Pathology Image Exchange: The Dutch Digital Pathology Platform for Exchange of Whole-Slide Images for Efficient Teleconsultation, Telerevision, and Virtual Expert Panels.

Among the many uses of digital pathology, remote consultation, remote revision, and virtual slide panels may be the most important ones. This requires basic slide scanner infrastructure in participating laboratories to produce whole-slide images. More importantly, a software platform is needed for exchange of these images and functionality to support the processes around discussing and reporting on these images without breaching patient privacy.

Whole slide images for primary diagnostics of urinary system pathology: a feasibility study.

Introduction: During the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have as yet not much been used for upfront diagnostics because of the lack of validation studies.

Objectives: The aim of this study was to test the feasibility of WSI for primary diagnosis of urinary tract pathology.

Myocardial fibrosis and pro-fibrotic markers in end-stage heart failure patients during continuous-flow left ventricular assist device support.

Objectives: During support with a left ventricular assist device (LVAD), partial reverse remodelling takes place in which fibrosis plays an important role. In this study, we analysed the histological changes and expression of fibrotic markers in patients with advanced heart failure (HF) during continuous-flow LVAD (cf-LVAD) support.

Methods: In 25 patients, myocardial tissue at the time of LVAD implantation (pre-LVAD) was compared with tissue from the explanted left ventricle (post-LVAD).

Distinct phenotypes of cardiac allograft vasculopathy after heart transplantation: a histopathological study.

Introduction: Long-term survival after heart transplantation (HTx) is hampered by cardiac allograft vasculopathy (CAV). Better understanding of the pathophysiological mechanisms of CAV might have considerable consequences for therapeutic approaches in the future. The aim of the present study was to investigate the histological phenotypes of CAV in relation with clinical patient characteristics.

Automatic nuclei segmentation in H&E stained breast cancer histopathology images.

The introduction of fast digital slide scanners that provide whole slide images has led to a revival of interest in image analysis applications in pathology. Segmentation of cells and nuclei is an important first step towards automatic analysis of digitized microscopy images. We therefore developed an automated nuclei segmentation method that works with hematoxylin and eosin (H&E) stained breast cancer histopathology images, which represent regions of whole digital slides.

Going fully digital: Perspective of a Dutch academic pathology lab.

During the last years, whole slide imaging has become more affordable and widely accepted in pathology labs. Digital slides are increasingly being used for digital archiving of routinely produced clinical slides, remote consultation and tumor boards, and quantitative image analysis for research purposes and in education. However, the implementation of a fully digital Pathology Department requires an in depth look into the suitability of digital slides for routine clinical use (the image quality of the produced digital slides and the factors that affect it) and the required infrastructure to support such use (the storage requirements and integration with lab management and hospital information systems).

Whole slide images for primary diagnostics of paediatric pathology specimens: a feasibility study.

Introduction: Whole slide images (WSI) have been used in many pathology applications such as teleconsultation, teaching and research, but not in primary diagnostics. The aim of this study was to test the feasibility of using WSI in primary diagnostics of paediatric pathology specimens and placental tissue.

Materials And Methods: Eighty consecutive tissues biopsies and resections from patients under 18 years old were selected, as well as 20 placentas.

Whole slide images as a platform for initial diagnostics in histopathology in a medium-sized routine laboratory.

Introduction: Whole slide imaging is the process of digitizing glass slides and the creation of Whole Slide Images (WSI), which enable the examination of pathology samples on a computer screen in a manner comparable to light microscopy. WSI have been used for different applications in pathology but their use for primary diagnostics is still limited. Implementing WSI for primary diagnostics would be a turning point necessitating extensive validation to unravel pitfalls and difficulties that could be encountered within the routine workflow.

Digital pathology for education.

The use of digital slides for educational purposes (both for medical students and during pathology traineeships) will eventually accelerate the acceptance of digital pathology in general. This chapter describes the advantages of using digital slides especially for education. Also the requirements for using digital slides for this purpose are evaluated, including software requirements, the slide scanner and the IT infrastructure needed to provide a robust infrastructure to end users.

Prognostic value of automatically extracted nuclear morphometric features in whole slide images of male breast cancer.

