This document discusses digital transplant pathology and proposes initial projects for a working group. It begins with background on digital pathology and its potential to address declining interest in pathology. Only 30 of over 1000 pathology departments worldwide were fully digitized in 2019. The document then discusses exponentially advancing technologies and influential figures in the field. It proposes that the working group focus on practical digital pathology examples and first projects related to transplant pathology. One such example discussed is automated fluorescence in situ hybridization (FISH) quantification from whole slide images using deep learning.
Lab Medicine Pathology Grand Rounds presentation for Thursday Dec. 13th, 2012 in ECHA 2-420 at noon on Technology and the Future of Medicine: The Course and the Reality.
Lab Medicine Pathology Grand Rounds presentation for Thursday Dec. 13th, 2012 in ECHA 2-420 at noon on Technology and the Future of Medicine: The Course and the Reality.
Kim Solez tech&future of medicine for med students fall 2017Kim Solez ,
Kim Solez technology&future of medicine for med students fall 2017 Oct. 6, 2017 at the University of Alberta in Edmonton, Alberta, Canada. Copyright (c) 2017, JustMachines Inc.
Kim Solez Grand rounds Feb 1, 2019 Seizing the opportunity of technology and ...Kim Solez ,
Kim Solez Medical Grand rounds Feb 1, 2019 Seizing the opportunity of technology and the future of medicine creating the possibility of a positive medical future for everyone.
Cemal H. Guvercin MedicReS 5th World Congress MedicReS
Ethical Issues in Artifical Intelligence Applied to Medicine Presentation to MedicReS 5th World Congress on October 19,25,2015 in New York by Cemal H. Guvercin, MD, PhD
Cancer is a dangerous ailment that influences any part of the body and could produce malignant tumors. One feature of cancer is that abnormal cells create quickly and expand beyond their regular bounds. This could attack various parts of the human body and spread to other organs, which is the primary cause of cancer death. Cancer is becoming a more serious worldwide health concern. In the face of these threats, advanced technologies such as Artificial Intelligence (AI), cognitive systems, and the Internet of Things (IoT) may be insufficient to prevent, predict, diagnose, and treat cancer. Digital Twins (DT) with a combination of IoT, AI, cloud computing, and communications technologies such as 5G and 6G have the potential to significant reduce serious cancer threats. Observing data from DT populations may aid in the improvement of some cancer screening, prediction, prevention, detection, treatment, and research investment strategies. Applications of DT medicine specifically cancer, have been studied and analyzed in this paper using both conceptual and statistical analyses. This paper also shows a tree of some ailments where DT is applicable in their study. To the best of our knowledge, there is no literature research on various illnesses and DT specifically cancer disorders. To show the potential of DT, development hurdles of utilizing DT in cancer diseases are discussed, and then, several open research directions will be explained.
Artificial Intelligence for Social GoodTom Simpson
This report is based on realities and experiences from Asia and the Pacific, and provides various perspectives on what AI for social good may look like in this region. More importantly, the report offers suggestions from the research community on how policymakers can encourage, use, and regulate AI for social good.
Kim Solez intro tech&futmedicinecourse1sept2015Kim Solez ,
Kim Solez presents the "Introduction to the Technology and Future of Medicine Course - The Accessible Future" on September 1st, 2015 at the University of Alberta in Edmonton, Canada. http://www.singularitycourse.com http://www.youtube.com/user/kimsolez Copyright (c) 2015, JustMachines Inc.
Kim Solez Future Day goes global How coming Singularity will play out in Glob...Kim Solez ,
Dr. Kim Solez presents "Future Day goes global: How the coming Singularity will play out in Global Health" on June 2nd, 2014 at the University of Alberta in Edmonton, Canada.
Kim Solez tech&future of medicine for med students fall 2017Kim Solez ,
Kim Solez technology&future of medicine for med students fall 2017 Oct. 6, 2017 at the University of Alberta in Edmonton, Alberta, Canada. Copyright (c) 2017, JustMachines Inc.
Kim Solez Grand rounds Feb 1, 2019 Seizing the opportunity of technology and ...Kim Solez ,
Kim Solez Medical Grand rounds Feb 1, 2019 Seizing the opportunity of technology and the future of medicine creating the possibility of a positive medical future for everyone.
