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Digital pathology and artificial intelligence (AI) rely on digitization of patient material as a necessary first step. AI development benefits from large sample sizes and diverse cohorts, and therefore efforts to digitize glass slides must meet these needs in an efficient and cost‐effective manner. Technical innovation in whole‐slide imaging has enabled high‐throughput slide scanning through the coordinated increase in scanner capacity, speed, and automation. Combining these hardware innovations with automated informatics approaches has enabled more efficient workflows and the opportunity to provide higher‐quality imaging data using fewer personnel. Here we review several practical considerations for deploying high‐throughput scanning and we present strategies to increase efficiency with a focus on quality. Finally, we review remaining challenges and issue a call to vendors to innovate in the areas of automation and quality control in order to make high‐throughput scanning realizable to laboratories with limited resources. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

The 2022 Annual Review Issue of The Journal of Pathology, Recent Advances in Pathology, contains 15 invited reviews on research areas of growing importance in pathology. This year, the articles include those that focus on digital pathology, employing modern imaging techniques and software to enable improved diagnostic and research applications to study human diseases. This subject area includes the ability to identify specific genetic alterations through the morphological changes they induce, as well as integrating digital and computational pathology with 'omics technologies. Other reviews in this issue include an updated evaluation of mutational patterns (mutation signatures) in cancer, the applications of lineage tracing in human tissues, and single cell sequencing technologies to uncover tumour evolution and tumour heterogeneity. The tissue microenvironment is covered in reviews specifically dealing with proteolytic control of epidermal differentiation, cancer‐associated fibroblasts, field cancerisation, and host factors that determine tumour immunity. All of the reviews contained in this issue are the work of invited experts selected to discuss the considerable recent progress in their respective fields and are freely available online (https://onlinelibrary.wiley.com/journal/10969896). © 2022 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were as follows: (1) to provide an overview of the feasibility, utility, merits, and demerits of virtual microscopy (VM) in pathological diagnostics and (2) to evaluate its advantages in dental and medical teaching over conventional microscopes. Materials and Methods: A literature survey was carried out in August 2020 in electronic databases such as PubMed using keywords such as virtual microscopy and whole slide imaging. The searches revealed 956 articles out of which 36 were selected after reading the full-text articles. Results: The review of 36 articles revealed that VM or whole-slide imaging (WSI) allows access to entire scanned sections of tissue that can be viewed on a computer in exactly the same way as conventional glass slides with a microscope and can be explored at several magnifications. VM offers many advantages like ease of accessibility through the Internet anytime or in any place, and moreover, the virtual slide does not get damaged or fade away like glass slide. Since it increases learning and comprehension, virtual microscopes have been used extensively in dental and medical education. Conclusions: VM opens a new world in tissue-based diagnosis through digitization of slides. The experiences of telepathology applications have already proved that it is a promising technology which has been adopted by histopathologists and cytologists across the world and contributing immensely to telepathology consultation in underserved areas. It is a feasible, valid, and approved technology for pathological diagnosis.

Objectives: The objectives of this study were as follows: (1) to provide an overview of the feasibility, utility, merits, and demerits of virtual microscopy (VM) in pathological diagnostics and (2) to evaluate its advantages in dental and medical teaching over conventional microscopes. Materials and Methods: A literature survey was carried out in August 2020 in electronic databases such as PubMed using keywords such as virtual microscopy and whole slide imaging. The searches revealed 956 articles out of which 36 were selected after reading the full-text articles. Results: The review of 36 articles revealed that VM or whole-slide imaging (WSI) allows access to entire scanned sections of tissue that can be viewed on a computer in exactly the same way as conventional glass slides with a microscope and can be explored at several magnifications. VM offers many advantages like ease of accessibility through the Internet anytime or in any place, and moreover, the virtual slide does not get damaged or fade away like glass slide. Since it increases learning and comprehension, virtual microscopes have been used extensively in dental and medical education. Conclusions: VM opens a new world in tissue-based diagnosis through digitization of slides. The experiences of telepathology applications have already proved that it is a promising technology which has been adopted by histopathologists and cytologists across the world and contributing immensely to telepathology consultation in underserved areas. It is a feasible, valid, and approved technology for pathological diagnosis. [ABSTRACT FROM AUTHOR]

