Development of a multi-scanner facility for data acquisition for digital pathology artificial intelligence.

Whole slide imaging (WSI) of pathology glass slides using high-resolution scanners has enabled the large-scale application of artificial intelligence (AI) in pathology, to support the detection and diagnosis of disease, potentially increasing efficiency and accuracy in tissue diagnosis. Despite the promise of AI, it has limitations. 'Brittleness' or sensitivity to variation in inputs necessitates that large amounts of data are used for training.

Pathologists light level preferences using the microscope-study to guide digital pathology display use.

Background: Currently, there is a paucity of guidelines relating to displays used for digital pathology making procurement decisions, and optimal display configuration, challenging.Experience suggests pathologists have personal preferences for brightness when using a conventional microscope which we hypothesized could be used as a predictor for display setup.

Methods: We conducted an online survey across six NHS hospitals, totalling 108 practicing pathologists, to capture brightness adjustment habits on both microscopes and displays.

Quantitative assessment of H&E staining for pathology: development and clinical evaluation of a novel system.

Background: Staining tissue samples to visualise cellular detail and tissue structure is at the core of pathology diagnosis, but variations in staining can result in significantly different appearances of the tissue sample. While the human visual system is adept at compensating for stain variation, with the growth of digital imaging in pathology, the impact of this variation can be more profound. Despite the ubiquity of haematoxylin and eosin staining in clinical practice worldwide, objective quantification is not yet available.

The need for measurement science in digital pathology.

Background: Pathology services experienced a surge in demand during the COVID-19 pandemic. Digitalisation of pathology workflows can help to increase throughput, yet many existing digitalisation solutions use non-standardised workflows captured in proprietary data formats and processed by black-box software, yielding data of varying quality. This study presents the views of a UK-led expert group on the barriers to adoption and the required input of measurement science to improve current practices in digital pathology.

Emissivity evaluation of human enamel and dentin.

Human enamel and dentin temperatures have been assessed with non-contact infrared imaging devices for safety and diagnostic capacity and require an emissivity parameter to enable absolute temperature measurements. Emissivity is a ratio of thermal energy emitted from an object of interest, compared to a perfect emitter at a given temperature and wavelength, being dependent on tissue composition, structure, and surface texture. Evaluating the emissivity of human enamel and dentin is varied in the literature and warrants review.

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments.

Is current body temperature measurement practice fit-for-purpose?

There has been a marked rise in the number of avoidable deaths in health services around the world. At the same time there has been a growing increase in antibiotic resistant so-called "superbugs." We examine here the potential role of body temperature measurement in these adverse trends.

A Point-of-Use Quality Assurance Tool for Digital Pathology Remote Working.

Pathology services are facing pressures due to the COVID-19 pandemic. Digital pathology has the capability to meet some of these unprecedented challenges by allowing remote diagnoses to be made at home, during periods of social distancing or self-isolation. However, while digital pathology allows diagnoses to be made on standard computer screens, unregulated home environments may not be conducive for optimal viewing conditions.

Guidance for Remote Reporting of Digital Pathology Slides During Periods of Exceptional Service Pressure: An Emergency Response from the UK Royal College of Pathologists.

Pathology departments must rise to new staffing challenges caused by the coronavirus disease-19 pandemic and may need to work more flexibly for the foreseeable future. In light of this, many pathologists and departments are considering the merits of remote or home reporting of digital cases. While some individuals have experience of this, little work has been done to determine optimum conditions for home reporting, including technical and training considerations.

Display evaluation for primary diagnosis using digital pathology.

As pathology departments around the world contemplate digital microscopy for primary diagnosis, making an informed choice regarding display procurement is very challenging in the absence of defined minimum standards. In order to help inform the decision, we aimed to conduct an evaluation of displays with a range of technical specifications and sizes. We invited histopathologists within our institution to take part in a survey evaluation of eight short-listed displays.

Development and Evaluation of a Novel Point-of-Use Quality Assurance Tool for Digital Pathology.

Context.—: Flexible working at diverse or remote sites is a major advantage when reporting using digital pathology, but currently there is no method to validate the clinical diagnostic setting within digital microscopy.

Objective.

Thermal Maps to Characterize Human Dental Enamel and Dentin.

The crown of a human tooth has an outer layer of highly-mineralized tissue called enamel, beneath which is dentin, a less-mineralized tissue which forms the bulk of the tooth-crown and root. The composition and structure of enamel and dentin are different, resulting in different thermal properties. This gives an opportunity to characterize enamel and dentin from their thermal properties and to visually present the findings as a thermal map.

Extra patient movement during mammographic imaging: an experimental study.

Objective: To determine if movement external to the patient occurring during mammography may be a source of image blur.

Methods: Four mammography machines with eight flexible and eight fixed paddles were evaluated. In the first stage, movement at the paddle was measured mechanically using two calibrated linear potentiometers.

Effect of display resolution on time to diagnosis with virtual pathology slides in a systematic search task.

Performing diagnoses using virtual slides can take pathologists significantly longer than with glass slides, presenting a significant barrier to the use of virtual slides in routine practice. Given the benefits in pathology workflow efficiency and safety that virtual slides promise, it is important to understand reasons for this difference and identify opportunities for improvement. The effect of display resolution on time to diagnosis with virtual slides has not previously been explored.