Numerous studies have shown the prognostic significance of nuclear morphometry in breast cancer patients. Wide acceptance of morphometric methods has, however, been hampered by the tedious and time consuming nature of the manual segmentation of nuclei and the lack of equipment for high throughput digitization of slides. Recently, whole slide imaging became more affordable and widely available, making fully digital pathology archives feasible.

Discrimination between benign and malignant prostate biopsies using three-dimensional chromatin texture analysis by confocal laser scanning microscopy.

Objective: To evaluate the clinical usefulness of computing three-dimensional (3-D) nuclear texture features on prostate biopsy specimens to discriminate among benign, prostatic intraepithelial neoplasia (PIN), and malignant specimens.

Study Design: Twelve prostate cancer biopsy specimens were selected, diagnosed as either benign (N = 4), PIN (N = 4), or malignant (N = 4). Sections 14 microm thick were stained.

Whole slide images for primary diagnostics in dermatopathology: a feasibility study.

Background: During the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have not regularly been used for routine diagnosis, because of the lack of validation studies.

Aim: To test the validity of using WSI for primary diagnosis of skin diseases.

Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study.

During the last decade, whole slide images have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation, and quality assurance testing. However, whole slide images have as yet not much been used for up-front diagnostics because of the lack of validation studies. The aim of this study was, therefore, to test the feasibility of whole slide images for diagnosis of gastrointestinal tract specimens, one of the largest areas of diagnostic pathology.

Digital pathology: current status and future perspectives.

During the last decade pathology has benefited from the rapid progress of image digitizing technology. The improvement in this technology had led to the creation of slide scanners which are able to produce whole slide images (WSI) which can be explored by image viewers in a way comparable to the conventional microscope. The file size of the WSI ranges from a few megabytes to several gigabytes, leading to challenges in the area of image storage and management when they will be used routinely in daily clinical practice.

Creation of a fully digital pathology slide archive by high-volume tissue slide scanning.

Digital slide scanners for scanning glass slides are becoming increasingly popular because current scanners are fast enough and produce good enough images for diagnostic purposes, education, and research. Also, the price for storing vast amounts of data has decreased over the last years, and this trend is expected to continue. Where most laboratories use their scanners mainly for education and research with limited financial and technical implications, we decided to face the huge challenges of prospectively setting up a fully digital pathology slide archive, primarily aiming to optimize the preparation and running of clinicopathological conferences.

A restaining method to restore faded fluorescence in tissue specimens for quantitative confocal microscopy.

The aim of this study was to develop a procedure to remove the TO-PRO-3 fluorescent dye from tissue sections and restain with TO-PRO-3, still allowing calculation of DNA content and distribution by confocal laser scanning microscopy (CLSM). This would allow repeated measurements on the same tissue sections and prevents loss of tissue material from valuable clinical samples. Thick sections (14 microm) were cut from a paraffin block of adrenal tissue and stained using TO-PRO-3.

Discrimination between benign and malignant prostate tissue using chromatin texture analysis in 3-D by confocal laser scanning microscopy.

Background: Analysis of chromatin texture may improve both the diagnosis and the assessment of the prognosis of prostate cancer. Confocal laser scanning microscopy (CLSM) allows performing measurements in nuclei reconstructed in 3-D. The aim of this study was to evaluate the clinical usefulness of 3-D texture analysis of prostate tissue.

Development of 3D chromatin texture analysis using confocal laser scanning microscopy.

Introduction: Analysis of nuclear texture features as a measure of nuclear chromatin changes has been proven to be useful when measured on thin (5-6 microm) tissue sections using conventional 2D bright field microscopy. The drawback of this approach is that most nuclei are not intact because of those thin sections. Confocal laser scanning microscopy (CLSM) allows measurements of texture in 3D reconstructed nuclei.

Implementation of accurate and fast DNA cytometry by confocal microscopy in 3D.

Background: DNA cytometry is a powerful method for measuring genomic instability. Standard approaches that measure DNA content of isolated cells may induce selection bias and do not allow interpretation of genomic instability in the context of the tissue. Confocal Laser Scanning Microscopy (CLSM) provides the opportunity to perform 3D DNA content measurements on intact cells in thick histological sections.