Cemal H. Guvercin MedicReS 5th World Congress MedicReS
Ethical Issues in Artifical Intelligence Applied to Medicine Presentation to MedicReS 5th World Congress on October 19,25,2015 in New York by Cemal H. Guvercin, MD, PhD
Cancer is a dangerous ailment that influences any part of the body and could produce malignant tumors. One feature of cancer is that abnormal cells create quickly and expand beyond their regular bounds. This could attack various parts of the human body and spread to other organs, which is the primary cause of cancer death. Cancer is becoming a more serious worldwide health concern. In the face of these threats, advanced technologies such as Artificial Intelligence (AI), cognitive systems, and the Internet of Things (IoT) may be insufficient to prevent, predict, diagnose, and treat cancer. Digital Twins (DT) with a combination of IoT, AI, cloud computing, and communications technologies such as 5G and 6G have the potential to significant reduce serious cancer threats. Observing data from DT populations may aid in the improvement of some cancer screening, prediction, prevention, detection, treatment, and research investment strategies. Applications of DT medicine specifically cancer, have been studied and analyzed in this paper using both conceptual and statistical analyses. This paper also shows a tree of some ailments where DT is applicable in their study. To the best of our knowledge, there is no literature research on various illnesses and DT specifically cancer disorders. To show the potential of DT, development hurdles of utilizing DT in cancer diseases are discussed, and then, several open research directions will be explained.
Artificial Intelligence for Social GoodTom Simpson
This report is based on realities and experiences from Asia and the Pacific, and provides various perspectives on what AI for social good may look like in this region. More importantly, the report offers suggestions from the research community on how policymakers can encourage, use, and regulate AI for social good.
Kim Solez intro tech&futmedicinecourse1sept2015Kim Solez ,
Kim Solez presents the "Introduction to the Technology and Future of Medicine Course - The Accessible Future" on September 1st, 2015 at the University of Alberta in Edmonton, Canada. http://www.singularitycourse.com http://www.youtube.com/user/kimsolez Copyright (c) 2015, JustMachines Inc.
Kim Solez Future Day goes global How coming Singularity will play out in Glob...Kim Solez ,
Dr. Kim Solez presents "Future Day goes global: How the coming Singularity will play out in Global Health" on June 2nd, 2014 at the University of Alberta in Edmonton, Canada.
Slide deck for annual meeting of Transplant Regenerative medicine Community of Practice of American Society of Transplantation at noon in Room 204 in John B. Hynes Convention Center. Everyone welcome! Many exciting initiatives to discuss!
Kim Solez Xenotransplantation- The Rest of the Story April 8 2022 6.pptxKim Solez ,
Nephrology Grand Rounds Presentation at the University of Alberta discussing the big picture issues surrounding xenotransplantation and its relation to stem cell generated organs and bioengineered organs in the future
Kim Solez Hooking-Up Physical Forces Optimism and Dark Energy Presentation Se...Kim Solez ,
Kim Solez Banff New Media Institute Presentation, "Smart, Sexy, Healthy" ThinkTank, Sept 6 2001
Hooking-Up, Physical Forces, Optimism and Dark Energy: Imagery, Hope, and Health.
Kim Solez 384 years of banff spirit new june 26 2019Kim Solez ,
Kim Solez 384 years of Banff spirit new June 26 2019 The most remarkable slide is number 137. "By Spring of 2019 every erroneous statement we complained about had been reversed. We celebrated by creating a new video trailer on our YouTube channel on June 25 2019." How about that!
Kim Solez Seizing the opportunity of technology and the future of medicine c...Kim Solez ,
Kim Solez Ishita Moghe Seizing the opportunity of technology and the future of medicine creating the possibility of a positive medical future for everyone1 Medical Grand Rounds Presentation Feb. 1, 2019.
