2007- SSVS for hand held microscopes

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Whole slide of small size. SSVS (small size virtual slide)

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2007- SSVS for hand held microscopes

  1. 1. Telepathology and Distant DiagnosisTelepathology and Distant Diagnosis with SMALL SIZEVIRTUAL SLIDESwith SMALL SIZEVIRTUAL SLIDES (SSVS)(SSVS) Eng. Marcano, Fco & Prof. Dr. O. Ferrer-RocaEng. Marcano, Fco & Prof. Dr. O. Ferrer-Roca 20072007.. UNESCO Chair in TelemedicineUNESCO Chair in Telemedicine University of La LagunaUniversity of La Laguna Quality Control in Telemedicine - BiobankingQuality Control in Telemedicine - Biobanking CATAI - XVI Winter CourseCATAI - XVI Winter Course ULL - XXI Image Analisys CourseULL - XXI Image Analisys Course http://www.teide.net/catai
  2. 2. ContentsContents • IntroductionIntroduction • VSVS • SSVSSSVS • SSVS quality assessmentSSVS quality assessment • ResultsResults • ConclusionsConclusions
  3. 3. Virtual SlidesVirtual Slides • Specimens converted to digitalSpecimens converted to digital imagesimages • Images are transmitted overImages are transmitted over networks, Internetnetworks, Internet • Remote Analysis, Diagnosis,Remote Analysis, Diagnosis, teaching purposesteaching purposes © Telemedicine Research Group - University of Udine, Italy Bone biopsy Area: 2.8x8.2 mm Pixels: about 290M
  4. 4. Virtual Slide Capture SystemsVirtual Slide Capture Systems High power VS (40x)  Image size in the order of Gigabytes Expensive equipments 50000€ - 250000€
  5. 5. Virtual Slides SizeVirtual Slides Size • Demands aDemands a lot oflot of storagestorage • JPEG basedJPEG based imagesimages 20x20x compressioncompression © Department of Pathology. Clínica Universitaria. University of Navarra. Pamplona. Spain.
  6. 6. Virtual Slides Size - QCVirtual Slides Size - QC • Technique:Technique: linearlinear scanningscanning • ImageImage artifactsartifacts • EquipmentEquipment price vs.price vs. ImageImage qualityquality ?? © Department of Pathology. Clínica Universitaria. University of Navarra. Pamplona. Spain.
  7. 7. Virtual Slides Size - QCVirtual Slides Size - QC • GoodGood AlignmentAlignment © Department of Pathology. Clínica Universitaria. University of Navarra. Pamplona. Spain.
  8. 8. VS – High PowerVS – High Power  Not alwaysNot always necessarynecessary to haveto have high-powerhigh-power imagesimages  Images:Images: severalseveral GigabytesGigabytes 1.3X 3.9X 11.1X 40X
  9. 9. e-Slidese-Slides • Telemedicine Research Group - University of Udine, ItalyTelemedicine Research Group - University of Udine, Italy © Telemedicine Research Group - University of Udine, Italy  Technique:Technique: stitching ofstitching of imagesimages  CheaperCheaper approachapproach  JPEG basedJPEG based imagesimages  Size: stillSize: still very largevery large
  10. 10. e-Slides - QCe-Slides - QC © Telemedicine Research Group - University of Udine, Italy  Stitching ofStitching of imagesimages  more imagemore image artifactsartifacts
  11. 11. e-Slides - QCe-Slides - QC © Telemedicine Research Group - University of Udine, Italy  ProblemsProblems with imagewith image alignmentalignment
  12. 12. Small Size Virtual Slides –Small Size Virtual Slides – SSVS©SSVS© • Novel TechniqueNovel Technique • Generates digital slides small in sizeGenerates digital slides small in size • High resolution cameras (8-12 Mpx)High resolution cameras (8-12 Mpx) • Excellent achromatic planapochromatic (infinite)Excellent achromatic planapochromatic (infinite) opticsoptics SSVS© 2008
  13. 13. Small Size Virtual Slides –Small Size Virtual Slides – SSVS©SSVS© • Uses Image-Compression format: JPEG2000Uses Image-Compression format: JPEG2000 (ISO 15444-1, Wavelet)(ISO 15444-1, Wavelet) • Take advantage of JPEG2000 Image format toTake advantage of JPEG2000 Image format to facilitate:facilitate: • navigation,navigation, • zooming,zooming, • transmission,transmission, • storagestorage SSVS© 2008
