New Applications in Whole Slide Imaging Future Clinical Solutions

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New Applications in Whole Slide ImagingFuture
Clinical Solutions

• Keith J. Kaplan, MD
• Department of Pathology and Laboratory Medicine
• Mayo Clinic

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Virtual microscopy
Telepathology
PACS signout Virtual IHC Consultation
Diagnosis Consultation
Reporting Links to images Digital archive
Targeted therapies Image based searches
Digital Pathology Digital Data Set/Whole slide
image
Image analysis CAD
Imaging Archiving
HSI Rare event detection
Undergraduate GME/CME
TMA Comparative analysis
Education
Research
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Telepathology at Mayo Clinic

• Intramural practice
• Extramural practice

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December 2, 1905 JAMA
December 28, 2005 JAMA
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Extramural cases

• Informal market research suggests about 25
  clients interested in sending cases using
  telepathology
• Clients purchasing systems and inquiring about
  practice
• Real-time consultation (FS) or discussion
• Retain original material (cytology)

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Digital Pathology WG

• Telepathology WG formed March 2008
• Name changed to Digital Pathology WG
• Primary vs. Consultation
• Real-time vs. Consultation remote access
• Whole slide images gt dynamic gt static
• FedEx argument
• Types of cases/deferrals
• Workflow accessioning, reporting, billing

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NCCTG Clinical Trials
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Hyperspectral Imaging
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General Image Capture Problems

• Fundamental problem of large background
  illumination levels that need to be removed from
  data
• Due to a weak reflection off glass slide
• Off-axis illumination improved problem
• Lamp stability across image and over time
• Improved with off-axis illumination and increased
  integration time of the camera
• Switch to filament lamp improved stability
• Use of 12-bit camera limited dynamic range

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Spectral Signature Matching
AKA fingerprint identification
Counts per second
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Signature Matching
An unknown sample is tested
Known Samples are measured, labeled and stored in
the Spectral Signature Library
And then the spectral signature compared against
those stored in the analyzers Signature Library.
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Medicine 2.0 and Digital Pathology
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What is Medicine 2.0?

• Web 2.0 Medicine
• Web 1.0 users follow content
• Web 2.0 users comment, edit and create content

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Web 1.0 ? Web 2.0
Source What Is Web 2.0 - Tim O'Reilly, modified
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Harnessing Collective Intelligence and Keeping it
Simple

• Yahoo (index catalog) ? Google (page rank)
• Directory of links ? Uses link structure
• Barnes and Noble ? Amazon
• Same inventory ? Multitude of reader reviews,
  most popular, real-time stats of purchases and
  1-click ordering
• Digital pathology no different
• Best content immediately available
• By users for users

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Digital Pathology and Medicine 2.0
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Patient report
Specialist report
Pathology report
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• PDF
• E-mail
• Web-enabled
• RSS

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Why is this important?

• Mayo Clinic website receives about 1 million hits
  per month
• Daily Kos has nearly that many page views on an
  average day
• About 10-15 of users become patients
• Getting the word out for Centers of Excellence
• Attracting e-consumers to patients

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www.tissuepathology.com www.digitalpathologyblog.c
om
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Thank you