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21(st) century workflow: A proposal.

Fine JL - J Pathol Inform (2014)

Bottom Line: Pathologists have not yet developed a well-articulated plan for effectively utilizing digital imaging technology in their work.This paper outlines a proposal that is intended to begin meaningful progress toward achieving helpful computer-assisted pathology sign-out systems, such as pathologists' computer-assisted diagnosis (pCAD). pCAD is presented as a hypothetical intelligent computer system that would integrate advanced image analysis and better utilization of existing digital pathology data from lab information systems.This proposal provides stakeholders with a conceptual framework that can be used to facilitate development work, communication, and identification of new automation strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.

ABSTRACT
Digital pathology is rapidly developing, but early systems have been slow to gain traction outside of niche applications such as: Second-opinion telepathology, immunostain interpretation, and intraoperative telepathology. Pathologists have not yet developed a well-articulated plan for effectively utilizing digital imaging technology in their work. This paper outlines a proposal that is intended to begin meaningful progress toward achieving helpful computer-assisted pathology sign-out systems, such as pathologists' computer-assisted diagnosis (pCAD). pCAD is presented as a hypothetical intelligent computer system that would integrate advanced image analysis and better utilization of existing digital pathology data from lab information systems. A detailed example of automated digital pathology is presented, as an automated breast cancer lymph node sign-out. This proposal provides stakeholders with a conceptual framework that can be used to facilitate development work, communication, and identification of new automation strategies.

No MeSH data available.


Related in: MedlinePlus

High level flow diagram of pathologists’ computer assisted diagnosis (pCAD). After a specimen is accessioned, the pCAD system reviews the specimen information from the Anatomic Pathology Laboratory Information System (APLIS) in order to classify the specimen into one or more predetermined templates (e.g., sentinel lymph node biopsy, benign supracervical hysterectomy, etc.). Once a template workflow has been selected, the pCAD assimilates both APLIS data and whole slide images. In the context of predefined work tasks, clinically relevant regions of interests (ROIs) are identified and triaged. Together, a pathologist and pCAD review the ROIs interactively; as they work through the case, a pathology report is automatically constructed by pCAD. When the case work is completed, the pathologist reviews the pathology report then releases it
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Figure 2: High level flow diagram of pathologists’ computer assisted diagnosis (pCAD). After a specimen is accessioned, the pCAD system reviews the specimen information from the Anatomic Pathology Laboratory Information System (APLIS) in order to classify the specimen into one or more predetermined templates (e.g., sentinel lymph node biopsy, benign supracervical hysterectomy, etc.). Once a template workflow has been selected, the pCAD assimilates both APLIS data and whole slide images. In the context of predefined work tasks, clinically relevant regions of interests (ROIs) are identified and triaged. Together, a pathologist and pCAD review the ROIs interactively; as they work through the case, a pathology report is automatically constructed by pCAD. When the case work is completed, the pathologist reviews the pathology report then releases it

Mentions: The future pathologist starts an axillary SLNB review by viewing ROIs of the primary tumor from a previous biopsy specimen; the prior report is also present on-screen. As the pathologist moves on to review the SNLB specimen, known tumor ROIs remain on the screen for easy reference. Rather than manually navigating the WSI, the pathologist instead clicks through a series of triaged lymph node ROIs, one at a time, in rapid succession, looking for tumor in the lymph node. Almost immediately, the pathologist sees a small fragment of probable tumor and takes control of the virtual microscope to zoom in and look more closely. The pathologist confirms the tumor finding and also verifies the computer's preliminary measurement of the metastasis [Figure 1]. Since tumor has been identified, the remainder of the review can be abbreviated; the pathologist could view the entire lymph node at lower magnification, or could review another 20% of the lymph node area microscopically. After the review, the pathologist reads the computer-generated report and then verifies it without having to make any manual corrections [Figure 2].


21(st) century workflow: A proposal.

Fine JL - J Pathol Inform (2014)

High level flow diagram of pathologists’ computer assisted diagnosis (pCAD). After a specimen is accessioned, the pCAD system reviews the specimen information from the Anatomic Pathology Laboratory Information System (APLIS) in order to classify the specimen into one or more predetermined templates (e.g., sentinel lymph node biopsy, benign supracervical hysterectomy, etc.). Once a template workflow has been selected, the pCAD assimilates both APLIS data and whole slide images. In the context of predefined work tasks, clinically relevant regions of interests (ROIs) are identified and triaged. Together, a pathologist and pCAD review the ROIs interactively; as they work through the case, a pathology report is automatically constructed by pCAD. When the case work is completed, the pathologist reviews the pathology report then releases it
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260324&req=5

Figure 2: High level flow diagram of pathologists’ computer assisted diagnosis (pCAD). After a specimen is accessioned, the pCAD system reviews the specimen information from the Anatomic Pathology Laboratory Information System (APLIS) in order to classify the specimen into one or more predetermined templates (e.g., sentinel lymph node biopsy, benign supracervical hysterectomy, etc.). Once a template workflow has been selected, the pCAD assimilates both APLIS data and whole slide images. In the context of predefined work tasks, clinically relevant regions of interests (ROIs) are identified and triaged. Together, a pathologist and pCAD review the ROIs interactively; as they work through the case, a pathology report is automatically constructed by pCAD. When the case work is completed, the pathologist reviews the pathology report then releases it
Mentions: The future pathologist starts an axillary SLNB review by viewing ROIs of the primary tumor from a previous biopsy specimen; the prior report is also present on-screen. As the pathologist moves on to review the SNLB specimen, known tumor ROIs remain on the screen for easy reference. Rather than manually navigating the WSI, the pathologist instead clicks through a series of triaged lymph node ROIs, one at a time, in rapid succession, looking for tumor in the lymph node. Almost immediately, the pathologist sees a small fragment of probable tumor and takes control of the virtual microscope to zoom in and look more closely. The pathologist confirms the tumor finding and also verifies the computer's preliminary measurement of the metastasis [Figure 1]. Since tumor has been identified, the remainder of the review can be abbreviated; the pathologist could view the entire lymph node at lower magnification, or could review another 20% of the lymph node area microscopically. After the review, the pathologist reads the computer-generated report and then verifies it without having to make any manual corrections [Figure 2].

Bottom Line: Pathologists have not yet developed a well-articulated plan for effectively utilizing digital imaging technology in their work.This paper outlines a proposal that is intended to begin meaningful progress toward achieving helpful computer-assisted pathology sign-out systems, such as pathologists' computer-assisted diagnosis (pCAD). pCAD is presented as a hypothetical intelligent computer system that would integrate advanced image analysis and better utilization of existing digital pathology data from lab information systems.This proposal provides stakeholders with a conceptual framework that can be used to facilitate development work, communication, and identification of new automation strategies.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.

ABSTRACT
Digital pathology is rapidly developing, but early systems have been slow to gain traction outside of niche applications such as: Second-opinion telepathology, immunostain interpretation, and intraoperative telepathology. Pathologists have not yet developed a well-articulated plan for effectively utilizing digital imaging technology in their work. This paper outlines a proposal that is intended to begin meaningful progress toward achieving helpful computer-assisted pathology sign-out systems, such as pathologists' computer-assisted diagnosis (pCAD). pCAD is presented as a hypothetical intelligent computer system that would integrate advanced image analysis and better utilization of existing digital pathology data from lab information systems. A detailed example of automated digital pathology is presented, as an automated breast cancer lymph node sign-out. This proposal provides stakeholders with a conceptual framework that can be used to facilitate development work, communication, and identification of new automation strategies.

No MeSH data available.


Related in: MedlinePlus