  14. 14. JPEG2000JPEG2000 • Created by theCreated by the JJointoint PPhotographichotographic EExpertsxperts GGroup committeeroup committee (2000)(2000) • Intended to supersede discrete cosine transform-based JPEGIntended to supersede discrete cosine transform-based JPEG standard (1991)standard (1991) • Standard Filename extension:Standard Filename extension: jp2 (ISO/IEC 15444-1 conforming files)jp2 (ISO/IEC 15444-1 conforming files) jpx (Extended part-2 specifications or ISO/IEC 15444-2)jpx (Extended part-2 specifications or ISO/IEC 15444-2) • Included in DICOM sup. 61 (Jan 2002)Included in DICOM sup. 61 (Jan 2002)
  15. 15. JPEG2000 Standard - PartsJPEG2000 Standard - Parts • Part 1, Core coding system (intended as royalty and license-fee free - NB NOT patent-free) • Part 2, Extensions (adds more features and sophistication to the core) • Part 3, Motion JPEG 2000 • Part 4, Conformance • Part 5, Reference software (Java and C implementations are available) • Part 6, Compound image file format (document imaging, for pre-press and fax-like applications, etc.) • Part 7 has been abandoned • Part 8, JPSEC (security aspects) • Part 9, JPIP (interactive protocols and API) • Part 10, JP3D (volumetric imaging) • Part 11, JPWL (wireless applications) • Part 12, ISO Base Media File Format (common with MPEG-4)
  16. 16. JPEG2000JPEG2000 • Complex algorithm for compression / decompression takes a long timeComplex algorithm for compression / decompression takes a long time Compressed Image decompression Source Image Color Transformation Tiling Wavelet Transform Quantization Tier-1 Encoder (Modeling & Arithmetic Coding) Tier-2 Encoder (Stream Creation) Rate Control 8 7 8 8 34 34 34 34 7 7 8 8 34 34 34 34 8 8 12 12 34 34 34 34 8 8 12 12 34 34 34 34 34 34 34 34 55 55 55 55 34 34 34 34 55 55 55 55 34 34 34 34 55 55 55 55 34 34 34 34 55 55 55 55 EBCOT - Embedded Block Coding with Optimal Truncation
  17. 17. JPEG2000JPEG2000 • Higher compression ratios, images get blurredHigher compression ratios, images get blurred 570k 57k 6k 2k
  18. 18. JPEG2000JPEG2000 Compression factor: 1:250Compression factor: 1:250 Jpeg2000 - blurred Jpeg - blocked
  19. 19. Distant Diagnosis - TEXCAN©-Distant Diagnosis - TEXCAN©- IIII • TEXCAN-II® implements SSVS technique, allowing: • Zoom-Focus© • Spatial resolution  extreme digital zoom; • High quality focused image • Small size of compressed images • Fast & efficient distant consultation • Non-expensive digital virtual microscope
  20. 20. TEXCAN®-II Capture System Intel 3.4 GHz Pentium® 4 / Intel® Core™2 Duo, 4 Gb RAM CCD Camera 8Mpixels, firewire 1394.a 4x – 0.13 NA 20x – 0.46 NA (ROI’s)
  21. 21. TEXCAN®-II Assessment Tools Preparación Diagnóstico conocido Maligno Inflamación F.S.M.* 1 CITOLOGIA ORINA: Positivo para celulas malignas. Sugestivo de Carcinoma de celulas claras + 2 CITOLOGÍA ORINA: Citologia positiva para celulas tumorales malignas. Frotis sugestivo de Carcinoma. + 3 CITOLOGÍA DE LÍQUIDO PLEURAL. CITOLOGÍA SOSPECHOSA DE MALIGNIDAD. FROTIS CON INTENSA LINFOCITOSIS. + + 4 CITOLOGÍA DE LÍQUIDO PLEURAL: CITOLOGÍA POSITIVA PARA CÉLULAS TUMORALES MALIGNAS. Frotis sugestivo de Carcinoma. + 5 PUNCIÓN ASPIRACIÓN DE MAMA: Frotis sugestivos de mastopatía fibroquística con lesión epitelial proliferativa benigna intraquística. 