Multimedia materials, which are one of the indispensable components of education-teaching processes; is the storage of text, images, sounds, drawings, graphics and animations on the computer and processing them for different purposes. Instructional technologies set sail for brand new techniques and applications after taking the impressive atmosphere of "multimedia", which means multimedia technologies, which replaced it. Many new inventions, from lesson preparation and planning to measurement and evaluation, have made the work of learners and instructors even more enjoyable than before. Until this stage, the production and use of visual materials was limited to broadcasting and personal efforts. The process of preparing and using in-class and extra-curricular instructional materials was a qualitative but also tedious and costly task. It was difficult to make valid, reliable, useful, low-cost and durable materials. Therefore, most of the educators preferred ready-made materials. This is the idea behind the opening of technology classrooms in schools. On the other hand, to design and create their own visual materials at each teaching level; After the middle of the 20th century, when the camera became widespread, it became one of the hobbies of educators. In addition to the camera, one of which took black and white or color photographs, a second camera was taken to take the aperture. In this period, when digital visuals could not enter schools yet, there were even educators who made the development of films as amateurs. With the arrival of computers in schools, the episcope, which takes turns in the way of warehouses, is the last slide machine to join opaque and transparent projectors such as epidiascope and overhead projector. In this study, the findings in the context of transforming personal diapositive archives into virtual slides for reuse were examined through document analysis. The concept of virtual slide has been used for the first time in pathological cell analysis in surgery since the 1990s. After making a general evaluation about the use of diapositive in the theoretical part, diapositives that I personally used between 1980-2010 were reviewed and classified in the first stage. Those suitable for scanning were scanned in a long time with a scanner device and saved in JPEG format. Then, the prominent points during the scanning of the diapositives were determined and the routes that should be followed by those who have a diapositive archive were emphasized. In the last stage, a discussion was held on the instructional value of the diapositives converted into digital images by taking the opinions of 21 academicians. [ABSTRACT FROM AUTHOR]

L'évaluation des images histologiques peut être parfois subjective et assez peu reproductible selon les cas. Par conséquent, l'analyse computationnelle de l'imagerie histologique via des approches dites d'intelligence artificielle (IA) a récemment reçu une attention considérable afin d'améliorer cette précision diagnostique. Ainsi, l'analyse computationnelle de lames virtuelles a récemment été évaluée pour l'optimisation du diagnostic histologique ou cytologique, la prédiction du pronostic ou du profil génomique des patients atteints de cancer. L'utilisation de l'IA progresse de plus en plus dans le domaine de la recherche translationnelle en anatomopathologie, mais n'a pas encore été mise en œuvre de la manière la plus pratique pour le transfert en routine clinique. Malgré des résultats prometteurs, il subsiste plusieurs défis ou enjeux majeurs à relever afin de réussir le transfert réel de cette nouvelle approche en routine clinique. Il s'agit ici de faire le point sur les applications récentes de l'IA en pathologie cancéreuse, mais aussi d'apporter des clarifications sur les avantages et les limites de cette approche, ainsi que les perspectives à mettre en œuvre pour un transfert potentiel dans la pratique quotidienne des pathologistes. The evaluation of histological images can sometimes be subjective and not very reproducible depending on the case. Therefore, computational analysis of histological imaging using the so-called «artificial intelligence» (AI) approaches has recently received considerable attention in order to improve the diagnostic accuracy. Thus, computational analysis of virtual slides has recently been evaluated for the optimization of histological or cytological diagnosis, the prediction of prognosis or genomic profile of cancer patients. The use of AI is increasingly advancing in the field of translational research in pathology, but has not yet been implemented in the most practical way for routine clinical transfer. Despite promising results, several major challenges remain to be addressed in order to successfully transfer this new approach to clinical routine. The objective is to review the recent applications of AI in cancer pathology, but also to clarify the advantages and limitations of this approach, as well as the perspectives to be implemented for a potential transfer into the daily practice of pathologists. [ABSTRACT FROM AUTHOR]