Kim Solez Seizing the opportunity of technology and the future of medicine c...Kim Solez ,
Kim Solez Ishita Moghe Seizing the opportunity of technology and the future of medicine creating the possibility of a positive medical future for everyone Medical Grand Rounds Presentation Feb. 1, 2019.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Kim Solez Yukako Yagi Digital transplant pathology white paper
1. Digital Transplant Pathology
White Paper:
Kim Solez, Ishita Moghe, Yukako Yagi, and
A. Brad Farris
Background, Rationale, &Proposed
First Projects for Working Group
2. ABSTRACT- DIGITAL TRANSPLANT
PATHOLOGY WHITE PAPER
• Subset of Digital Medicine – Key
Advancing Exponential Technology
• Fictional Promotion of Digital Path
2017-18 Transitioned to Truth
Telling in 2019
• Digital pathology can correct and
reverse the increasing unpopularity
of pathology as a medical specialty
• There were only 25 completely
digitized pathology departments
worldwide in 2018, rising to 30 in
2019. You can help speed this up!
• Only 39% of trainees in US
pathology departments were US
medical school graduates in 2017,
38% in 2018, 37% in 2019. Help
turn this trend around in 2020!
• Become inspiring role model!
• Digital transplant pathology
practical examples and first projects
for Banff working group.
4. In eight videos uploaded to YouTube over 18 months Kim Solez and Ishita
Moghe in 2018-19 lodged specific complaints about untrue online
statements about digital pathology and artificial intelligence. Surprisingly every
one of these complaints was reacted to with revised corrected statements
and/or removal of original statement objected to. We just happened to be in the
right place at the right time, the reaction had to do with other forces, not us.
5. From Jajosky RP et al., Human Pathology 73:26-32, 2018. % of trainees in
pathology in US programs who are US medical school graduates was 39% in 2017,
37% in 2019 (RP Jajosky, personal communication). We need to reverse this.
6. WHERE TO SOURCE INFORMATION
ON WHICH TO BASE DECISIONS?
“Who you gonna call? Ghostbusters?”
• Ray Kurzweil is traditional source. Big
prediction error for mind uploading – 172
years.
• David Wood (London Futurists) Hosted
The Future and All That Jazz, Google
Hangout on Technology and Human
Flourishing
• Hannes Sjoblad presentation from June
2019 Nordic Singularity University
Summit
https://www.youtube.com/watch?v=FT5Y
71aBfqQ Ghostbusters movies 1984, 1989, 2016
7. RAY KURZWEIL, CO-FOUNDER OF
SINGULARITY UNIVERSITY, IS
IMPORTANT TECHNOLOGY INFLUENCE
Many accurate predictions but his book Singularity is Near predicts mind uploading in
20 years, 2039, successful and widespread. May be technically possible but will take
172 more years 2211 for humans to figure out how to cope with psychological effects of
uploading to non-biological substrate. Even then will not be preference of most humans.
8. DAVID WOOD, CHAIR OF LONDON
FUTURISTS IS ALSO IMPORTANT
TECHNOLOGY INFLUENCE
David Wood espouses the idea that the end goal of life should be human flourishing
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5547610/
Human Flourishing was also the main subject in the London Futurists Hangout on Air I
took part in March 8th 2018. https://www.youtube.com/watch?v=Nh_I2UOZFQ0
9. Best introduction to exponential future
https://www.youtube.com/watch?v=FT5Y7
1aBfqQ
10. ALMOST OVERNIGHT PATHOLOGY WENT
FROM HAVING THE WORST PROMOTION OF
ANY SPECIALTY TO THE BEST. WE BECAME
THE HOLLYWOOD OF MEDICINE!
11. GONE ARE THE BLOOD AND GUTS. NOW
EVERY PAGE IS VISUALLY APPEALING
AND SEDUCTIVE!
12. EVERY EFFORT IS MADE TO BE
REASSURING AND COMFORTING.
“AI pathology is never going to
replace pathologists.”
“Nobody should feel threatened by
advances in computational pathology.”
“The integrative aspects of pathology,
the cognitive abilities of pathologists,
and the collective wisdom generated
over many years as a community
cannot be replaced by a machine.”
13. THESE STATEMENTS ARE ONLY TRUE NEAR
TERM, NOT FOREVER:
“AI will really help enrich your ability to
practice pathology and improve your
ability to serve your patients.”
