Tag Archives: Pathology Informatics Selected Abstracts

May 2023—Computational pathology is a subspecialty of pathology that exploits computational analysis to analyze patient specimens and that often uses multiple sources of related data. Artificial intelligence systems are typically used in this subspecialty. The field of pathology is rapidly being transformed by the development of AI algorithms trained to perform diagnostic, prognostic, and predictive tasks. However, routine use of artificial intelligence in anatomic pathology remains limited, making it difficult to measure the long-term clinical impact of AI. With this issue in mind, the authors surveyed 24 subject matter experts worldwide regarding the anticipated role of AI in pathology by the year 2030.

March 2023—Whole slide imaging is increasingly being adopted by pathology laboratories worldwide. In 2013, the College of American Pathologists published guidelines on validating whole slide imaging (WSI) for diagnostic purposes. The CAP updated the recommendations in 2021. The guidelines include three strong recommendations and nine good-practice statements. The purpose of the validation guidelines is to ensure that a WSI system performs as intended in a particular clinical environment before it is used in patient care. In other words, the process is intended to make sure pathologists can render accurate diagnoses with WSI that are at least comparable to those provided via traditional light microscopy and that there are no interfering artifacts or technological risks to patient safety.  

November 2022—Lab test result formats are not standardized, potentially causing confusion when the same test results are displayed differently—for example, when a positive pregnancy test appears as +, P, or positive, or an indeterminate test result appears as DNR, which could be interpreted to mean did not report, did not react, or even do not resuscitate. Because of this issue, the authors trialed standard laboratory result formats across the 130 facilities that are part of the Veterans Health Administration, each of which has one or more CLIA-certified laboratories. The authors selected the most common laboratory tests from each facility, which composed at least 95 percent of a facility’s monthly laboratory test volume between 2000 and 2015. They then specified the standard result formats for these tests based on the facilities’ feedback. Personalized emails were sent weekly, over a 15-week period in 2016, to the facilities’ lab information systems managers, lab managers, and laboratory directors.

September 2022—Artificial intelligence in pathology has progressed recently, with at least four machine-learning algorithms classified for clinical use in the United States. While many challenges of implementing AI in pathology labs are well documented, one area that has not received much study is how an AI algorithm designed to augment pathologist performance will impact pathologists’ clinical decisions.

July 2022—Numerous factors affect blood product inventory in hospitals. Among them are component-processing methods, geographic population characteristics, available medical procedures, diagnostic categories, and global epidemics.

May 2022—An outgrowth of the COVID-19 pandemic has been a need to provide SARS-CoV-2 molecular testing and an increased need to manage workforce shortages, respond to fluctuations in specimen volumes, and shift to digital platforms for diagnostic work and education, among other challenges.

March 2022—Over the past decade, the field of pathology has increasingly been using Twitter for educational purposes, due in part to the ease with which one can share images for review on the social media platform. However, not all pathologists use Twitter, and only a portion of those who do use it employ the platform for educational purposes. To identify the challenges of using Twitter to create educational posts, the authors created a short multiple-choice Likert scale survey using Google Forms and distributed it through Twitter. The survey was divided into the categories of user demographics—work setting, job role, and history of posting educational content on Twitter; the biggest obstacle to creating educational content; and further exploration of the challenges faced when posting content to Twitter. One hundred and seventy-four medical professionals responded to the survey, of which pathology residents and fellows (n = 68; 39.1 percent) and practicing pathologists (n = 60; 34.5 percent) composed the largest groups.

January 2022—With modern HIV testing incorporating p24 antigen detection, fourth- and fifth-generation HIV screening tests have halved the time between acquiring and detecting the infection.

November 2021—When the COVID-19 pandemic struck, many pathology training programs scrambled to formulate a plan to teach their pathology residents in a physically distanced learning environment. Using double- or multi-headed optical light microscopes, even with plexiglass barriers, is not ideal because they do not permit physical distancing. Many training programs leveraged digital imaging technology to continue teaching microscopy during the pandemic. Pathology departments that could not afford whole slide imaging for this purpose sometimes employed the less expensive option of dynamic virtual microscopy (DVM). A DVM platform includes a digital camera mounted to a light microscope and videoconferencing software so an educator can stream a slide image to one or more remote learners.

September 2021—Chronic myelogenous leukemia is a clonal stem cell disorder driven by the BCR-ABL1 fusion oncogene and accounts for 15 percent of adult leukemias. Patients typically present with abnormalities in their complete blood cell counts with differential classification.

July 2021—Despite growing awareness of whole slide imaging, few pathology laboratories have implemented and validated such a digital pathology system for primary diagnosis. Among the barriers to adopting whole slide imaging (WSI) for routine clinical work is the difficulty of justifying the expense, time and effort, and change management involved in deploying this disruptive technology.

May 2021—As whole slide imaging has matured, pathologists have been focusing on the use of artificial intelligence algorithms. At the same time, the need to develop computer-assisted diagnostic tools to evaluate prostate core needle biopsies has intensified with the dramatic increase in the number of prostate cancer cases.

March 2021—A significant benefit of whole slide imaging is the ability to view digital slides remotely. This benefit has been reinforced during the COVID pandemic as pathologists render pathology diagnoses from home. At the same time, the FDA has temporarily relaxed regulations for modifying FDA-cleared digital pathology devices and the marketing of devices that are not FDA 510(k) cleared. This contrasts with previous requirements that various digital pathology systems use computer displays with specifications that have satisfied regulatory or institutional approval, or both. This, in turn, raises concern about pathologists working in unregulated home settings where they use a variety of monitors that vary in visual quality and, therefore, in image clarity.

January 2021—A major barrier to adopting whole slide imaging for primary diagnosis in the United States was FDA regulatory approval. However, the FDA approved marketing of the first whole slide imaging (WSI) system for digital pathology in 2017. The agency subsequently cleared Leica’s Aperio AT2 DX system for in vitro diagnostic use to aid pathologists in reviewing and interpreting digital images of surgical pathology slides prepared from formalin-fixed paraffin-embedded tissue. The authors conducted a study in which they compared pathologists’ primary diagnoses rendered through the use of WSI versus standard glass microscopy. Their multicenter, double-blind, randomized clinical trial was conducted at five sites: the University of California Davis, Pacific Rim Pathology, Dignity Health, TriCore Reference Laboratories, and Intermountain Healthcare.

November 2020—Telepathology is a leading application for digital pathology. The ability to easily share a digital image in practice offers pathology laboratories clinical, operational, and financial benefits. This is best demonstrated by the longstanding success of telepathology in allowing pathologists to remotely perform intraoperative consultations—that is, to read frozen sections. Neuropathologists were one of the first specialists to leverage digital pathology for this clinical use. The authors, all of whom were from the University of Pittsburgh Medical Center, performed teleneuropathology at their institution, which implemented the practice 17 years ago.

September 2020—Whole slide imaging has been available for clinical, research, and educational use for decades, with several digital pathology systems cleared by the FDA for primary diagnosis. However, widespread adoption of this technology for routine practice has been slow. Likely reasons for the slow uptick in employing whole slide imaging (WSI) for sign-out include the cost of these systems, their lack of interoperability with laboratory information systems, pathologist resistance to using this digital modality, and regulatory restrictions on remote sign-out imposed by the Clinical Laboratory Improvement Amendments (CLIA). However, the COVID-19 pandemic led the Trump administration, on March 26, to temporarily waive these CLIA regulations, giving pathologists the flexibility to sign out cases digitally from their homes.