Digital microscopy combines the benefits of traditional optical microscopy and the advantages of computer sciences. Using digital whole slides in all areas of pathology is increasingly popular. Telepathology or long distance diagnosis is one such area. In our study we have evaluated digital slide based histopathology diagnosis in an international setting, between Sweden and Hungary. Routine cases from the Sundsvall County Hospital (Landstinget Vasternorrland) were collected. Glass slides were scanned using Pannoramic 250 Flash II. (3DHISTECH Ltd., Budapest, Hungary). During the first round of evaluation the glass slides were shipped to Hungary for primary diagnosis. Two pathologists from Hungary, reading glass slides and one pathologist from Sweden reading digital slides signed out 500 cases. Pathologists from Hungary reached the hospital information system with a secure connection. During the second round the pathologists in Hungary reevaluated 200 from the 500 cases using digital slides after three months washout period. Diagnostic accuracy was calculated and diagnostic errors was graded according to clinicopathological consequences. In 182/200 (91%) cases digital and optical diagnoses were in full agreement. Out of the remaining 18 cases, 1 (0.5%) critical error was identified. In this case the error had therapeutic and prognostic consequence and no uncertainty either because of case complexity or poor image quality was recorded by the pathologist. We think language and communication issues as well as differences in minimal data sets of pathological reports and in guidelines used in Sweden and in Hungary are factors potentially limiting the widespread use of digital slides in a teleconsultation service provided to Sweden from Hungary. We found the quality of digital slides in our study setting acceptable to reach correct primary diagnosis in routine, unselected, random cases of a small-to-medium sized pathology department in Sweden.

Abstract: Dermoscopic evaluation of acral volar skin is helpful in differentiating malignant melanomas (MM) from benign melanocytic nevi. However, histological diagnosis remains difficult because sufficient evidence of histopathological changes to establish a diagnosis of MM are not easily obtained. The aim of the present study was to evaluate the effective use of fluorescence in situ hybridization (FISH) in the diagnosis of acral volar melanocytic lesions, and to determine whether acral volar melanocytic lesions show characteristic molecular biological features of malignant melanoma via FISH. We classified acral volar melanocytic lesions showing junctional findings into three groups: (A) parallel ridge pattern (PRP) on dermoscopic examination with melanoma in situ; (B) PRP with insufficient melanocyte proliferation and atypia to diagnose malignant melanoma using hematoxylin–eosin staining; and (C) junctional nevi. We performed FISH analysis using the same tissue section that was used for hematoxylin–eosin staining. FISH positivity was seen in 80% (4/5) of the group A sections, and in 80% (4/5) of the group B sections. One case in group C was only 0.3% over the established criteria line (63.3% > 63% in RREB1). Our results suggest that FISH using whole‐slide digital imaging may be useful in the diagnosis of early in situ MM when a typical PRP is observed in an acral volar skin lesion with non‐diagnostic histopathology. [ABSTRACT FROM AUTHOR]

In recognition of the importance of zebrafish as a model organism for studying human disease, we have created zebrafish content for a web-based reference atlas of microanatomy for comparing histology and histopathology between model systems and with humans ( http://bio-atlas.psu.edu ). Fixation, decalcification, embedding, and sectioning of zebrafish were optimized to maximize section quality. A comparison of protocols involving six fixatives showed that 10% Neutral Buffered Formalin at 21 °C for 24 h yielded excellent results. Sectioning of juveniles and adults requires bone decalcification; EDTA at 0.35 M produced effective decalcification in 21-day-old juveniles through adults (≥~3 Months). To improve section plane consistency in sets of larvae, we have developed new array casting molds based on the outside contours of larvae derived from 3D microCT images. Tissue discontinuity in sections, a common barrier to creating quality sections of zebrafish, was minimized by processing and embedding the formalin-fixed zebrafish tissues in plasticized forms of paraffin wax, and by periodic hydration of the block surface in ice water between sets of sections. Optimal H&E (Hematoxylin and Eosin) staining was achieved through refinement of standard protocols. High quality slide scans produced from glass histology slides were digitally processed to maximize image quality, and experimental replicates posted as full slides as part of this publication. Modifications to tissue processing are still needed to eliminate the need for block surface hydration. The further addition of slide collections from other model systems and 3D tools for visualizing tissue architecture would greatly increase the utility of the digital atlas. [ABSTRACT FROM AUTHOR]

