that should be applied to AI image analysis solutions.
The AI image analysis model validation is like any other assay validation. It starts with finding out the boundaries of the assay's usability. As for any assay, also in the case of an AI model its precision and recall are the most important parameters we want to check. We need to perform a conceptual validation and find out if the platform used does what we want it to do and an analytical validation to precisely quantify the accuracy of the method.
Validation is different from improving the AI model on a given data set and always needs to be performed on an independent data set. Unfortunately, there seems to be confusion about that in the scientific community which weakens many of the biomedical publications describing the development and use of AI models.
Another important concept - the intended use, is crucial not only for the use of the assay but also for its validation. The validation of a screening tool will be performed differently than the validation of a diagnostic tool.
As powerful as they are, the AI-based tools are just tools and will not do the things they are not designed (trained) to do so the validation should be tailored to the things they ARE trained to do.
As supervised AI methods rely on human-generated ground truth both for training and for validation the decision of how many validation regions to include depends heavily on the human capacity to provide adequate ground truth - in the case of image analysis it often includes annotations. If the users are pressed to generate a large number of annotations, precision may suffer so a middle ground needs to be found to provide an adequate number and maintain precision.
Another important aspect of generating ground truth is interobserver variability. It needs to be quantified and accounted for during the validation, which is why comparing model outputs against ground truth generated by just one individual is of limited value.
In a nutshell, the subject is complex, and to understand these and other nuances of AI model validation the following resources may be of use:
Jared organized a fundraiser and Gabe donated to the fundraiser, but he didn't donate money, he donated an augmented reality system - basically, the most expensive piece of equipment Jared was raising money for.
This collaboration was born on-line when Jared Block from Carolinas Pathology Group in Charlotte, NC published a post about his fundraiser and Gabe Siegel from Augmentiqs read it and realized it was a match - a great contribution could be made to a place in need where solid collaboration has already been established.
The collaboration was established by Jared with the Muhimbili National Hospital in Dar es Salaam, Tanzania. Since Jared's visit in June 2019 as part of a program supported by the American Society of Hematology and Health Volunteers Overseas, the doctors in Dar es Salaam were supported not only with equipment bought with the fundraiser money but also with lectures, videos and case consultations (often over Whatsapp) provided by Jared.
The plan was to visit the Muhimnbili National Hospital again this July...Obviously, due to COVID-19, all our travel plans have changed drastically, but we are keeping our fingers crossed for the next visit whenever it will take place.
Due to the coronavirus pandemic, so many pathologists need to work from home today. The microscopes and the slides were packed and brought home. Everyone is now on their own. No more knocking at a colleague's door to consult a diagnosis...
But what if pathologists could still collaborate with ease, and consult colleagues from their home offices while reading the slides under the microscope? In real-time. What if at the same time they could also have access to image analysis tools while reading the slides under the microscope? In real-time.
In this episode, my guest is Gabe Siegel, the founder and CEO of Augmentiqs, a company offering digital pathology inside the microscope. Listen to how Augmentiqs approaches digital pathology by respecting and improving the normal pathologists' workflow, how they enable real-time telepathology and image analysis with their electro-optical module which can be incorporated into any microscope.
To learn more about Augmentiqs visit their website: https://www.augmentiqs.com/ Read the peer-reviewed articles describing their projects:
She is a researcher herself and during her research, she experienced the great histopathology pain point first hand: it was too slow! So to help researchers solve this problem she created a company - Histowiz, which not only provides fast histology services but also provides her customers access to a centralized pathology image database that can be used for data mining and to a large network of pathologists providing telepathology services.
In this interview Ke Cheng, the CEO of Histowiz tells the story of her company, explains how Histowiz is different than other digital pathology companies and tells us what the Histowiz team harnesses AI to do for them.
Do you remember a presentation where the presenter had to switch between their powerpoint and a whole slide viewer to show a case and do you remember how annoying that was? Or a presentation where the presenter tried to show the highlights of a case with screenshots embedded in their presentation, but they were not representative at all and you wished you could see the whole slide?
Now you don't need to repeat these suboptimal experiences. There is a tool that can do it all - create presentations with whole slides embedded in it with full viewing capacities seamlessly integrated into the presentation - it's the PathParesenter platform. In addition to killer presentations, users can create a virtual slide box, get access to a slide library, use high yield fully described cases for reference or education, create quizzes and chat in groups.
Today I am joined by Rajendra Singh, MD, the creator of the PathPresenter platform. He tells us the story behind the platform and how we can start using PathPresenter for free now!
Do you think your pathology laboratory is modern? If so, you have most probably gone digital. Nowadays modern pathology means digital pathology. However, to fully embrace digital pathology a scanner is not enough. You need the correct tools. Tools to manage your whole slide images in a systematic way and artificial intelligence-based tools enhancing your performance. Proscia is offering both.
Today my guest is Nathan Buchbinder, one of the co-founders and Chief Product Officer of Proscia. Listen to Proscia's creation story, what tools they have to offer and how these tools can help your laboratory.
Disclaimer: Proscia's products are for research use only
For pathologists and scientists microscope does not seem like a luxury, it is an everyday tool necessary to do their jobs. It is not a cheap tool, but there is no option not to have one, especially if you work in a pathology or microbiology lab. Otherwise, you cannot do your job, you cannot help patients, and every day there are so many cases to diagnose.
But what to do, in places, where there are as many cases to diagnose, as many patients who need this diagnosis, but a lot fewer microscopes? This was the question Yuchun Ding asked himself. After quite some time as a computer scientist in the field of digital pathology, he decided to go beyond his science to help patients in the underserved areas directly. This is what his project (now an official trademark) X-wow is about.
Listen to his story and see how you can help as well.
In this very first episode, I want to welcome you to the Digital Pathology Podcast. If you are interested in Digital Pathology and medical and scientific advancements, this is a place for you. Every other week we will be publishing interviews, discussion and journal club-type updates on the newest advancements in the field of digital pathology described in the literature.
How can you work remotely as a doctor? Clearly some specialties, give more possibilities to do that than others and pathology is one of them.
In this episode, I talk to Dr. Todd Randolph, a pathologist living the remote pathologist lifestyle.
Dr. Randolph shares his journey into digital pathology, including his background, the evolution of his practice, and the transition to remote work.
We discuss the benefits and challenges of digital pathology, including the importance of pathology and business experience, as well as insights into AI in pathology.
Dr. Randolph also provides advice for those looking to pursue a career in digital pathology and emphasizes the importance of taking initiative and staying informed about the field.
TIMESTAMPS
00:00 Introduction to the Guest: Dr. Todd Randolph
01:05 Todd's Pathology Journey
02:04 Specialization in Pathology
03:55 Transition to Digital Pathology
05:01 Working with Lumea
11:44 Daily Life as a Remote Pathologist
13:36 Challenges and Benefits of Digital Pathology
20:37 Starting a Career in Digital Pathology
24:45 Early Days of Digital Pathology
26:17 Challenges in Digital Pathology Systems
27:46 Exploring Different Digital Pathology Systems
29:03 Impact of Digital Pathology on Work-Life Balance
The third episode of DigiPath Digest just took place live, but I have an audio version for the listeners.
DigiPath Digest is a review of digital pathology and IA publications abstract review that I host weekly as a live stream (on YouTube, LinkedIn, Facebook etc.)
This episode was originally recorded for "People of Pathology Podcast" and I had the pleasure of being interviewed by Dennis Strenk after I have published my book "Digital Pathology 101 - All you need to know to start and continue your digital pathology journey". This was my third appearance on his show, so I was really honored!
Our talk about digital pathology focused on the cultural shift and learning mentality essential for embracing rapid advancements in the field.
We highlighted the importance of open-mindedness, interdisciplinary collaboration, and the practical applications of AI to enhance diagnostic and workflow processes.
I also shared insights from my book, "Digital Pathology 101," which Dennis called "a comprehensive resource for beginners and experts". We covered key topics such as regulatory milestones, interoperability, and the role of toxicologic pathology.