An investigation of the radiation doses to the lower legs and feet of staff undertaking interventional procedures.

Objective: Occupational radiation doses from fluoroscopic procedures are some of the highest doses of exposure amongst medical staff using radiography. Protective equipment and dose monitoring are used to minimize and control the risk from these occupational doses. Other studies have considered the effectiveness of this protection, but this study further considers whether protection is adequate for the lower leg and foot and the extent to which these doses can be reduced.

Surfing the spectrum - what is on the horizon?

Diagnostic imaging techniques have evolved with technological advancements - but how far? The objective of this article was to explore the electromagnetic spectrum to find imaging techniques which may deliver diagnostic information of equal, or improved, standing to conventional radiographs and to explore any developments within radiography which may yield improved diagnostic data. A comprehensive literature search was performed using Medline, Web of Knowledge, Science Direct and PubMed Databases. Boolean Operators were used and key-terms included (not exclusively): terahertz, X-ray, ultraviolet, visible, infra-red, magnetic resonance, dental, diagnostic, caries and periodontal.

Organ and effective dose reduction in adult chest CT using abdominal lead shielding.

Objectives: The purpose of this study was to evaluate and compare organ and effective dose savings that could be achieved using conventional lead aprons and a new, custom-designed shield as out-of-plane shielding devices during chest CT scans.

Methods: Thermoluminescent dosimeters were used to measure doses throughout the abdomen and pelvis during CT scans of the chest of a RANDO phantom. Dose measurements were made with no shielding, with lead aprons and with the new shield around the abdomen and pelvis in order to quantify the achievable organ and effective dose reductions.

The impact of digital image processing artefacts mimicking pathological features associated with restorations.

Background: Image processing of digital X-ray images is known to have the potential to produce artefacts that may mimic pathology. A study was conducted at a UK dental radiology conference to demonstrate this effect in dentistry.

Method: Sixteen digital X-rays of single teeth containing restorations were randomly presented in both unprocessed and processed formats to an auditorium of 42 participants.

Assessment of ultrasound monitor image display performance.

The display monitor on an ultrasound scanner is used to make primary diagnoses. In this study, 31 ultrasound systems were assessed against current American Association of Physicists in Medicine (AAPM) display standards. Measurements of peak levels (L(max) and L(min)) were generated.

Investigation of uncertainties in image registration of cone beam CT to CT on an image-guided radiotherapy system.

Methods of measuring uncertainties in rigid body image registration of fan beam computed tomography (FBCT) to cone beam CT (CBCT) have been developed for automatic image registration algorithms in a commercial image guidance system (Synergy, Elekta, UK). The relationships between image registration uncertainty and both imaging dose and image resolution have been investigated with an anthropomorphic skull phantom and further measurements performed with patient images of the head. A new metric of target registration error is proposed.

Measurement of cone beam CT coincidence with megavoltage isocentre and image sharpness using the QUASAR Penta-Guide phantom.

For image-guided radiotherapy (IGRT) systems based on cone beam CT (CBCT) integrated into a linear accelerator, the reproducible alignment of imager to x-ray source is critical to the registration of both the x-ray-volumetric image with the megavoltage (MV) beam isocentre and image sharpness. An enhanced method of determining the CBCT to MV isocentre alignment using the QUASAR Penta-Guide phantom was developed which improved both precision and accuracy. This was benchmarked against our existing method which used software and a ball-bearing (BB) phantom provided by Elekta.

Modelling the effect of lead and other materials for shielding of the fetus in CT pulmonary angiography.

The aim of this work is to construct and validate a model to describe the variation in fetal dose as a function of the thickness of abdominal lead shielding used during CT pulmonary angiography and to determine the optimal shielding material. An anthropomorphic phantom was modified to contain a 15 cm(3) ionization chamber at the site of the uterus. Fetal dose was measured with varying thicknesses of lead shielding at four values of tube potential (kV(p)).

Display considerations for hospital-wide viewing of soft copy images.

Digital imaging is progressively replacing film for the acquisition and display of diagnostic images in modern health care. Specifications for the devices used for the soft copy display of images are not currently well defined, nor are the requirements for optimal set-up and quality assurance. This paper considers the current situation and presents potential hospital-wide solutions for the outstanding issues.

Investigation into the effects of lead shielding for fetal dose reduction in CT pulmonary angiography.

This work aims to determine whether lead shielding can be used to decrease the radiation dose to the fetus during CT scans for the diagnosis of pulmonary embolism during early stage pregnancy. An anthropomorphic phantom was modified to contain a 15 cc ionization chamber at the site of the uterus to enable fetal dose to be measured. The effects of a range of scan parameters, positioning of lead and thicknesses of lead were investigated.

Quantification of dental fluorosis using fluorescence imaging.

Fluorescence imaging hardware and software have been recently employed to assess demineralization due to early dental caries. Dental fluorosis also presents as diffuse surface hypomineralization of enamel and in principle similar measurement methods might be applicable to both. The caries analysis system requires the user to select an area of sound enamel around the lesion so that the affected surface can be reconstructed and the lesion subtracted.