Aims We occasionally encounter patients with idiopathic pulmonary fibrosis ( IPF) who have similar imaging patterns to those of pleuroparenchymal fibroelastosis ( PPFE) in the upper lung fields but are not diagnosed as having PPFE clinically. The aim of this study is to identify the clinicopathological features and intrapulmonary distribution of elastic fibres and collagen fibres in these patients. Methods and results We retrospectively reviewed the medical records of patients with a clinical diagnosis of IPF, and selected consecutive patients who underwent autopsy or pneumonectomy for lung transplantation. Patients with histologically confirmed PPFE were also reviewed for comparison. We quantified the collagen fibres and elastic fibres in each lobe as a percentage of the non-aerated lung area (collagen fibre score and elastic fibre score, respectively) in histological specimens by using whole-slide image analysis, and compared these scores between IPF and PPFE patients. In a total of 55 patients ( IPF, 48; PPFE, 7), there were no significant differences in the collagen fibre scores between IPF and PPFE patients. The elastic fibre scores in the upper lobe in PPFE patients were significantly higher than those in IPF patients (23.5 versus 10.3, P = 0.005). However, it is of note that, in 12 of 48 IPF patients, the elastic fibre scores of the upper lobes were above the first quartile of those in PPFE patients. Conclusions IPF occasionally shows intense elastosis in the upper lobes, and such cases are histologically indistinguishable from PPFE. There seem to be histologically borderline cases between PPFE and IPF. [ABSTRACT FROM AUTHOR]

Light microscopy analysis of diatom frustules is widely used in basic and applied research, notably taxonomy, morphometrics, water quality monitoring and paleo-environmental studies. Although there is a need for automation in these applications, various developments in image processing and analysis methodology supporting these tasks have not become widespread in diatom-based analyses. We have addressed this issue by combining our automated diatom image analysis software SHERPA with a commercial slide-scanning microscope. The resulting workflow enables mass-analyses of a broad range of morphometric features from individual frustules mounted on permanent slides. Extensive automation and internal quality control of the results helps to minimize user intervention, but care was taken to allow the user to stay in control of the most critical steps (exact segmentation of valve outlines and selection of objects of interest) using interactive functions for reviewing and revising results. In this contribution, we describe our workflow and give an overview of factors critical for success, ranging from preparation and mounting through slide scanning and autofocus finding to final morphometric data extraction. To demonstrate the usability of our methods we finally provide an example application by analysing Fragilariopsis kerguelensis valves originating from a sediment core, which substantially extends the size range reported in the literature. [ABSTRACT FROM AUTHOR]

Tissue microarrays are commonly used in modern pathology for cancer tissue evaluation, as it is a very potent technique. Tissue microarray slides are often scanned to perform computer-aided histopathological analysis of the tissue cores. For processing the image, splitting the whole virtual slide into images of individual cores is required. The only way to distinguish cores corresponding to specimens in the tissue microarray is through their arrangement. Unfortunately, distinguishing the correct order of cores is not a trivial task as they are not labelled directly on the slide. The main aim of this study was to create a procedure capable of automatically finding and extracting cores from archival images of the tissue microarrays. This software supports the work of scientists who want to perform further image processing on single cores. The proposed method is an efficient and fast procedure, working in fully automatic or semi-automatic mode. A total of 89% of punches were correctly extracted with automatic selection. With an addition of manual correction, it is possible to fully prepare the whole slide image for extraction in 2 min per tissue microarray. The proposed technique requires minimum skill and time to parse big array of cores from tissue microarray whole slide image into individual core images.