CHAPTERS
earning Mentality (00:00): Exploring the mindset required for adapting to new technologies in digital pathology.
Welcome to the Digital Pathology Podcast (00:53)
The Journey of Writing Digital Pathology 101 (02:03): Sharing the process and inspiration behind writing the book.
Balancing Content for Different Readers (05:29): How to make the book accessible and valuable for newcomers and seasoned professionals.
Digital Pathology Milestones and Surprises (10:27): Highlighting significant achievements and unexpected developments in the field.
Interoperability in Digital Pathology (15:19): The importance of systems working together seamlessly.
Collaborating with Vendors (17:29): The benefits and challenges of working with technology providers.
The Cultural Shift in Digital Pathology (21:47): Emphasizing the need for a cultural change within the pathology community to embrace digital tools fully.
AI in Pathology: Narrow vs. General AI (27:17): Differentiating between specific AI applications and broader AI capabilities.
Companion Diagnostics and Personalized Medicine (35:34): The role of digital pathology in advancing personalized medicine.
The Role of Toxicologic Pathology (38:49): Discussing the role of toxicologic pathology in the digital age.
Conclusion and Final Thoughts (42:37): Wrapping up the discussion with reflections and future outlooks.
It was great to be Dennis' guest instead of the host this time, and be able to talk about digital pathology and the book to his audience. I liked this episode a lot and I hope you will to.
To learn digital pathology fast, be sure to check out my book "Digital Pathology 101." You can get your copy here: Digital Pathology 101 E-book.
Today I explain what happened with my "beginning of year initiative" to post an audio version of the Digital Pathology Newsletter sent out in an email form.
In a nutshell: I just stopped posting it, you will find out why in this episode.
TIMESTAMPS
00:00 Introduction to DigiPath Digest 00:13 Challenges in Digital Pathology 01:31 Consistency and Sustainability 02:51 Abstract Review Process 04:25 Engaging with the Community 08:31 First Abstract: Molecular Classification of Breast Cancer 14:21 Second Abstract: AI in Breast Cancer Detection 20:53 AI-Assisted Pathology: Time Reduction and Sensitivity Improvement 21:36 Environmental Impact of Digital Pathology 22:23 Technical Difficulties and Viewer Interaction 24:30 French Authorities on Digital Pathology's Environmental Cost 28:45 Cephalometric Analysis: Digital vs. Manual Tracing 31:46 Exploring Undermined.ai for Scientific Research 43:05 Concluding Remarks and Future Plans
Clinical implementation of artificial-intelligence-assisted detection of breast cancer metastases in sentinel lymph nodes: the CONFIDENT-B single-center, non-randomized clinical trial (https://pubmed.ncbi.nlm.nih.gov/38937624/)
In this episode, join me as I speak with Dr. Greg Rose, a retired radiologist who played a key role in the digital transformation of radiology. His journey offers valuable insights and lessons for the digital pathology community.
Key Points Discussed:
Initial Digital Adoption Challenges: Greg's experience with transitioning from analog to digital, focusing on the challenges related to change management and personality dynamics.
Digitization Process: How radiology moved from plain film to digital modalities like CT, MRI, and ultrasound, and the steps involved in digitizing these images
Technical and Political Hurdles: Navigating technical issues, workflow optimization, and dealing with political dynamics within medical institutions.
Managing Change: Effective strategies for involving senior staff and managing resistance to change.
AI in Radiology: Current applications of AI in radiology, its potential for pathology, and the legal implications of AI-assisted diagnostics.
Future Directions: Greg's vision for the future of digital health, including the development of tappable databases and the evolving roles of radiologists and pathologists.
Greg's insights into the digital transformation of radiology provide a valuable perspective for pathologists looking to embrace digital tools and techniques. His experience highlights the importance of managing change, leveraging AI, and improving diagnostic workflows.
In this episode Dr. Aleks Zuraw sits down with Mariano De Socarraz, President of CorePlus and member of the board of directors at the Digital Pathology Association.
CorePlus is an anatomic and clinical pathology lab in Puerto Rico that has fully embraced digital pathology and AI.
Key Takeaways
CorePlus converted to 100% whole slide imaging for primary diagnosis in January 2020, before the pandemic
They are pioneering the use of AI algorithms from companies like IBEX, AlpenGlow, Artera and TechCyte for cancer detection and precision pathology
Digital pathology increases efficiency by ~30% and enables benefits like remote reading, better ergonomics, and seamless sharing of cases
AI helps detect missed lesions, reduce interoperator variability, and eliminate false negatives in prostate biopsies
The future of pathology will involve predictive and prognostic information generated right from digital slides (histomics)
Making the Digital Transition
Mariano shares how CorePlus, as a technology-forward company, decided in 2018 to fully convert to digital pathology. They took 2019 to prepare, validate their processes following CAP guidelines, and get full buy-in from stakeholders. On January 1st, 2020 they were fully digital.
While acknowledging that glass slides have advantages in simplicity, Mariano believes the benefits of digital pathology for patients and pathologists are too great to ignore. His advice for other practices considering the digital transition:
Focus on re-engineering your workflows first before choosing scanners
Plan for IT redundancy to avoid any disruption
Get full buy-in from your team
Start focused and build successes in stages
Unlocking the Power of AI
After seeing a press release about UPMC and IBEX using AI to diagnose prostate cancer, CorePlus reached out to partner with them. They became the first site outside the UK to validate and implement IBEX's algorithm, running it on over 9500 cases as a QC tool.
The algorithm was able to alert pathologists to missed lesions in 73 patients that would have otherwise been false negatives. CorePlus has now moved the algorithm to the front-end to pre-screen and triage all prostate cases.
They are also partnering with other AI companies like AlpenGlow, Artera and TechCyte to bring these benefits to breast, GI, cytology and other subspecialties. Mariano sees AI generating predictive and prognostic insights right from slides.
The Future is Digital
Mariano believes medical education must quickly incorporate digital pathology and AI training to prepare the next generation of pathologists. The Digital Pathology Association is key in fostering collaboration to expand access, especially in underserved communities.
While going digital requires some reinvention, Mariano is excited to pioneer this space. He and CorePlus aim to be "missionaries" doing what's best for patients and the field of pathology.
Swarm Learning in Digital Pathology: Revolutionizing Cancer Histopathology
Today on the Digital Pathology Podcast my guest is Oliver Saldana, the first author of a significant Nature Medicine paper published in 2022 on 'Swarm Learning for Decentralized Artificial Intelligence in Cancer Histopathology'.
Oliver shares his journey from Mangalore, India, to Germany, where he pursued his master's and PhD, delving into histopathology and decentralized AI under the supervision of Professor Dr. Jakob Nicolas Kather.
The discussion explores the concept of swarm learning as a novel method for deep learning in histopathology, its advantages over centralized learning including compliance with data protection laws like GDPR, and its potential for global collaboration in medical research without sharing sensitive data.
Oliver emphasizes swarm learning’s ease of setup and its alignment with the FAIR principles for scientific data management. The podcast aims to shed light on the groundbreaking work being done in the convergence of pathology and computer science, urging researchers and pathology centers to digitize their slides and contribute to global swarm learning projects.