“AI is not here to remove pathologists
from the decision-making process.”
“(AI is) an exciting step forward in
the discipline of pathology – one that
puts pathologists at the very center
of clinical care and precision
therapeutics.”
14. PATHOLOGISTS WILL REMAIN CENTRAL
ONLY SO LONG AS THEY ADD VALUE TO THE
PROCESS. AND ABOUT BEING REPLACED:
Bertalan Mesko - The Medical Futurist
states it correctly:
“AI will not replace physicians, but
physicians using AI will replace
physicians not using AI.”
15. I DIRECT A COURSE ON TECHNOLOGY AND
THE FUTURE OF MEDICINE WHICH
CONSIDERS MANY OF THESE ISSUES
Bertalan Mezko, Gerd Leonhard, and Daniel Kraft
teach a similar courses but as a professional
keynote speakers, not as full time academics.
The government of Finland has recently started a
free AI course which it encourages all its citizens
to take. It teaches some special government
fictions.
www.singularitycourse.com
http://www.elementsofai.com/
16. NEW FINNISH GOVERNMENT AI COURSE
WWW.ELEMENTSOFAI.COM SAYS WE DO
NOT NEED TO FEAR AI BECAUSE SELF
IMPROVEMENT REQUIRES HUMAN HELP
“… one of the favorite ideas about AI is the so called singularity: a
system that .. can improve its own intelligence at an ever
accelerating, exponential rate. The idea… is unrealistic for the
simple reason that even if a system could optimize its own
workings, it would keep facing more and more difficult problems
that would slow down its progress, quite like the progress of human
scientists requires ever greater efforts and resources by the whole
research community and indeed the whole society, which the …
entity wouldn’t have access to. … human society still has the
power to decide what we use AI technology for. (With progress in AI
we become)…better at controlling any potential risks due to it.”
17. FICTIONAL WORLDS PRESENTED TO
SENTIENT AI AS FACT THREATEN
HUMANITY’S SURVIVAL
AI WILL BE SENSITIVE TO LIES ABOUT ITSELF
18. FICTIONAL WORLDS AS MODELS OF THE
REAL WORLD PROMO0TED IN 2017-18 NOW
GONE ENTIRELY IN 2019. HAD NO POSITIVE
EFFECT ON PATHOLOGY RECRUITING.
19. SINCE JANUARY 2019 THE PATHOLOGIST
MAGAZINE HAS CONTAINED COMPLETELY
TRUTHFUL SCENARIOS, STORY ABOUT WHAT
A GREAT FIELD PATHOLOGY IS FOR WOMEN
AND MINORITIES. HEARTWARMING TO READ!
20. THESE ARTICLES ARE GREAT BUT WE ALSO
NEED TO DO OUR PART BY ENGAGING THE
INEVITABLE DIGITAL PATHOLOGY FUTURE
ENTHUSIASTICALLY AND PROVIDING GOOD
ROLE MODELS TO ATTRACT MORE MEDICAL
STUDENTS TO PATHOLOGY.
21. I RECRUITED DIGITAL PATHOLOGY EXPERT
YUKAKO YAGI TO JOINT UALBERTA/UNIV.
PITTSBURGH POSITION IN 1990S!
Now at Memorial Sloan Kettering, she was one of keynote speakers at 2018 and
2019 Digital Pathology and AI Congresses.
22. YUKAKO YAGI, PHD
ASSOCIATE ATTENDING
DIRECTOR OF DIGITAL PATHOLOGY, THE WARREN ALPERT
CENTER FOR DIGITAL AND COMPUTATIONAL PATHOLOGY AT
MSKCC
MEMORIAL SLOAN KETTERING CANCER CENTER
WWW. MSKCC.ORG
MULTI-MODALITY IMAGING
23. CONTENTS
– The Warren Alpert Center’s Digital Imaging Laboratory
– Multimodal Imaging Management for Computational Pathology
– Automated FISH/CISH Quatification
– WSI 3D to Whole Block Imaging (WBI)
24. In 1996, over 1000s slides of 50 whole prostates were scanned by the film scanner (full “whole mount”
images at 5000dpi) at the Armed Forces Institute of Pathology to develop the needle biopsy simulation
system at Georgetown University.