Background: In recent papers, Ki67 labeling index (LI) has been used to classify breast cancer patients into the low and high Ki67LI groups for comparison studies, which showed significant differences in many prognostic factors. It has not been clarified whether image analysis software can be used for calculating LI in breast cancer. In our study, we examined whether Ki67LI in breast cancer calculated using image analysis software correlates with that measured on the basis of visual. Methods: Fifty patients were randomly selected among breast cancer patients who underwent surgical operation from March, 2010 to May, 2010 in our hospital without preoperative chemotherapy. In this study, for the virtual slide system (VSS: VS120-L100, Olympus, Tokyo, Japan), the high-resolution VSs of all the 50 patients were prepared as samples. The image analysis software use for calculating LI was Tissuemorph Digital Pathology (Tissuemorph DP: Visiopharm, Hoersholm, Denmark). The calculated LI was extracted from 3 to 5 views containing hot spots. The LI calculated using Tissuemorph DP was designed as LI/image/T. The digital image of 3 to 5 LI/image/T views was printed out, and on the digital photograph, we counted visually the number of Ki67-immunopositive cells in exactly the same area, and the percentage of Ki67-immunopositive cells was designed as LI/direct. Moreover, a pathologist's assistant (PA) determined the tumor area in the same specimen using VSS and calculated LI using Tissuemorph DP, which was designed as LI/image/PA. The chief pathologist (CP) similarly calculated LI which was designed as LI/image/CP. We evaluated the degree of agreement between different data sets 'LI/image/T and LI/direct' and 'LI/image/T, LI/image/CP, and LI/image/PA' by using interclass correlation coefficient (ICC). Results: The average counts of cells were as follows: LI/direct, 3209.7 ± 1970.4 (SD); LI/image/T, 2601.6 ± 1697.1; LI/image/PA, 2886.5 ± 2027.5; LI/image/CP, 18805.5 ± 22293.4. The values of LI/direct and LI/image/T showed almost perfect agreement as showed by an ICC of 0.885 (95 % CI, 0.806-0.933; p < 0.001). The agreement among three investigators was almost perfect. The obtained ICC was 0.825 (95 % CI, 0.739-0.890; p < 0.001) among the data of LI/image/T, LI/image/CP and LI/image/PA. There were five cases that immunopositivity for Ki67 showed a more than 10 % disagreement between LI/direct and LI/image/T. Conclusion: The merits of calculating Ki67 LI using Tissuemorph DP are as follows. First, the staining intensity of the cells to be counted can be adjusted. Second, the portion of a tumor including 'hot spots' for counting can be chosen. Third, many cancer cells can be counted more rapidly using Tissuemorph DP than by visual observation. However, it is important that pathologist should check and carry out the final decision of the data, when Ki67 LI using Tissuemorph DP is calculated. [ABSTRACT FROM AUTHOR]

Virtual microscopy is a method for digitizing images of tissue on glass slides and using a computer to view, navigate, change magnification, focus and mark areas of interest. Virtual microscope systems (also called digital pathology or whole slide imaging systems) offer several advantages for biological scientists who use slides as part of their general, pharmaceutical, biotechnology or clinical research. The systems usually are based on one of two methodologies: area scanning or line scanning. Virtual microscope systems enable automatic sample detection, virtual-Z acquisition and creation of focal maps. Virtual slides are layered with multiple resolutions at each location, including the highest resolution needed to allow more detailed review of specific regions of interest. Scans may be acquired at 2, 10, 20, 40, 60 and 100 × or a combination of magnifications to highlight important detail. Digital microscopy starts when a slide collection is put into an automated or manual scanning system. The original slides are archived, then a server allows users to review multilayer digital images of the captured slides either by a closed network or by the internet. One challenge for adopting the technology is the lack of a universally accepted file format for virtual slides. Additional challenges include maintaining focus in an uneven sample, detecting specimens accurately, maximizing color fidelity with optimal brightness and contrast, optimizing resolution and keeping the images artifact-free. There are several manufacturers in the field and each has not only its own approach to these issues, but also its own image analysis software, which provides many options for users to enhance the speed, quality and accuracy of their process through virtual microscopy. Virtual microscope systems are widely used and are trusted to provide high quality solutions for teleconsultation, education, quality control, archiving, veterinary medicine, research and other fields. [ABSTRACT FROM AUTHOR]

