Search

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products. [ABSTRACT FROM AUTHOR]

Anatomic pathology reports (APR) provide diagnostic and prognostic information crucial to patient care, clinical research and epidemiology. Currently, it is difficult to collect and exchange APR data between different healthcare organizations at an international level. Objective: IHE and HL7 anatomic pathology joint efforts aim at providing a methodology and tools to define an international HL7 “Clinical Document Architecture” (CDA) implementation guide for APRs and especially in the domain of cancer. Methods: A four-step methodology is employed, consisting of comparing existing clinical model of APRs originating from different countries; deriving consensus-based clinical models (Delphi technique); providing the corresponding HL7 CDA implementation guide (“CDA templates”) and validating these templates. Results: International experts defined HL7 CDA implementation guides for breast and colon cancer APRs within an IHE content profile. CDA templates include required data elements, as well as optional ones, that can be further specified as required in national extensions. Conclusion: This study demonstrates that it is possible to define an international HL7 CDA implementation guide for cancer APRs. Further efforts are needed to provide CDA templates for approximately 60 other cancer APRs dedicated to different organs, diagnoses, and procedures as well as for APRs of non neoplastic pathologies. The methodology is not confined to APRs and could be applied to clinical documents of any type. [ABSTRACT FROM AUTHOR]

The COST Action IC0604 “Telepathology Network in Europe” (EURO-TELEPATH) is an initiative of the COST (European Cooperation in the field of Scientific and Technical Research) framework, supported by the Seventh Framework Programme for research and technological development (FP7), of the European Union will be running from 2007 to 2011 and is aimed to coordinate research efforts to develop the most adequate technological framework for the management of multimedia electronic healthcare records (data and images) applied to Anatomic Pathology. Sixteen countries are participating in EURO-TELEPATH. Activities are organized in four Working Groups (WGs): WG1 – Pathology Business Modeling, WG2 – Informatics Standards in Pathology, WG3 – Images: Analysis, Processing, Retrieval and Management, and WG4 – Technology and Automation in Pathology. During the first year of work, the collaboration between software engineers, computer scientists, pathologists and other clinicians has been essential to detect three main areas of interest in digital pathology research: virtual microscopy scanning solutions, health informatics standards, and image processing and analysis. Research in these areas is essential to a correct approach to telepathology, including primary diagnosis, and secondary or teleconsultation services. Managing microscopic pathology images (virtual slides) is a challenge to existing information systems, mainly due to its large size, large number, and complex interpretation. Regarding interoperability, the integration of pathology reports and images into eHealth records is an essential objective that research groups should consider. Promoting participation in standards bodies (DICOM, IHE, HL7, IHTSDO) is an essential part of the project work. Understanding the business process of pathology departments in daily practice, including healthcare, education, research, and quality control activities, is the starting point to be sure that standardization efforts converge with user needs. Following a recent IHE proposal, coordination with public health services like national or regional tumor registries must also be supported. Virtual or digital slides are fostering the use of image processing and analysis in pathology not only for research purposes, but also in daily practice. Nowadays, further discussion is needed on the adequacy of current existing technical solutions, including for instance quality of images obtained by scanners, or the efficiency of image analysis applications. [ABSTRACT FROM AUTHOR]

For making medical decisions, healthcare professionals require that all necessary information is both correct and easily available. We address the issue of integrating anatomical pathology department information into the electronic healthcare enterprise. The pathology workflow from order to report, including specimen processing and image acquisition was modelled. An integration profile - pathology general workflow- was created in the framework of the Integrating the Healthcare Enterprise (IHE). This Integration Profile relies on 8 transactions based on HL7 or DICOM standards. An important issue was to define information entities (order, imaging study and report) and real-world objects (specimen, tissue sample, slide, etc.). Joint efforts between IHE and DICOM WG26 has resulted in a proposed common model for “specimen” usable for both HL7 and DICOM transactions related to anatomic pathology. [ABSTRACT FROM AUTHOR]