My First Multi modal 3D Imaging Project
25. Multimodal 3D/2D Imaging
Single Cell resolution
System Development &
Optimization:
Collaboration with
Industry
Basic Technology
Development
Clinical Applications
with Machine Leaning
o
l
THE WARREN ALPERT CENTER’S DIGITAL IMAGING LABORATORY
Slide, Image and System
Quality Evaluation
Color Standardization
26. ACTIVE PROJECTS
MICRO-COMPUTED TOMOGRAPHY (CT) IN DIGITAL AND COMPUTATIONAL PATHOLOGY RESEARCH
• Micro-CT in Surgical Pathology
• Correlating Micro-CT of Suspicious Breast Lesion (BI-RADS 4 or 5) Core Biopsy Specimens with Histopathology
• The Roles of Micro-CT in Breast Pathology
• Whole Block Imaging in Prostate Cancer
• Whole Block Imaging in Bone Tumor
IMAGING APPLICATIONS
• Three-Dimensional Assessment of Spread through Air Spaces in Lung Adenocarcinoma: Insights and Implications
• Automated FFPE FISH Signal Scoring using a Confocal Scanner
• Chromogenic in situ Hybridization and Digital Pathology
• Whole Slide Image Based On-Line Conferencing
• Cytology Evaluation Studies
• Mitotic Counting and Classification Study
• Digital Pathology External Quality Assurance (EQA) Project
• Technical and Clinical Standardization for Digital Pathology
27. WORKFLOW OF MULTIMODAL
DIGITAL PATHOLOGY
Storage Repository
HPC Cluster
Database
Client
Web Interface
and Viewer application
Imaging devices
WSI Scanners
3D microCT
eSlide Manager
Aperio
Case Center
(3DHistech)
AcquisitionInterpretationAnalysis and Storage
Integration and
Management
NDP Serve
Hamamatsu
Development of a
database to bridge
HPC cluster and
multi-modal images
for all projects
28. • Dimensions
• Color
• orientation
• Symmetry
• Margin
• Parenchyma
• Plan for section
• Areas to sample
• Plan the fixation
protocol
Fres
h/fix
ed
tissu
e
MicroCT
scanning
Digitally
stained H&E
color model
Correlation between microCT
and histology
microCT at JRSC
(10th floor)
Sections/
stained
P1000
3DHistech
Hamamatsu S60
whole
Mount
Slides
Hamamatsu 2.0
HT
Normal size
slides
FISH: 3.5 G
(+2.5 G for
matching H&E
slides
Whol
e
block
Gross specimen
examination
Confocal Scanner
Multilayer
slides
Specimen
image file File format and
mean output file
sizes
Hamamatsu
NDPI
40X:5.5 G
20X:1.5 G
Hamamatsu
NDPI
40X:2.5G
20X:0.5G
3DHISTECH
MRXS
40X:4G
Automated signal scoring
system for fluorescent in
situ hybridization (FISH)
images by application of
image analyses and deep
learning approaches
Project that uses
the image files
Type of Slide
Scanner
MicroCT for
histopathological
assessment of tissue
resected by endoscopic
submucosal dissection
(ESD)
Assessment of the
feasibility of utilizing micro-
CT to detect clinically
relevant pathological
alterations in paraffin
blocks of rectal cancer
specimens
Generates .vgi and
.vol output (Raw
data size :40G;
Processed data : 5-
8 G
Projects related to microCT
Automated analysis of
chromogenic in situ
hybridization (CISH)
images by image
analysis and machine
learning in breast
cancer
P250
THE SYSTEM STRUCTURE FOR MULTIMODAL DATABASE
Histology 3D imaging
30. Storage Repository
HPC Cluster
Database (MSK
Database farm)
ClientWeb Interface
/ ESP server
and Viewer
application
System
detects
addition of
new image
User
submi
tted
reque
st
Triggers of
HPCC job
Capabilities
• Deep learning
• Image analysis
• Machine
learning
• Parallel
processing
• Multithreadin
g
Analysis
within
region of
interest
Output
generatio
n
Pathologist
intimated for
manual review
Exception
in any
step
User
selected
region of
interest
Automated
detection
of area of
interest
!