Summary Conventional light microscopy has been used to characterize and classify renal diseases, evaluate histopathology in studies and trials, and educate renal pathologists and nephrologists. The advent of digital pathology, in which a glass slide can be scanned to create whole slide images (WSIs) for viewing and manipulating on a computer monitor, provides real and potential advantages compared with conventional light microscopy. Software tools such as annotation, morphometry, and image analysis can be applied to WSIs for studies or educational purposes, and the digital images are available globally to clinicians, pathologists, and investigators. New ways of assessing renal pathology with observational data collection may allow better morphologic correlations and integration with molecular and genetic signatures, refinements of classification schema, and understanding of disease pathogenesis. In multicenter studies, WSIs, which require additional quality assurance steps, provide efficiency by reducing slide shipping and consensus conference costs, and they allow slide viewing anytime and anywhere. Although validation studies for the routine diagnostic use of digital pathology still are needed, this is a powerful tool currently available for translational research, clinical trials, and education in renal pathology. [ABSTRACT FROM AUTHOR]

Digital microscopy combines the benefits of traditional optical microscopy and the advantages of computer sciences. Using digital whole slides in all areas of pathology is increasingly popular. Telepathology or long distance diagnosis is one such area. In our study we have evaluated digital slide based histopathology diagnosis in an international setting, between Sweden and Hungary. Routine cases from the Sundsvall County Hospital (Landstinget Vasternorrland) were collected. Glass slides were scanned using Pannoramic 250 Flash II. (3DHISTECH Ltd., Budapest, Hungary). During the first round of evaluation the glass slides were shipped to Hungary for primary diagnosis. Two pathologists from Hungary, reading glass slides and one pathologist from Sweden reading digital slides signed out 500 cases. Pathologists from Hungary reached the hospital information system with a secure connection. During the second round the pathologists in Hungary reevaluated 200 from the 500 cases using digital slides after three months washout period. Diagnostic accuracy was calculated and diagnostic errors was graded according to clinicopathological consequences. In 182/200 (91%) cases digital and optical diagnoses were in full agreement. Out of the remaining 18 cases, 1 (0.5%) critical error was identified. In this case the error had therapeutic and prognostic consequence and no uncertainty either because of case complexity or poor image quality was recorded by the pathologist. We think language and communication issues as well as differences in minimal data sets of pathological reports and in guidelines used in Sweden and in Hungary are factors potentially limiting the widespread use of digital slides in a teleconsultation service provided to Sweden from Hungary. We found the quality of digital slides in our study setting acceptable to reach correct primary diagnosis in routine, unselected, random cases of a small-to-medium sized pathology department in Sweden. [ABSTRACT FROM AUTHOR]

Abstract: Telepathology provides pathology services over a distance using digital imaging and telecommunication for primary diagnostic practice, including intraoperative frozen sections. Virtual slide technology provides digitizing of histological slides by scanner systems and improved remote assessment substantially. In this retrospective study, diagnostic accuracy of intraoperative frozen sections assessed as virtual slide was determined. Tissue assessment was mainly requested for urological, gynecological and dermatological resections. Issues of time consumption, cost and cost effectiveness of this diagnostic method are discussed. 1204 intraoperative frozen sections were conducted in the course of this study at our department over a period of 2.5 years. 98.59% of all intraoperative frozen sections were accurately diagnosed in the initial telepathological assessment. Tumor affection was present in 15.6% of frozen sections, in 174 instances already assessed in the initial slides (sensitivity 92.6%). Discrepant diagnoses compared to the final diagnosis occurred in 1.41%. Our determined averaged time for virtual slide technology of 10.58±8.19min can be ranged in well. Our study did not allow a full economic assessment, but some preliminary insights are pointed out. The quality of services is highly acceptable and the investment costs and the labor cost of virtual slide technology are lower than those of robotic microscopy. [Copyright &y& Elsevier]

Aims: To create and evaluate a virtual reality (VR) microscope that is as efficient as the conventional microscope, seeking to support the introduction of digital slides into routine practice. Methods and results: A VR microscope was designed and implemented by combining ultra-high-resolution displays with VR technology, techniques for fast interaction, and high usability. It was evaluated using a mixed factorial experimental design with technology and task as within-participant variables and grade of histopathologist as a between-participant variable. Time to diagnosis was similar for the conventional and VR microscopes. However, there was a significant difference in the mean magnification used between the two technologies, with participants working at a higher level of magnification on the VR microscope. Conclusions: The results suggest that, with the right technology, efficient use of digital pathology for routine practice is a realistic possibility. Further work is required to explore what magnification is required on the VR microscope for histopathologists to identify diagnostic features, and the effect on this of the digital slide production process. [ABSTRACT FROM AUTHOR]