00:00 Introduction to Swarm Learning and Its Applications 00:50 Intro 01:17 Meet Oliver Saldana: A Trailblazer in Decentralized AI for Cancer Histopathology 03:57 Exploring the Concept of Decentralized AI and Its Importance 06:52 Understanding Centralized vs. Decentralized Learning 08:47 The Revolutionary Approach of Swarm Learning 10:38 Blockchain's Role in Enhancing Histopathology with Swarm Learning 14:50 Addressing Preprocessing and Generalizability in Swarm Learning 21:26 Swarm Learning's Compliance with GDPR and Data Protection 25:05 Exploring Swarm Learning in Medical Data Analysis 25:34 Prototype Study and Real Cohorts in Swarm Learning 27:01 Comparing Swarm Learning with Centralized Models 27:44 The Role of Bare Metal Servers in Swarm Learning 30:01 Centralized Slide Repositories vs. Swarm Learning 44:11 Commercializing Swarm Learning Models 47:07 FAIR Principles and Swarm Learning 51:11 Global Ambitions and the Future of Swarm Learning
THIS EPISODES RESOURCES
📝 Swarm Learning for decentralized and confidential clinical machine learning 🔗 https://www.nature.com/articles/s41586-021-03583-3
📝The FAIR Guiding Principles for scientific data management and stewardship 🔗https://www.nature.com/articles/sdata201618
🎧BIGPICTURE – THE LARGEST WHOLE SLIDE REPOSITORY FOR AI MODEL DEVELOPMENT IN PATHOLOGY. WHERE DO WE STAND AT MONTH 15/72? 🔗https://digitalpathologyplace.com/podcast/bigpicture-the-largest-whole-slide-repository-for-ai-model-development-in-pathology-where-do-we-stand-at-month-15-72/
Navigating Ethical Challenges in AI-Powered Pathology
This episode is a webinar recording. It delves into the complex ethical considerations of incorporating artificial intelligence (AI) in pathology.
Dr. Zuraw begins by exploring the fundamentals of ethics and moves on to discuss the impact of AI in pathology, focusing on:
ethical dilemmas,
data diversity issues,
biases, and
the importance of maintaining professional and societal ethical standards in the wake of AI integration.
The session touches upon the ethical guidelines and regulatory frameworks guiding ethical decision-making in healthcare, alongside the role of regulatory agencies like the FDA.
It also highlights the significance of data diversity and mitigation strategies to address potential ethical pitfalls in AI utilization.
The webinar emphasizes the constant balance between advancing technology and ethical responsibility, underlining the need for transparency, governance, and accountability in deploying AI tools in pathology.
00:00 Introduction to Ethics in AI-Powered Pathology 00:30 Exploring the Ethical Dilemmas in Healthcare 00:36 Webinar Overview and Digital Pathology Insights 01:05 Defining Ethics and Its Importance in AI Pathology 02:05 Interactive Webinar Engagement and Audience Participation 03:25 Deep Dive into Ethics: Definitions and Applications 09:31 Ethical Considerations in Biomedical Research 10:34 Navigating Ethical Dilemmas: A Practical Example 13:57 Understanding Ethical Principles in Decision Making 17:14 AI Bias and Representation in Pathology 20:52 Frameworks and Guidelines for Ethical Oversight 25:02 AI Applications in Pathology: Ethical Perspectives 27:21 Exploring AI in Research and Its Capabilities 29:22 AI's Role in Medical Imaging and Diagnostics 33:11 Ethical Considerations and AI in Pathology 34:04 Addressing AI Challenges: Bias, Interpretability, and Security 44:26 AI as a Medical Device: Regulatory Perspectives and Future Directions 49:16 Concluding Thoughts and Audience Engagement
The episode explores the concept of blind review, a process designed to eliminate hindsight bias by allowing medical experts to evaluate cases without knowing the outcome or the hiring party.
Stephanie Franckewitz, JD, MBA, founder of Blind Review, discusses its application in legal cases, particularly for digital pathology and radiology. By providing an unbiased expert opinion, blind review aids the defense and plaintiff parties in court, increasing the chances of a favorable verdict.
Stephanie outlines her journey from a medical malpractice defense lawyer to starting Blind Review and highlights the potential for digital pathology to revolutionize the legal process, reduce bias, and improve case outcomes.
Collaboration with platforms like PathPresenter enables pathology slides to be reviewed efficiently and effectively within a legal context. This approach benefits both defendants and plaintiffs by ensuring objective evaluations and enhancing the credibility of expert testimonies in trials.
00:00 Introduction to Blind Review 01:19 The Role of Digital Pathology in Legal Cases 02:16 Stephanie Franke Reid's Journey 07:19 Challenges in Traditional Expert Reviews 10:09 Implementing Blind Review in Pathology 18:16 Collaboration with PathPresenter 25:43 Streamlining the Legal Process with Digital Pathology 26:51 Collaborative Tools for Legal Experts 27:20 Path Presenter: A Game Changer for Attorneys 28:17 Understanding Pathology for Juries 29:20 Streamlining Case Preparation with Path Presenter 31:54 Setting Up a Blind Review Process 35:38 The Gold Standard of Blind Review 41:53 Impact of Blind Review on Legal Outcomes 49:49 Empowering Legal and Medical Professionals 54:50 Conclusion and Call to Action - contact Stephanie
➡️ You know AI and Machine Learning are already part of the pathology workflow, but maybe you are not exactly sure which part of the workflow?
➡️ “AI” is still a bit of overhyped, fuzzy buzzword for you?
➡️ You would like to learn about how it can help pathologist and labs work smarter and patients get better care.
Then this webinar is for you!
This is the second part of the “Digital Pathology 101” webinar series, based on the “Digital Pathology 101” book, where Dr. Aleks Zuraw explains digital pathology and AI concepts.
This journey through Chapter 3 illuminates how image analysis, AI, and machine learning not only complement traditional pathology but propel it into new realms of precision and insight.
As we delve into the essence of tissue image analysis and the transformative role of AI and machine learning in modern pathology, you'll discover how these technologies augment diagnostic methods, enhance research, and redefine what's possible in our field.
From the basics of tissue image analysis to the advanced realms of computer vision and the pivotal role of quality control, this webinar bridges the gap between high-level computational domains and daily pathology practice.
What You'll Explore:
The foundational principles of image analysis, AI, and machine learning in pathology. The crucial balance between classical and AI-based approaches to tissue image analysis and their applications in both regulated and non-regulated environments. The importance of quality control in ensuring accurate, reliable results from AI-assisted analyses. An introduction to the key terminology of pathology informatics, demystifying the language that underpins digital pathology and AI. Who Should Attend: This webinar is tailored for:
🔴 pathologists,
🔴 researchers, and
🔴 healthcare professionals
who are eager to learn about and/or integrate AI and machine learning into their work.
Whether you're just starting or looking to deepen your expertise in digital pathology, this series offers invaluable insights into leveraging technology for enhanced diagnostic precision and patient care.
Date and Time: April 11, 2024 at 9:00 - 10:30 a.m., EST
Location: Online
AI is here, so let’s learn what it means for pathology
how can you leverage it for your work?
and how to navigate this new technology responsibly.
What can digital pathology be used for? Is it just diagnostics or does it go beyond that?
In this webinar, based on chapter 4 of my “Digital Pathology 101” book
you will learn about:
The transformative impact of digital pathology on healthcare.
Strategies for integrating digital tools into clinical practice for improved outcomes.
The pivotal role of digital pathology in advancing drug development and personalized medicine.
Insights and reflections on the future directions of our profession.
Join me for a session filled with enthusiasm, knowledge, and a shared vision for the future of pathology. Together, we'll uncover digital pathology's possibilities for our field and the broader healthcare community.
Your engagement and curiosity drive this field forward, and I can't wait to share this time with you.
This week, the digital pathology community gathered at the United States and Canadian Academy of Pathology (USCAP) annual meeting in Baltimore. I had the incredible opportunity to attend, spurred by an invitation from Hamamatsu, known for their revolutionary digital pathology scanners like the FDA-cleared S360 and the new S20 model.
Key Takeaways from USCAP:
Innovative Partnerships and Technology: My agenda was filled with meetings that explored the latest in digital pathology. Key highlights include the launch of Hamamatsu's S20 scanner, Techcyte's technological advancements, and Proscia's FDA-approved AP Dx software. The collaboration between Hamamatsu and Agilent, utilizing Proscia's platform, underscored the collaborative spirit driving the field forward.
Community Engagement and Recognition: The warmth and recognition from the community were overwhelming. It reinforced the value of our work and the podcast, blending technical insights with personal stories that underline the human aspect of pathology.
Advancing Research and Education: A standout moment was learning about the World Tumor Registry initiative from Andrey Bychkov and Alyaksandr Nikitski. This initiative marks a significant step in making valuable pathological data more accessible for research and education, starting with a comprehensive collection of thyroid case slides.