Aims: The prognostic impact of programmed death-ligand 1 (PD-L1) cells in classic Hodgkin lymphoma (cHL) tumour microenvironment remains undefined., Methods: Model development via Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guidelines were followed. PD-L1+ and CD30+ tumoral Reed-Sternberg cells were quantified through whole slide imaging and digital image analysis in 155 digital histopathological slides of cHL. Univariate and multivariate survival analyses were performed. The analyses were reproduced for patients with advanced stages (IIB, III and IV) using the Advanced-stage cHL International Prognostic Index., Results: The PD-L1/CD30 ratio was statistically significantly associated with survival outcomes. Patients with a PD-L1/CD30 ratio above 47.1 presented a shorter overall survival (mean OS: 53.7 months; 95% CI: 28.7 to 78.7) in comparison with patients below this threshold (mean OS: 105.4 months; 95% CI: 89.6 to 121.3) (p=0.04). When adjusted for covariates, the PD-L1/CD30 ratio retained prognostic impact, both for the OS (HR: 1.005; 95% CI: 1.002 to 1.008; p=0.000) and the progression-free survival (HR: 3.442; 95% CI: 1.045 to 11.340; p=0.04) in a clinical and histopathological multivariate model including the male sex (HR: 3.551; 95% CI: 0.986 to 12.786; p=0.05), a percentage of tumoral cells ≥10.1% (HR: 1.044; 95% CI: 1.003 to 1.087; p=0.03) and high risk International Prognostic Score (≥3 points) (HR: 6.453; 95% CI: 1.970 to 21.134; p=0.002)., Conclusions: The PD-L1/CD30 ratio identifies a group of cHL patients with an increased risk of treatment failure. Its clinical application can be performed as it constitutes an easy to implement pathological information in the diagnostic work-up of patients with cHL., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Unlabelled: Anatomic pathology reports (APR) provide diagnostic and prognostic information crucial to patient care, clinical research and epidemiology. Currently, it is difficult to collect and exchange APR data between different healthcare organizations at an international level., Objective: IHE and HL7 anatomic pathology joint efforts aim at providing a methodology and tools to define an international HL7 "Clinical Document Architecture" (CDA) implementation guide for APRs and especially in the domain of cancer., Methods: A four-step methodology is employed, consisting of comparing existing clinical model of APRs originating from different countries; deriving consensus-based clinical models (Delphi technique); providing the corresponding HL7 CDA implementation guide ("CDA templates") and validating these templates., Results: International experts defined HL7 CDA implementation guides for breast and colon cancer APRs within an IHE content profile. CDA templates include required data elements, as well as optional ones, that can be further specified as required in national extensions., Conclusion: This study demonstrates that it is possible to define an international HL7 CDA implementation guide for cancer APRs. Further efforts are needed to provide CDA templates for approximately 60 other cancer APRs dedicated to different organs, diagnoses, and procedures as well as for APRs of non neoplastic pathologies. The methodology is not confined to APRs and could be applied to clinical documents of any type.

The COST Action IC0604 "Telepathology Network in Europe" (EURO-TELEPATH) is an initiative of the COST (European Cooperation in the field of Scientific and Technical Research) framework, supported by the Seventh Framework Programme for research and technological development (FP7), of the European Union will be running from 2007 to 2011 and is aimed to coordinate research efforts to develop the most adequate technological framework for the management of multimedia electronic healthcare records (data and images) applied to Anatomic Pathology. Sixteen countries are participating in EURO-TELEPATH. Activities are organized in four Working Groups (WGs): WG1 - Pathology Business Modeling, WG2 - Informatics Standards in Pathology, WG3 - Images: Analysis, Processing, Retrieval and Management, and WG4 - Technology and Automation in Pathology. During the first year of work, the collaboration between software engineers, computer scientists, pathologists and other clinicians has been essential to detect three main areas of interest in digital pathology research: virtual microscopy scanning solutions, health informatics standards, and image processing and analysis. Research in these areas is essential to a correct approach to telepathology, including primary diagnosis, and secondary or teleconsultation services. Managing microscopic pathology images (virtual slides) is a challenge to existing information systems, mainly due to its large size, large number, and complex interpretation. Regarding interoperability, the integration of pathology reports and images into eHealth records is an essential objective that research groups should consider. Promoting participation in standards bodies (DICOM, IHE, HL7, IHTSDO) is an essential part of the project work. Understanding the business process of pathology departments in daily practice, including healthcare, education, research, and quality control activities, is the starting point to be sure that standardization efforts converge with user needs. Following a recent IHE proposal, coordination with public health services like national or regional tumor registries must also be supported. Virtual or digital slides are fostering the use of image processing and analysis in pathology not only for research purposes, but also in daily practice. Nowadays, further discussion is needed on the adequacy of current existing technical solutions, including for instance quality of images obtained by scanners, or the efficiency of image analysis applications.

For making medical decisions, healthcare professionals require that all necessary information is both correct and easily available. We address the issue of integrating anatomical pathology department information into the electronic healthcare enterprise. The pathology workflow from order to report, including specimen processing and image acquisition was modelled. An integration profile - pathology general workflow- was created in the framework of the Integrating the Healthcare Enterprise (IHE). This Integration Profile relies on 8 transactions based on HL7 or DICOM standards. An important issue was to define information entities (order, imaging study and report) and real-world objects (specimen, tissue sample, slide, etc.). Joint efforts between IHE and DICOM WG26 has resulted in a proposed common model for "specimen" usable for both HL7 and DICOM transactions related to anatomic pathology.