Abstract: Follicular lymphoma (FL) is one of the most common types of non-Hodgkin''s lmphomas in the world. Diagnosis of FL is based on morphological and immunohistochemical characteristics found on tissue sections. Our project''s aim is to develop computer-aided analysis tools on virtual slide images (VSI) of lymphoid tissues with the purpose of improving the FL grading performed in malignant follicles. In this paper, we focus on the first step of our work, an automated system for detecting follicles in VSI of lymphoid tissues. To mimic the human expert process, the system works on low-resolution CD20 images and maps the follicle boundaries on high-resolution H&E images. [Copyright &y& Elsevier]

Abstract: Rapid advances are occurring in the field of cytopathology education and training. Web-based cytopathology educational resources and whole slide imaging (WSI) have revolutionized cytopathology education and helped to centralize the cytopathology resources enabling simultaneous delivery of interactive cytopathology educational programs to a wide range of students and learners nationally and across the globe. WSI is playing a central role in digital pathology and are being utilized as an educational tool in many areas of pathology and cytopathology. This is mainly due to their easy access from anywhere and anytime, with no need for replication of glass slides or a big concern about the issue of protection of patient privacy. Today, WSI is used in a variety of educational settings, as a substitute to multi-headed microscopic sessions, multisite conferences, cytopathology web pages, self-assessment in cytology, cytology proficiency testing, virtual atlases, and very recently in scientific publications. [Copyright &y& Elsevier]

Background: An online consultation system using virtual slides (whole slide images; WSI) has been developed for pathological diagnosis, and could help compensate for the shortage of pathologists, especially in the field of dermatopathology and in other fields dealing with difficult cases. This study focused on the performance and future potential of the system. Method: In our system, histological specimens on slide glasses are digitalized by a virtual slide instrument, converted into web data, and up-loaded to an open server. Using our own purpose-built online system, we then input patient details such as age, gender, affected region, clinical data, past history and other related items. We next select up to ten consultants. Finally we send an e-mail to all consultants simultaneously through a single command. The consultant receives an e-mail containing an ID and password which is used to access the open server and inspect the images and other data associated with the case. The consultant makes a diagnosis, which is sent to us along with comments. Because this was a pilot study, we also conducted several questionnaires with consultants concerning the quality of images, operability, usability, and other issues. Results: We solicited consultations for 36 cases, including cases of tumor, and involving one to eight consultants in the field of dermatopathology. No problems were noted concerning the images or the functioning of the system on the sender or receiver sides. The quickest diagnosis was received only 18 minutes after sending our data. This is much faster than in conventional consultation using glass slides. There were no major problems relating to the diagnosis, although there were some minor differences of opinion between consultants. The results of questionnaires answered by many consultants confirmed the usability of this system for pathological consultation. (16 out of 23 consultants.) Conclusion: We have developed a novel teledermatopathological consultation system using virtual slides, and investigated the usefulness of the system. The results demonstrate that our system can be a useful tool for international medical work, and we anticipate its wider application in the future. [ABSTRACT FROM AUTHOR]

Background: Medical education in pathology and histology in low-resource countries face many obstacles because of equipment cost and telecommunication deficiencies. Digital Pathology may provide solutions. We report student experience to virtual slides on a local network and a remote image server. Methods: Using an iPad tablet device, fifty 3rd and 4th year medical students viewed digital pathology slides from a Web server at the National Library of Medicine and a mirror server on the local network. Results: The quality of images from both servers was found to be satisfactory, but the local server was deemed faster and preferred by the participants in this study (p < 0.005). Conclusions: Virtual slides on a local network server may provide solutions to equipment and technical obstacles and could enhance student learning in developing countries. [ABSTRACT FROM AUTHOR]