Looking Forward: The USCAP meeting was a testament to the enthusiasm and innovation within digital pathology. Stay tuned for a detailed video blog covering the conference, highlighting the S20 and more, coming soon on YouTube!
USCAP BULLET UPDATES
Hamamatsu: Known for their FDA-cleared scanner, S360, and the newly launched S20 model.
Techcyte: Discussed their dynamic evolution and upcoming projects and their partnership with BD for cervical cytology AI based evaluation.
Corista: Learned about their software advancements, including voice recognition for improving pathologist workflows.
Smart In Media: Discussed their new camera for microscopes and grossing rooms.
Proscia: Celebrated their FDA clearance for the AP Dx software.
Epredia: Showcased their pathology equipment, including scanners like the P1000 with water immersion.
Aiforia: Highlighted their AI for image analysis, especially the GLP-compliant module for toxicologic pathology.
Indica Labs: Featured their pathologist cockpit setup and discussed their comprehensive software solutions.
PathPresenter: Met with the CEO, Patrick Myles, and discussed the company's rapid growth and services.
Pramana: Discussed their archival scanning services and their new benchtop scanner that runs algorithms during scanning.
Grundium: Showed off their new four-slide scanning Ocus and the cute one-slide Ocus scanner.
Andrej Bychkov to discuss his poster on the use of ChatGPT by pathologists and told me about the
She did it all on her own, to keep serving her patients.
In this episode of Digital Pathology Podcast, host Dr. Aleksandra Zuraw is joined by Dr. Elizabeth Plocharczyk, a pathologist based in Ithaca, New York.
Beth shares her experience integrating digital pathology into her practice at Guthrie Cortland Medical Center and Cayuga Medical Center at Ithaca, NY. Her journey offers insights into the practicalities of adopting digital tools in a community hospital setting.
🔥 The discussion highlights:
The factors that influenced Beth to start using digital pathology.
How digital tools have addressed challenges related to being a solo practitioner in a rural area.
The significance of compliance, internal validation, and administrative support in transitioning to digital pathology.
Suggestions for pathologists considering digital pathology, emphasizing iterative implementation and the importance of validation regardless of FDA approval status.
Dr. Plocharczyk's account underscores the role of digital pathology in enhancing the efficiency and flexibility of pathology practice, especially in geographically constrained settings.
The episode provides a REALISTIC OVERVIEW OF TRANSITIONING TO DIGITAL PATHOLOGY, including overcoming potential hurdles and leveraging technology for more effective pathology services.
Be sure to watch or listen to the full episode, as Dr. Plocharchyk reveals all the details about the equipment she used, the way she validated the system as well as her budget.
This episode is particularly relevant for pathologists and healthcare professionals exploring digital pathology's potential to improve practice management and patient care.
Questions that will be answered:
Who is Dr. Beth? What did her pathology practice look like before digital pathology?
When did Dr. Beth start using digital pathology?
What was impossible before going digital?
How did you determine which tools to use?
Why did you opt for Whole Slide Imaging, for frozen sections?
What was the budget and how did you know this is a reasonable budget?
How long have you had the equipment?
If budget was not a constraint, what would you add to your digital pathology arsenal?
Are you building your tools or seeking the help of a third-party provider?
What does the day-to-day practice with your digital pathology tools look like?
How have the community hospitals responded to the new cutting-edge technology?
What advice would you give to those starting with digital pathology?
Would digital pathology help you grow your practice?
THIS EPISODE RESOURCES:
Smart in Media PathoZoom Live View and Scan: 🔗 https://www.youtube.com/watch?v=PZA9HX3qSfk&list=UULF-bagVf7bqp3L0bAdNYaaQg
Remote Digital Second Opinions: Pioneering Global Patient Care
Imagine a future where accessing world-class diagnostic expertise is just a click away for any patient, anywhere. In this episode you will learn how remote digital second opinions, a specialized application of digital pathology, can drive global adoption of digital pathology and significantly expand access to patient care.
Together with Dr. Raj Singh, founder of PathPresenter, we explore this cutting-edge approach that promises to transcend current digital pathology uses, making specialized medical consultations more accessible and efficient than ever before.
The Evolution of Digital Pathology
Digital pathology is rapidly becoming indispensable in modern healthcare. It equips pathologists with advanced digital tools and platforms, significantly boosting the speed and scope of diagnoses. Remote second opinion has a transformative role here. By leveraging digital slides and cloud-based infrastructure, pathologists can collaborate seamlessly across distances, breaking down geographical barriers like never before.
PathPresenter: Filling the Gaps in Pathology Workflow
Dr. Singh unfolds the story behind PathPresenter, highlighting its inception, mission, and the significant void it fills within the pathology field. PathPresenter is more than a platform; it's a catalyst for bridging educational and clinical gaps in pathology. It enables effortless sharing and collaborative analysis of cases among pathologists globally, fostering a vast network of professional expertise.
Embracing the Digital Shift: A Call to Action
The shift towards digital workflows is not merely a technological leap but a comprehensive strategy to enhance patient care, ensuring diagnoses are faster, more accurate, and widely accessible.
The transition to digital pathology is inevitable and it is happening quickly. Dr. Singh emphasizes the urgency for pathologists and healthcare institutions to adapt to these technological advances proactively. Proactive adoption will give us the power to decide how we want to implement digital pathology and what tools we want to use. If the pathology community does not take charge of this process it will be imposed on us by others. We don't want to figure out how to digitize slides in a panic mode when other specialties require it for patient care. We want to be in the drivers seat and guide the patient care according to the most up-to-date pathology expertise.
Why This Matters More Than Ever
In an era where healthcare demands are ever-increasing, and the need for specialized knowledge is paramount, digital pathology and remote second opinions present an unprecedented opportunity. This application democratizes access to expert diagnostics, ensuring patients, regardless of location, receive the best care possible.
It's more than an advancement; it's a new way of thinking about and delivering pathology services. Explore the vast possibilities remote second opinions offer and how they serve as a bridge to a more connected, efficient, and patient-centric healthcare system.
Today our special guest is Dr. Keith Kaplan, the creator of TissuePathology.com himself! The publisher of a platform that inspired the creation of Digital Pathology Place.
The Digital Pathology Trailblazer on the Web
Dr. Keith Kaplan, a surgical pathologist and a pivotal figure in the digital pathology community, has significantly contributed to the field with his groundbreaking website, tissuepathology.com. His passion and dedication have made his platform the first resource many turn to when searching for anything related to digital pathology.
From Traditional to Digital
Dr. Kaplan's unique journey in pathology began in Chicago, shaped by his military service and academic path at Northwestern University. His early exposure to telepathology and digital imaging during his military tenure set the stage for his impactful venture into digital pathology, initiating a transformative career trajectory.
TissuePathology.com: A Pioneering Platform
Dr. Kaplan launched tissuepathology.com, driven by his enthusiasm for utilizing the internet to disseminate knowledge. This platform quickly became a leading blog in the digital pathology realm, motivating others to establish their blogs and engage in the dynamic digital pathology conversation.
The Evolution of Digital Pathology
Keith's work with robotic telepathology and his involvement in deploying digital pathology solutions across various settings highlight the significant advancements in the field. His stories of early digital pathology efforts, including the deployment of systems for military applications and the subsequent adoption in civilian medical practice, showcase the progressive integration of technology in pathology.
Embracing Change: The Digital Shift
Recently Dr. Kaplan's practice transitioned to digital pathology for primary diagnosis. The integration of digital pathology has streamlined diagnostic processes, enabling faster and more efficient patient care despite initial reservations about moving away from traditional microscopy.
Future Directions and Ongoing Challenges
Looking ahead, the future of digital pathology will be impacted by AI and the ongoing pathology workforce shortage. Keith emphasizes the need for the pathology community to adapt and embrace new technologies while also addressing regulatory, ethical, and practical challenges.