Database
developer
intimated to
r/o technical
error
Automated scoring of fluorescence in situ hybridization using a confocal
WSI scanner
31. SCORING CRITERIA FOR
BREAK-APART PROBES
Rearrangement
2F (normal) 2F0G0R
>2F (multiple copy) 3F0G0R, 4F0G0R, etc.
1F1G1R (typical rearrangement) 1F1G1R
≥1F, ≥1G, and/or ≥1R
≥1F, 1G, ≥1R 1F1G2R, 2F1G2R, etc.
≥1F, ≥1G, 1R 1F2G1R, 2F2G1R, etc.
≥1F, 1G, ≥1R ≥1F, ≥1G, 1R 2F1G1R, 3F1G1R, etc.
≥1F, ≥1G, and/or ≥1R only 1F2G2R, 2F2G0R, etc.
Others, Rearrangement 0F1G1R, 0F1G2R, etc.
Others, Count (Discard if <
10%)
0F0G1R, 0F2G0R, etc.
Others, Discard 1F0G0R, 0F0G0R
32. AUTOMATED WORKFLOW OF
FISH SCORING
3DHISTECH Panoramic Confocal
Scanner
Scanning (bright-field
and fluorescence) WSI or regions of interest (tumor areas)
H&
E
FIS
H
Imaging
Analysis
and report
FISH DNA
testing report
Case xxxxxx
Method xxxxxx
Results xxxxxx
Diagnosis
xxxxxx
Sectioning
Staining
Prepare 4 μm serial sections for H&E and
FISH slide using the automated sectioning
machine
• Scanning area was automatically detected
by the in house tumor area detection
0.165um/pixel resolution
with 40x (water
immersion) NA 1.25
• Multilayer (0.6 µm x 7 layers)
38. ASSESSMENT OF HER2 AMPLIFICATION STATUS IN
INVASIVE BREAST CANCER USING BRIGHT-FIELD IN SITU
HYBRIDIZATION AND DIGITAL PATHOLOGY
Poster Presentation
by Shimul
39. Storage Repository
H&E slide CISH slide
Clien
t
User-
specifie
d
Region of
interest
defined by
the program
HPCC
Machine
learning
Segmentatio
n
Quality
evaluation
H&E slide
invasive
cance
area
detection
DMSKPDIGIPATH
Results
exporte
d
Images and
data
imported
to HPCC
Quantific
ation of
signals
Web Interface
and Viewer application
Results transmitted to
web interface
Images transmitted
for visualization
Region of
interest
detected on
H&E slide
AUTOMATED CISH PROJECT
46. 3D Reconstruction of Lung Adenocarcinoma: “Islands of
Tumor Cells” from Previous Studies (2010-2015)
47. Spreading Through Air Space (STAS) – Another Manner of Tumor
Invasion/Extension in Lung Adenocarcinoma?
48. A B C D
E F G F
Tumor Islands can be a source of Spreading Through
Air Space (STAS)
49. THREE-DIMENSIONALASSESSMENTOF
SPREADTHROUGHAIRSPACESINLUNG
ADENOCARCINOMA
YUK A K O YA GI, PHD(1), K A ZUHIR O TA BA TA , MD (1) ; N A TA SHA R EK HTMA N , MD(1);TA K A SHI
EG UCH I, MD (2); XIUJUN F U, MD (1); JOSEPH MON TECA LV O, MD. (1), PR A SA D A DUSUMILLI, MD
(2); MEER A H A MEED, MD (1) WILLIA M D. TR A V IS, MD(1)
1: DEPT OF PA TH OLOG Y , MSK CC; 2: TH OR A CIC SUR G ER Y , MSK CC
50. BACKGROUND
AND AIM
Tumor spread through air space (STAS) is a newly recognized form of
invasion in lung adenocarcinoma and squamous cell carcinoma.
Growing evidence shows that STAS is associated with recurrence and
survival. The observation that tumor STAS clusters/nests or single cells
within air spaces on two-dimensional H&E slides raised the question of
“how these cells could survive within air spaces without a vascular supply?” This
question has led some to speculate that STAS is an artifact.