6 CITOLOGÍA DE LAVADO PERITONEAL: CITOLOGÍA POSITIVA PARA CÉLULAS TUMORALES MALIGNAS. Frotis sugestivo de Carcinoma + 7 CITOLOGÍA DE LÍQUIDO PLEURAL: CITOLOGÍA SOSPECHOSA DE MALIGNIDAD. + + 8 Frotis con estimulo estrogenico mediano, algo inflamatorio, con espermatozoides, elementos cervicales asi como cambios celulares queratosicos y celulas pavimentosas con atipias nucleares moderadas. HSIL (High grade squamous intraepitelial lesion) + + + 9 Frotis pseudoluteal, algo inflamatorio, con elementos endocervicales sin anomalias. Hay cambios celulares queratosicos, asi como binucleaciones y elementos pavimentosos con atipias nucleares. LSIL-HPV? (Lesion escamosa intraepitelial de bajo grado-Human Papiloma Virus?) + + 10 Frotis mixto, moderadamente inflamatorio, con alteraciones celulares degenerativas, asi como escasos elementos pavimentosos con atipias ligeras, de probable origen reactivo. + 11 Estimulo estrogenico moderado, con citolisis, algo inflamatorio. Elementos cervicales bien conservados y escasos elementos pavimentosos con atipias ligeras. ASCUS (Atipical scamous cells of unknown significance). + 12 Estimulo estrogenico moderado, con citolisis, algo inflamatorio. Elementos cervicales bien conservados y celulas metaplasicas con atipias nucleares y algun pseudokoilocito, asi como cambios queratosicos. LSIL-HPV (Lesion escamosa intraepitelial de bajo grado-Human Papiloma Virus) + 13 Microcarcinoma papilar de tiroides. + 14 Adenoma tubular 15 Adenoma tubulovelloso (*) F.S.M.: Fase secretora Menstrual + : Positivo para el caso JPIP JPEG2000 www.cataibreezee.ull.es:81. V5.2 Samples Stat. Software Viewer & Transmissione-forms
  22. 22. SSVS CaptureSSVS Capture • SSVS captured with the 4x objectiveSSVS captured with the 4x objective • ROI’s (Region of Interest) selected byROI’s (Region of Interest) selected by technician, captured with the 20xtechnician, captured with the 20x objectiveobjective • Some clinical data included in eachSome clinical data included in each SSVSSSVS
  23. 23. SSVS – samplesSSVS – samples • Small powerSmall power enough forenough for having anhaving an image withimage with diagnosticdiagnostic qualityquality 53MB 68MB 7.8x 250x 1.6x 6.3x Digital zoom 500x
  24. 24. 6x 3x SSVS - samplesAreas identified by pathologist / technician Random captured areas 26Mb 16Mb 40x 40x
  25. 25. SSVS Samples 1Mb8Mb 31.3x 42.5x 250x 250x
  26. 26. SSVS AssessmentSSVS Assessment • 10 pathologists, not trained in10 pathologists, not trained in TelepathologyTelepathology • 3 pathologists, trained in TelePathology3 pathologists, trained in TelePathology • 9 cytological/histological samples9 cytological/histological samples
  27. 27. Evaluation formEvaluation form
  28. 28. Results – ROCResults – ROC SSVS - Validity for diagnosis:SSVS - Validity for diagnosis: • Area under the ROC curve ofArea under the ROC curve of 0.95 p<0.0010.95 p<0.001, (good diagnostic quality), (good diagnostic quality)
  29. 29. Results - KappaResults - Kappa Concordance and precision was high forConcordance and precision was high for telepathology trained pathologiststelepathology trained pathologists • k=0.73, p<0.001k=0.73, p<0.001 • Concordance and precision was low forConcordance and precision was low for pathologists non-trained in telepathologypathologists non-trained in telepathology • low k=0.4, p<0.001low k=0.4, p<0.001 • Comments of the users where mainly devoted toComments of the users where mainly devoted to improve the sampling area of the ROI.improve the sampling area of the ROI.
  30. 30. ConclusionsConclusions • The SSVS technique allows the technicians to digitize aThe SSVS technique allows the technicians to digitize a virtual slide easy to storage due to its small size.virtual slide easy to storage due to its small size. • SSVS is perfectly suitable for discussion and diagnosis atSSVS is perfectly suitable for discussion and diagnosis at distance through intranet and Internet providing a cheapdistance through intranet and Internet providing a cheap digital microscope and an online collaborative system.digital microscope and an online collaborative system. • For specimens that require high power to make diagnosis,For specimens that require high power to make diagnosis, the SSVS+ROI technique has been proved of value.the SSVS+ROI technique has been proved of value.
  31. 31. Thanks!Thanks!

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