This is the audio version of the second episode of the DIGITAL PATHOLOGY NEWSLETTER. that should have already landed in your inbox if you are on my digital pathology trailblazer list.
Can pathology be truly digital without getting rid of glass?
In this episode with Dr. Richard Levenson, Professor and Vice Chair for Strategic Technologies at the Pathology Department of UC Davis, you’ll learn how close we are to “glassless pathology” and other digital innovations that could transform the field.
In this episode we cover:
Richard's Background
With an eclectic background spanning English literature, medical school, research, and even a tech startup, Richard brings unique expertise in digital pathology. At UC Davis, he's pioneering new microscopy methods like MUSE and FIBI that enable imaging thick tissue sections without slides or stains.
Pigeon Research
You may also know Richard for his famously viral research training pigeons to detect cancer in pathology slides. As he explains, “Pigeons have the skills to tell...tiny, tiny pattern differences” critical for pathological diagnosis. This project brought fun and creativity to his lab, even as they push new frontiers in glassless pathology.
Histolix and Glassless Pathology
His company Histolix is commercializing the glassless pathology approach, which Richard envisions bringing pathology on par with radiology’s direct-to-digital workflow. Their validation study already achieved 97% concordance between glassless and standard H&E reads. As Richard explains, these techniques “open up the possibility for rapid intraoperative diagnosis without freezing or sectioning.”
Digital Pathology Innovation
Combined with AI, innovations like these could automate workflow steps like staining, analysis, and prioritization. However, as their recent paper explores, AI does pose risks. Richard believes we must tread carefully, using human oversight and judgment to guide implementation. Still, he sees great potential to augment diagnostics with computational tools.
Conclusion
There’s no better guide to exploring these frontiers than Richard. Tune into the full conversation using the link above for an insightful tour of digital pathology’s cutting edge. Check Histolix for the latest on their research, and access key publications from Richard’s lab through the links below. Where will you help take pathology next?
This is the audio version of the first brand new DIGITAL PATHOLOGY NEWSLETTER. that should have already landed in your inbox if you are subscribed to my list.
What is the status of digital pathology in under-researched areas?
Is it even a thing? Can it be used? And in what capacity?
In this exciting episode with Dr. Talat Zehra, a trailblazing pathologist from Karachi, Pakistan, and a finalist on the Pathologist Power List we are answering all the above questions.
Dr. Zehra is a beacon of innovation and determination, reshaping the landscape of healthcare in her region.
🔍 Don’t Miss:
The Trailblazing Journey in Digital Pathology: Learn about Dr. Zehra's path to becoming a leader in digital pathology.
Addressing Challenges in Low-Resource Settings: Discover how digital pathology can overcome healthcare barriers.
Impact of Digital Tools in Developing Nations: Explore the transformative effect of technology in pathology.
The Future of Pathology: Insights into embracing AI and upcoming trends in the field.
Dr. Zehra takes us through her groundbreaking journey in digital pathology. She shares her evolution from using basic static imaging techniques to embracing AI-enhanced pathology, overcoming numerous challenges to pioneer advanced pathology technologies in Pakistan.
Listen as Dr. Zehra recounts her mission to elevate pathology education and technology. Her story is a powerful testament to how dedication and innovative thinking can break down global healthcare barriers, transforming the field of pathology with a blend of cutting-edge technology and unwavering perseverance.
In this episode, I celebrate another milestone of the Digital Pathology Place YouTube channel that was achieved thanks to you, my digital pathology trailblazer, reflecting on its journey since its inception in 2019.
I delve into the developments in digital pathology, focusing on the first video I ever published on YouTube about AI in pathology, highlighting trends, tools, and challenges in the field.
The video was based on a presentation I gave on the day I got engaged, so if you want to know the whole story listen in.
I explain key concepts like - artificial intelligence, - machine learning, and - deep learning, and discuss - How could AI eventually support pathology practice despite current challenges?
00:00 Welcome and AI Co-Host Feedback 00:19 YouTube Monetization Milestone 01:18 Reflecting on the First Video 02:47 Special Day and Personal Story 05:06 Introduction to AI in Pathology 07:26 AI Terminology and Concepts 13:17 Current Status of AI in Pathology 17:33 Challenges and Future of AI in Pathology 22:42 Conclusion and Call to Action 23:30 Updates and Future Plans
Exploring Image Analysis Innovation with Trevor McKee of Pathomics.io
If you work in digital pathology, you likely rely on image analysis tools to gain insights from complex visual data. But how do you stay on top of the latest innovations in this fast-evolving field?
In this podcast episode together with Trevor McKee, CEO of Pathomics.io, we discuss innovation in image analysis using open source tools.
Pathomics takes an innovative approach by building image analysis solutions on open source platforms like QuPath. As Trevor explained, open source fosters collaboration, democratizes access, and drives rapid advances - key in a fast-moving field like digital pathology. This enables rapid progress that proprietary systems can't match.
Trevor's Career Journey
Trevor’s journey lead him from chemical engineering into pioneering image analysis, inspired by solving complex biological problems. His diverse experiences, from photon imaging at MIT to leading a core lab facility, fueled a passion for leveraging image analysis to extract insights. Today, in addition to leading Pathomics.io he is an Adjunct Lecturer at the University of Toronto, and the Chief Scientific Officer at BioCache™ Lab Solutions.
Transparent and Reproducible Image Analysis & Explainable AI
A core ethos at Pathomics is making image analysis transparent and reproducible. through explainable AI techniques. Tools like XGBoost create models that are easier to interpret than "black-box" end-to-end neural networks. This builds trust and acceptance among the scientific community.
Streamlining Workflows
In addition, Pathomics develops solutions to streamline clients' image analysis workflows. For example, their Universal StarDist plugin makes it easy to run advanced models like StarDist in QuPath. Overall, the goal is to automate tedious tasks so you can concentrate on high-value decision making.
The Future of Image Analysis
Looking ahead, Trevor shared his vision for an AI-powered online platform enabling users to go seamlessly from images to insights. He also discussed open wikis to prevent redundant work and encourage knowledge sharing as the field rapidly evolves.
Trevor plans to launch it to catalogue digital pathology resources such as image analysis focused machine learning papers to prevent redundant research work and encourage knowledge sharing as the field rapidly evolves.. It aligns with his commitment to open science and community knowledge sharing.
Key Takeaways
I came away from our wide-ranging discussion with an insider’s view of the huge potential of image analysis to transform digital pathology. By leveraging open source tools and staying atop the latest advances, you can work smarter and unlock new capabilities.
So tune in to explore these innovations and more from a leader in the field! The episode provides practical insights you can apply to make the most of the newest techniques
In this episode, based on a webinar I recently gave, I delve deep into the captivating world of Natural Language Processing (NLP) and its role in pathology.
Have you ever pondered how language models like ChatGPT are shaping our scientific understanding?
Or how they might redefine the way we process and interpret vast amounts of data?
Let's embark on this journey together as I share my insights and findings.
Key Points:
The ChatGPT Debate: Is ChatGPT a revolutionary tool or a looming data concern? I've heard the buzz in the digital pathology community, and I'm here to shed light on this debate.
Natural Language Processing (NLP): As a branch of AI, NLP is transforming industries. From tools like Google Translate to Siri, it's evident NLP's influence is vast. But how does it intertwine with pathology?
The Might of Large Language Models: Imagine models trained on data equivalent to streaming 4K movies non-stop for years! Their ability to predict and generate text opens up a world of possibilities.
The Transformer Architecture: It's the game-changer in NLP. It's not just about words; it's about discerning patterns and extracting logic from data.
Ethical Considerations: With the power of these models comes immense responsibility. I'll discuss the ethical dilemmas we face, especially in medicine and pathology.
The horizon of pathology is expanding with the advancements in AI and NLP. As I delve deeper into tools like ChatGPT, I believe it's imperative to stay updated and make informed decisions.
I prepared a book for you that is a great starting point: "Digital Pathology 101". You can grab the FREE PDF here.