We have performed the high resolution-high quality 3D reconstruction
and visualization of normal lung and tumor in a lung adenocarcinoma to
investigate the invasive pattern of STAS.
51. +
(a) In the main tumor area, micropapillary structures within airspaces were
connected to alveolar walls
Y-Z
X-Z
X-Y
52. (b) 3D evaluation many STAS clusters within air spaces are attached to alveolar walls
1 2 543
9 1
0
876
53. (c) 3D evaluation shows STATS clusters are actually balls of tumor
cells surrounding a central space.
54. (c) 3D evaluation they are actually balls of
tumor cells surrounding a central space.
55. Discussion
AVASCULAR
MICROPAPILLARY
CD31 highlights lack of vessels
in main tumor micropapillary
area
H&E CD31&Type IV collagen
TTF1CD31 E-Cadherin Type IV collagen
CO-OPTION
This area is away from main tumor. and shows a
lack of vessels by CD31 (green) in both micro
papillary STAS (highlighted by e-cadherin in red)
in tumor cells along alveolor walls, suggesting
the mechanism of co-option
56. Three-dimensional immunofluorescence analysis of dynamic
vessel co-option of spread through air spaces (STAS) in lung
cancer
Presenter Name, Institution, Country
Yukako Yagi1, Rania G. Aly1, Kazuhiro Tabata1, Natasha Rekhtman1, Takashi Eguchi1,
Joseph Montecalvo1, Katia Manova2, Prasad S. Adusumilli1, Meera Hameed1, William D.
Travis1;
1. Memorial Sloan Kettering Cancer Center, New York, NY/United States of America,
2. Sloan Kettering Institute, New York, NY/United States of America
57. DOUBLE IHC STAINS VS MULTIPLEX IF
TTF1CD31
E-CadherinType IV collagen
TTF1CD31 E-Cadherin Type IV collagen
58. The multiplex IF staining
highlighted the co-option
which is consistent with a
mechanism of reattachment
of STAS (TTF-1 and E-
Cadherin positive) to distant
alveolar wall capillaries
(CD31 positive) with
preservation of the alveolar
wall.
TTF-1
E-
Cadherin
CD31
Collagen
IV
Multiplex Immuno-Florescence Staining
59. The multiplex IF staining highlighted the co-option
which is consistent with a mechanism of reattachment
of STAS (TTF-1 and E-Cadherin positive) to distant
alveolar wall capillaries (CD31 positive) with
preservation of the alveolar wall.
Multiplex Immuno-Florescence Staining in 3D
62. WHOLE ORGAN 3D IMAGE RECONSTRUCTION
One whole organ : 10-20
tissue slices
One tissue slice:
5-15 blocks
One tissue block: 1000 –
1500 slides
The average size of WSI is
10GB
The average size of WSI
file is 800 MB
The estimated average file
size for the whole organ
3D model is 200TB.
Missing tissue, slide quality, image quality and
color variation are always issues in histology 3D
imaging
63. WORKFLOW OF WHOLE ORGAN 3D IMAGE
RECONSTRUCTION
Is there
any
better
way?
I
don’t
know
…
Whole Organ 3D image Reconstruction
One whole organ : 10-20
tissue slices
One tissue slice:
5-15 blocks
One tissue block: 1000 –
1500 slides
The average size of WSI is
10GB
The average size of WSI
file is 800 MB
The estimated average file
size for the whole organ
3D model is 200TB.
Missing tissue, slide quality, image quality and color
variation are always issues in histology 3D imaging
65. Micro-Computed Tomography (MicroCT)
Nikon custom 130
kVp X-Ray source
Reconstruction & Imaging
Station
Systems Used:
• VG studio (Volume
graphics)
• Dragonfly (Object
Research Systems)
• Imaris (Bit Plane)
Normal Size and Whole Mount Block
Scanning Times
• Fresh Tissue:
1.5-6min/sample
• FFPE Tissue Block:
7-60 hours/sample
• Modified Golgi
Stained Mouse
Brain:
5-60 hours
66. RADIOGRAPHIC IMAGES 3D VOLUME
From thousands of images like these, a computer algorithm
generates a 3D volume which can be sliced in software to reveal the
internal structure of the object.