The Future Landscape of Digital Pathology: Insights from Kate Lillard Tunstall, Indica Labs
What insights can be gained from a 12-year-long digital pathology journey as part of one of the leading tissue image analysis solution providers? A lot has happened in that time and Kate Lillard Tunstall, the Chief Scientific Officer at Indica Labs, shares her vast knowledge and experiences in this podcast episode. With a career spanning over a decade, Kate has witnessed firsthand the transformative shifts in the industry.
The Genesis of Halo:
Kate reminisced about the early days of Indica Labs and the birth of their core product, the Halo platform. Designed with precision and adaptability in mind, Halo has become a beacon in the digital pathology and tissue image analysis landscape. The platform's name, inspired by the unique halo-like appearance around cells visible during image analysis, showcases Indica Labs' attention to detail and their connection to the core of pathology.
Services Beyond Software:
Indica Labs isn't just about software; they offer a plethora of services tailored to the needs of the pharma sector and beyond. Their pharma services team, which has been around the longest, acts as a bridge between product development and real-world application. By serving as an internal customer, this team ensures that Indica Labs' offerings are not only cutting-edge but also practical and user-friendly.
Embracing the AI Revolution:
The integration of AI into digital pathology was a significant pivot point for Indica Labs. Kate candidly shared her initial skepticism towards AI's role in pathology. However, witnessing the profound impact of deep learning, especially in tissue classification, turned her into a believer. By 2017, Indica Labs had fully embraced AI, setting itself apart in the industry.
Looking Ahead:
Kate's vision for the future is a world where digital pathology isn't the exception but the norm. As more hospitals and health systems go digital, the volume of data will skyrocket. This data surge, combined with the power of AI, promises unprecedented advancements in pathology. Kate also shared lessons from Strata, a project aimed at merging image analysis data with patient data. Spoiler alert - the project was not pursued, but the challenges it faced underscored the importance of innovation adaptability and a deep understanding of customer needs in the world of digital pathology.
Toxicologic pathology plays a critical role in drug development, yet its intersection with digital pathology is often overlooked. As a veterinary pathologist, I want to shed light on this important application.
This is Chapter 5 of the "Digital Pathology 101" book and in this chapter, you will learn how whole slide imaging is transforming preclinical trials. I'll explain key concepts like creating faithful digital replicas of glass slides. We'll also dive into validations needs for digital systems in regulated GLP studies.
Whole Slide Imaging Overview
I'll start by explaining whole slide imaging. This technology creates 2D digital copies of glass slides. The focus is not 3D images, but flat digital images containing the visual information pathologists need for analysis and reporting.
The FDA states these digital images can substitute for glass slides in preclinical toxicity studies, provided they meet requirements as "faithful digital replicas." With proper validations, digital slides enable remote assessments for multisite trials.
Validation and Documentation
For regulated GLP studies, replacing glass slides necessitates validating the whole digital pathology system. This includes IT infrastructure, scanners, software and more based on intended use.
Documentation is also key. Peer review statements should note the use of digital slides. Images must be securely stored and transmitted to maintain raw data integrity.
Conclusion
In closing, the FDA's guidance on digital pathology in preclinical trials signals an important step towards regulatory acceptance. Digital tools promise more controlled, efficient toxicity assessments, ultimately advancing drug development.
This chapter provides a compass for teams navigating digital pathology in regulated environments. Understanding principles of validation, security, and transparency allows us to realize the benefits while ensuring high standards.
You can find the original FDA guidance document this chapter is based on here:
Have you started your digital pathology journey already?
Chances are that if you are reading this, you have. You have started it in a particular point of "digital pathology entry". Maybe it was tissue image analysis, virtual rounds on whole slide images or validation of a scanner.
My "digital pathology entry point" was tissue image analysis and only through the lens of this application have I learned what are the other digital pathology applications.
In this chapter you will learn about all the current applications of digital pathology.
Because of where I started my journey I will always be biased towards tissue image analysis and AI, but revisiting the overview provided in this chapter will help me have all the other applications in mind, when I continue my journey of promoting digital pathology in the scientific and medical community.
I hope it will be a good basis for you as well. So let's dive into the contents.
Here is what you will learn in Chapter 4 of the "Digital Pathology 101" book:
We'll start by looking at the clinical applications. This includes
the use of digital pathology for primary diagnosis in surgical pathology and cytopathology.
It facilitates more detailed examination and collaboration between pathologists. We'll also discuss
how telepathology enables remote intraoperative consultations and second opinion consults.
And we'll touch on the
education and training benefits, from resident teaching to continuing medical education.
Moving to research, we outline key applications like
quantitative image analysis,
AI and machine learning for predictive modeling, and
high throughput analysis.
collaboration, allowing researchers to simultaneously access images
large scale studies and validation across institutions.
In drug development, digital pathology enhances
preclinical histopathology and
biomarker evaluation
clinical trials by eliminating slide shipment and enabling centralized review.
Digital tools can also assist in developing companion diagnostics, although regulatory requirements here are still evolving.
While each application has its challenges, the overarching benefit of digital pathology is its
capacity to connect workflows,
enhance efficiency, and
open new possibilities across clinical, research, and drug development spheres.
Understanding the breadth of these applications provides a compass for navigating our own digital pathology journeys.
Enjoy this chapter and I'll talk to you in chapter 5.
Image analysis has supported pathology since the introduction of whole slide scanners to the market, and when deep learning entered the scene of computer vision tissue image analysis gained superpowers.
There are regulatory compliant AI-based image analysis tools available for practicing pathology around the globe.
So what shall you do, just embrace them and start using?
I would learn a bit about image analysis and AI first, to be able to make an informed decision.
Good news, you can get all the information needed for this informed decision from this very chapter of the "Digital Pathology 101" book that I have published for you.
From Chapter 3 you will learn the fundamentals of tissue image analysis and how it helps extract meaningful data from digital pathology images.
We break it down into basic concepts like
regions and objects of interest,
matching computer vision techniques to pathology tasks, and the
differences between classical machine learning and AI-based deep learning approaches.
Understanding these foundations sets the stage for appreciating how image analysis is applied in regulated clinical settings versus exploratory research environments. You will learn the importance of quality control, because flawed data inputs inevitably lead to faulty outputs, regardless of the analysis method used.
Moving on, you will familiarize yourself with the key terminology from the world of artificial intelligence and machine learning.
The chapter clarifies the meaning of concepts like
supervised learning,
GPUs,
data augmentation, and
heat maps.
It emphasizes how techniques like
patching and
data augmentation
enable the training of machine learning algorithms on large datasets.
Ultimately, by comprehending this terminology and the basics of tissue image analysis, you'll gain clarity on how these tools can provide decision support to pathologists through computer-aided diagnosis. Rather than seeing AI as a black box, you'll have insight into how it arrives at its outputs.
With this balanced understanding, you'll be equipped to make discerning choices about embracing AI tools in your pathology practice, leveraging their benefits while being aware of current limitations.
Stay tuned as we continue unpacking the transformative potential of digital pathology! Talk to you in chapter 4!
As enthusiastic as the digital pathology community is about digital pathology, you are also grounded in reality and know that like every technology, digital pathology in parallel with its enormous benefits also has some drawbacks.
This is the second chapter of the "Digital Pathology 101" book and in this episode, I take a balanced look at the pros and cons of going digital.
Benefits
First, we highlight some of the key advantages:
enhanced accuracy and efficiency in diagnostics,
seamless collaboration opportunities,
advanced research capabilities,
integration with digital health systems, and
exciting educational prospects.
Real-world examples showcase how these benefits have been leveraged, like the successful implementation of digital workflows in a large US hospital and the application of digital pathology in pharmaceutical research.
Challenges
However, we acknowledge this new frontier has its challenges. Technological hurdles around
image quality,
data storage, and management are significant.
Navigating regulatory compliance and
acceptance within the pathology community will take time.
Cost-efficiency and specialized training remain issues to tackle.