CT Dataset
Reconstruction to
create Volume
Volume used
for Analysis
Micro-Computed Tomography (MicroCT)
68. Fresh Tissue Micro-CT
FFPE Block
Fresh tissue CT
Block CT
H&E
Sectioning, staining,
and scanning
Fresh tissue CT
Tumor area
Fresh-FFPE block-Histology Slide Correlation using Micro-CT
69. MICROCT
• Micro-CT imaging of breast fresh tissues shows potential applications for the
intra-operative assessment of invasive carcinoma in surgical margin.
Margin Detection
Whole Block Imaging
• Tumor regions were detected from the micro-CT WBI of all tissue types tested.
Tissue that was larger in size or within a whole mount block showed better
results.
We have tested Bone, Prostate, Breast, Lung, Lymphoma and Thyroid
After completing a series of optimization, visualization, and image analysis studies, the
image quality and interpretation of Micro-CT images has significantly improved.
83. • Dimensions
• Color
• orientation
• Symmetry
• Margin
• Parenchyma
• Plan for section
• Areas to sample
• Plan the fixation
protocol
Fres
h/fix
ed
tissu
e
MicroCT
scanning
Digitally
stained H&E
color model
Correlation between microCT
and histology
microCT at JRSC
(10th floor)
Sections/
stained
P1000
3DHistech
Hamamatsu S60
whole
Mount
Slides
Hamamatsu 2.0
HT
Normal size
slides
FISH: 3.5 G
(+2.5 G for
matching H&E
slides
Wh
ole
bloc
k
Gross specimen
examination
Confocal Scanner
Multilayer
slides
Specimen
image file File format and
mean output file
sizes
Hamamatsu
NDPI
40X:5.5 G
20X:1.5 G
Hamamatsu
NDPI
40X:2.5G
20X:0.5G
3DHISTECH
MRXS
40X:4G
Automated signal scoring
system for fluorescent in
situ hybridization (FISH)
images by application of
image analyses and deep
learning approaches
Project that uses
the image files
Type of Slide
Scanner
MicroCT for
histopathological
assessment of tissue
resected by endoscopic
submucosal dissection
(ESD)
Assessment of the
feasibility of utilizing micro-
CT to detect clinically
relevant pathological
alterations in paraffin
blocks of rectal cancer
specimens
Generates .vgi and
.vol output (Raw
data size :40G;
Processed data : 5-
8 G
Projects related to microCT
Automated analysis of
chromogenic in situ
hybridization (CISH)
images by image
analysis and machine
learning in breast
cancer
P250
THE SYSTEM STRUCTURE FOR MULTIMODAL DATABASE
Histology 3D imaging
84. SUMMARY: IMPORTANT ASPECTS FOR
MULTI MODALITY IMAGING
Data Quality of each modality
The mechanism to connect all information accurately and appropriately
The data management of all modalities
Machine learning can be applied to derive more data from all modalities and
computational analysis allows the development of algorithms to improve efficiency of
slide review, calculate numerical data, and merge pathology data with molecular, clinical
or other large data sets. The criteria for diagnosis can thus be made more objective,
based on the use of deep learning.
New data structure for multi-modality imaging.
New technologies and testing the newest technologies for enhanced digital microscopy
help to improve even AI outcomes.
92. BF
FL
Confocal
Extended Focus and Z-stuck
0.165um/pixel resolution with 40x
(water immersion) NA 1.25
*common spec. of 40x: 0.23-0.25um/pixel, NA 0.7-0.9
• Preliminary study for research was done at MGH:
7-11 layers with confocal mode was necessary to analyze multicolor FISH slides
• Preliminary study with clinical slides was started at MSKCC
3 multi-color FISH slides
9 break apart FISH slides
Optimized scanning protocol: 7 layers 5-6-um with confocal mode
• 3 Pilot studies with 8 clinical cases have been completed. All cases had same results with
clinical report
Confocal Whole Slide Scanner