Yet for each obstacle, there are solutions and opportunities to learn. Case studies teach us how institutions overcame cost barriers through long-term planning and addressed training needs via technology partnerships.
Constant advances promise more efficient scanning and sophisticated cloud storage on the horizon. And an evolving regulatory environment is steadily validating digital tools, albeit with a need to standardize guidelines.
While adoption is uneven, momentum is building towards digitization. By understanding the landscape and staying engaged with developments, pathologists can shape an ethical integration of these tools. Guided by both optimism and pragmatism, we can realize the potential of digital pathology to transform patient care.
This is the second part of the first chapter of the recently published “Digital Pathology 101” book.
This part of the chapter addresses a question that I keep hearing from those just entering the world of digital pathology: “Will pathologists lose their jobs now, that algorithms can be developed to diagnose disease?”
The short answer is “No”.
Keep reading for the explanation why not.
The Rise of Deep Learning
One of the most notable trends has been the rise of deep learning and AI in digital pathology. These advanced techniques are being embraced by the pathology community to analyze complex issues from sclerotic glomeruli through liver fibrosis to different types of cancer. The user-friendliness of new tools powered by deep learning makes it accessible even for non-experts.
Industry Paradigm Shifts
Several paradigm shifts are occurring in the digital pathology industry:
Transition from handcrafted algorithms to deep learning
Shift to cloud-based Software as a Service (SaaS) solutions
Movement towards pathologist decision support systems rather than fully autonomous analysis
Enhanced user-friendliness of digital pathology software
Empowering Pathologists
An important change has been the emphasis on empowering pathologists with decision support systems rather than replacing them with algorithms. The goal is to accelerate the case review process without compromising accuracy or integrity. Pathologists remain responsible for the final diagnosis.
Blending Analog and Digital Worlds
Some innovative companies are pioneering solutions to blend traditional microscopes and digital pathology, such as Augmentics' augmented reality microscope cameras or systems used by Smart in Media. This allows professionals to collaborate in real-time and apply algorithms while still using the cherished microscope.
Personalized Digital Pathology
The industry has moved away from a one-size-fits-all approach to personalized solutions tailored to each institution's workflow and challenges. This shift leverages the power of deep learning while enhancing user experience.
The trusted microscope remains an essential part of pathology, but digital solutions open new doors for analysis and efficiency. As this field evolves, quality control and understanding the capabilities and limitations of technology is crucial.
Exciting times are ahead in digital pathology! Be sure to listen to the full podcast episode for an in-depth discussion.
This book is the culmination of months of passion and hard work. If you've been following me on social media, you know it's been a labor of love. But why did I write this book, you might ask? Well, it's your comprehensive guide to navigating and thriving in the realm of digital pathology.
But first, let's rewind a bit. Back in 2003, Dr. Anil Parwani predicted that everyone would be digital by 2007. Well, that might have been a bit too optimistic, but guess what? The digital age in pathology is here, and it's not a distant future; it's right around the corner.
I'm convinced that now is the time, and that's why I'm so excited to share this book with you.
In that webinar, I delved deep into why digital pathology is the future, and trust me, it's a future you don't want to miss out on.
But enough about that, let's dive into the first chapter of the audio version of "Digital Pathology 101." In this chapter, we'll explore the historical milestones that paved the way for digital pathology. So, without further ado, let's get started on this journey into the world of digital pathology.
Here is what we will cover in this part of chapter 1:
DIGITAL PATHOLOGY MILESTONES
A. Historical Milestone
B. Regulatory Milestone
BASIC DIGITALIZATION CONCEPTS
A. About Digitization, Digitalization and Digital Transformation
B. Digitization - The Scanner and its Components
C. Digitalization and its challenges - Data Generation and Management
D. Digital transformation: Advantages and Challenges of Digital Pathology
In this episode of "The Digital Pathology Podcast," we delve into the fascinating career of Dr. Anil Parwani from Ohio State University, a visionary whose ardor for technology and research paved the way for groundbreaking advancements in digital pathology.
Dr. Parwani's journey commenced with a bold move – launching a web educational series during his residency – well ahead of digital pathology's mainstream emergence. As we delve into his narrative, you'll witness how his pioneering spirit laid the groundwork for a transformative trajectory. The pivotal moment? It arrived with the debut of the first digital pathology scanners. Dr. Parwani envisioned a future where patient care and pathology research could soar to unprecedented heights through digitization. His role in implementing digital pathology solutions, including collaborations with startups, deepened his grasp of the clinical significance of this game-changing technology.
As the COVID-19 pandemic accelerated technological advancements in digital pathology, Dr. Parwani witnessed a significant 20% surge in adoption within his institution. How did they strike the ideal balance between remote and in-person interactions? Discover the insights in this episode.
Furthermore, in an era where the number of medical students pursuing pathology is dwindling, we'll examine how digital pathology is sparking renewed interest. Dr. Parwani reveals how this field, with its research prospects, educational promise, and collaborative ethos, is reshaping perceptions and attracting fresh talent.
Stay tuned for an expedition through the dynamic realm of digital pathology with Dr. Anil Parwani. It's a captivating odyssey into innovation, precision, and the future of medical science that promises not to disappoint!
In this episode of DigiPath Digest you will learn about the development of AI models for glaucoma screening using fundus images, the use of AI in detecting metastatic deposits in colorectal cancer, and leveraging immunofluorescence data to reduce pathologist annotation requirements.
Dr. Aleks also invited two AI Co-hosts and shared personal reflections on AI's role in the industry and invites feedback from listeners on AI-generated content.
00:00 Introduction to the Livestream Disaster 00:24 AI to the Rescue: Enhancing Audio Quality 00:38 Meet the AI Co-Hosts 01:04 Welcome to the Digital Pathology Podcast 01:30 Technical Difficulties and Audience Interaction 02:49 Exploring AI in Veterinary Medicine 04:34 Hybrid Convolutional Neural Network for Glaucoma Screening 07:49 Model for Detecting Metastatic Deposits in Lymph Nodes 11:23 Leveraging Immunofluorescence Data for Lung Tumor Segmentation 18:05 AI-Generated Content and Future Plans 21:37 AI Co-Hosts Take Over 32:42 Conclusion and Audience Feedback
TODAY'S EPISODES RESOURCES 📰 Hybrid convolutional neural network optimized with an artificial algae algorithm for glaucoma screening using fundus images 🔗https://pubmed.ncbi.nlm.nih.gov/39301801/
📰 Automatic segmentation of esophageal cancer, metastatic lymph nodes and their adjacent structures in CTA images based on the UperNet Swin network 🔗https://pubmed.ncbi.nlm.nih.gov/39300922/
📰 Retrosynthetic analysis via deep learning to improve pilomatricoma diagnoses 🔗https://pubmed.ncbi.nlm.nih.gov/39298885/
📰 Obesity-Associated Breast Cancer: Analysis of Risk Factors and Current Clinical Evaluation 🔗 https://pubmed.ncbi.nlm.nih.gov/39287872/
📰 Model for detecting metastatic deposits in lymph nodes of colorectal carcinoma on digital/ non-WSI images 🔗 https://pubmed.ncbi.nlm.nih.gov/39285483/
📰 Leveraging immuno-fluorescence data to reduce pathologist annotation requirements in lung tumor segmentation using deep learning 🔗 https://pubmed.ncbi.nlm.nih.gov/39284813/
📰 Globalization of a telepathology network with artificial intelligence applications in Colombia: The GLORIA program study protocol 🔗 https://pubmed.ncbi.nlm.nih.gov/39280257/
📰 Sex differences in sociodemographic, clinical, and laboratory variables in childhood asthma: A birth cohort study 🔗 https://pubmed.ncbi.nlm.nih.gov/39019434/
What happened to digital pathology in the last decade?
Step into a time machine with us as we explore "The Evolution OF Digital Pathology– From Improved Histology Quality to Fair Use of Pathology Data" alongside Dr. Matt Leavitt, President of the Digital Diagnostics Foundation and Founder of Lumea. In this captivating podcast episode, we'll journey through the years and witness the incredible transformation of digital pathology.
Travel back to 2013, when digital pathology was still in its infancy, and fast forward to the present day, where innovation and technology have reshaped the landscape and ethical questions about patient data use urgently need answers.
Dr. Leavitt provides unique insights into the challenges, breakthroughs, and trends that have defined this transformative decade.
Gain a front-row seat to the evolution of healthcare innovation as we compare and contrast digital pathology then and now. Whether you're a seasoned pathologist, a tech enthusiast, or simply curious about the future of medicine, this episode promises to enlighten and inspire.
Join us on this remarkable journey through time and innovation. Subscribe to the podcast now to uncover the secrets of digital pathology's evolution and chart a course for the future. Don't miss out—tune in and be a part of this fascinating exploration!
How is digital pathology used in clinical trials? Because digital pathology as a discipline began with the aim of streamlining clinical trials, one could assume that this is currently the default. Unfortunately, this is not the case… In today's discussion, our guest, Dr. Monika Lamba, a pathologist from Q2 Solutions, the lab division of IQVIA, sheds light on how digital pathology revolutionizes the landscape of clinical trials but also where we can still see the gaps.
In this engaging conversation, we discover how the origins of telepathology marked the inception of digital pathology and its journey to becoming an essential component of clinical trials. Dr. Lamba walks us through the complexities of clinical trials, their organization, and patient matching across multiple sites and international boundaries.
As we unravel the role of pathology in clinical trials, we delve into how eligibility criteria, participant engagement, and informed consent are intricately woven into the process. Dr. Lamba educates us on the critical role of pathology in stratifying and randomizing patients, as well as evaluating outcome measures.
From disease staging to pathologic complete response assessments, pathology guides the way toward precision medicine and targeted therapies. Don't miss this captivating episode where we explore the synergy between digital pathology and clinical trials, paving the path for medical advancements and transformative healthcare solutions. Tune in now to expand your horizons on the ever-evolving intersection of digital pathology and clinical trials.
Welcome to a very spontaneous and exciting episode of the Digital Pathology Podcast. In this episode, I had the pleasure of sitting down with Dr. Giovanni Lujan from Ohio State University, whom you might remember from our previous crossover podcasts with Beyond the Scope.
Recently, we were at the Digital Pathology and AI Congress in New York organized by Global Engage, and guess what? We decided to record this episode right there, surrounded by the buzz of the conference. No fancy preparations, just real and raw insights for you.
Giovanni and I are sharing our impressions and discussing the latest trends in digital pathology that were highlighted at the Congress. It's fantastic to finally meet in person after collaborating on two podcasts together. Giovanni has been a devoted follower of our podcast and all things digital pathology, and I'm truly inspired by his passion for the field.
The Congress organized by Global Engage has a unique vibe. It's smaller, which allows for more meaningful interactions and networking opportunities with fellow professionals and vendors. The longer breaks and one-on-one meetings foster valuable connections, making this conference stand out from the rest.
Keywords: Digital Pathology Congress Recap, Networking, Insights, Global Engage Impact, Giovanni Lujan, Beyond the Scope, Cutting-edge Innovations, Stay Updated, Join Now
Bringing Science into the Clinic with Prof. Anant Madabhushi
Translational research - what is it actually? How do you do it?
I can already tell you how not to do it - halfheartedly.
If you want to translate your scientific discoveries into something that actually benefits patients, you need to do all in!
And this is what my guest Prof. Anant Madabhushi from the Emory University and Georgia Tech has dedicated his entire professional career to.
He offers his insights on what it really takes to "walk your scientific talk" and work as a truly translational researcher in the space of digital pathology, radiology and medical engineering.
Listen to an in-depth discussion about conducting high-quality science and the rigorous journey of commercializing the research and actually benefiting the patients with it.
With his vast experience and profound understanding, Prof. Madabhushi gives us an insider's view of the effort and time required to successfully take a scientific discovery from the lab to a clinical trial, and then to the market. His perspective is enriched by his role as founder of several med tech companies, co-author of numerous high impact factor scientific publications, and a mentor and teacher to the next generation of brilliant computational pathology scientists.
Exploring Spatial Biology and Image Analysis with Lorenz Rognoni
Get ready for a deep dive into spatial biology and image analysis with Lorenz Rognoni, the Director of Image Data Science at Ultivue. Ultivue is a company specializing in spatial biology and Lorenz brings his wealth of knowledge in multiplex immunofluorescence (mIF) and image data science to this great conversation.
Multiplex IF: Challenges and Complexities
We kick off our discussion by addressing the inherent challenges in multiplex IF. The conversation spans a range of issues including tissue preparation artifacts, unique tissue morphology, and antibody-specific staining. The vast variability of tissues, differing across body regions, species, and health conditions, is a recurring theme. We also delve into the effectiveness of expert visual evaluation for traditional stains and the need for new strategies to interpret high-dimensional data.
Brightfield Imaging in Spatial Biology: Does it Still Play a Role?
Shifting gears, we discuss the role of brightfield imaging in spatial biology. Is there still space for brightfield if we want to learn the spatial interactions of cells in the tissue? Is this method not too limiting? Lorenz underscores its continued relevance, particularly when robustness and scalability are prerequisites. He suggests transitioning to simpler methods like singleplex IF or even brightfield imaging, once research zeroes in on specific biomarkers of relevance with multiplex IF.
Transitioning from Image Analysis to Data Interpretation: Navigating the Pitfalls
Our conversation culminates in a look at the challenges and potential missteps in moving from image analysis to interpreting the data generated. Lorenz points out the crucial process of extracting meaningful insights from millions of cells, defining appropriate phenotypes, and considering the intricacies of downstream data mining.
Key Takeaways
mIF is an exploratory method and the insights gained can later be transitioned ti simpler methods such as single market IF or IHC
The spatial biology research relies on accurate cell segmentation and identifying the correct phenotypes of cells.
Correct segmentation is the first step to explore the insights and this exploration is being done through informed data mining that takes into consideration all the information about the study. This is best done by an image data science team where image analysis scientists, data mining experts and pathologists work together.
Join us for this insightful conversation and gain a deeper understanding of the complexities and nuances of spatial biology and image data science with Lorenz Rognoni.
Welcome to the crossover podcast with David, Giovanni and myself (Aleks) again. During this episode, we explore the world of digital pathology, artificial intelligence, including Chat GPT, and their growing importance in the field.
Is 2023 the year of AI for digital pathology?
We will talk about it and about the impact of AI in digital pathology and how Chat GPT could transform the way pathology reports are written. We discuss the benefits of using AI in digital pathology and what the future holds for this field.
As the discussion progresses, the experts explain the workflow of digital pathology and its advancements, including deep learning, and the role of AI in these advancements. They also discuss how Open AI Chat GPT is changing the landscape of artificial intelligence news.
Join Giovanni, David and myself for an engaging and insightful conversation about the latest advancements in digital pathology and the future possibilities of AI and Chat GPT in this field.
Have you heard the stereotype of a pathologist hidden behind the microscope (or in the era of digital pathology behind the computer screen). Pathologist as the doctors' doctor?
Today, I have a special guest who defies this stereotype!
Dr. Marilyn Bui, a specialized cytopathologist, is patient-focused and emphasizes the patient-centricity of pathology work. She co-authored a book, "The Healing Art of Pathology", and amplifies her message by being a leader in various organizations.
Dr. Bui is the current president of the Florida Society of Pathologists and previously held the same role in the Digital Pathology Association.
In this episode, Dr. Bui shares her background and how she became a patient-centered pathologist. She talks about her work in tissue pathology, cytopathology, and digital pathology at Moffitt Cancer Center in Tampa, Florida, where she also teaches and conducts research.
Dr. Bui believes that pathology and laboratory medicine are essential disciplines in healthcare, and she advocates for their protection and augmentation.
Join me in this conversation with Dr. Marilyn Bui as we delve deeper into the world of pathology and learn more about her book, "The Healing Art of Pathology."