Telepathology, Pathology Informatics and Artificial Intelligence

Two abstracts were submitted and accepted to the 2018 meeting of Pathology Informatics. 

Augmentiqs will be presenting on May 23rd, 2018 at the Association for Pathology Informatics. Artificial Intelligence built via automatic data acquisition during the routine pathology workflow and the use of live telepathology in multi-national pathology studies.

Pathology Informatics & Telepathology Abstract

Use of Telepathology for Pathology Peer Review in Multinational Studies

  1. Siegel1, D. Regelman1, R. Maronpot2 M. Rosenstock3, A. Nyska4,

1Augmentiqs, Misgav, Israel

2Maronpot Consulting LLC, Raleigh, NC

3 LEA, Nonclinical Safety Consultancy, Talmei Elazar, Israel

4 Consultant in Toxicologic Pathology and Tel Aviv University, Timrat, Israel

Content: Toxicologic pathology is a highly collaborative science that relies on both real time consultation and “peer review”.  The consultation stage of study ensures both quality and timeliness, and has a direct impact on the drug development cycle. The use of real-time telepathology can enhance collaboration and expedite the peer review process, while reducing the need for travel and increasing efficiency.

 Technology: Using an existing microscope with a novel telepathology system (AugmentiqsTM) that operates by sharing high resolution live views of slides on the microscope stage with remote parties.

 Design: Following completion of the pathology evaluation of a preclinical toxicity study at a laboratory in the United States, histopathology slides were shipped to the peer review pathologist (PRP) located in Israel. The PRP reviewed the slides, and then using the telepathology technology and his microscope, conduct a live telepathology session with the study pathologist (SP) sharing the slides for which there were questions or disagreements in the initial diagnoses.

Results: The PRP was able to simultaneously share the actual histopathology slides with the SP and obtain a consensus diagnosis for lesions in question. The SP was able to see the slides on his personal computer screen in high resolution, and discuss these lesions with the PRP, while mcroscopic fields were instantly photographed in publication quality high resolution and saved by the participating pathologists. Following this live telepathology session and achieved consensus, the SP issued a revised report expressing the agreed upon consensus diagnoses. Following completion of the entire peer review process and updating of the study pathology report, a formal GLP-compliant Peer Review Statement was signed by both the SP and PRP for regulatory submission.

 Conclusion: Telepathology running live and directly off the microscope is a highly cost and time efficient method for conducting peer review with documented images. Based upon our experience, telepathology running off the microscope can be used for general collaboration, peer review and other GLP-compliant review applications.

Pathology Informatics & Artificial Intelligence Abstract

Automated Imaging and Scoring of Histological Specimens During Routine Pathology Workflow

Gabe Siegel1; Edmund. Sabo2

1Augmentiqs, Misgav, Israel

2 Lady Davis Carmel Medical Center, Haifa, Israel

Content: Large scale collection of pathology images will play a key role in developing deep-learning artificial intelligence algorithms for pathology diagnostics. Image capture from the existing pathology workflow of pathologist and microscope, without active participation on the part of the pathologist, could potentially result in gathering relevant regions of interest, in a fast and cost-efficient manner. These collected regions of interest can be reexamined by the pathologist for assuring accuracy of the diagnosis and research purposes.

Technology: A novel system based on augmented reality was added to the pathologist’s existing microscope. The system integrates within the microscope’s optical plane, adding a digital overlay of the tissue and embedded image sensor of the field of view – thereby enhancing the existing microscope with digital capabilities. Without altering the optical view, the system enables multiple digital pathology applications and automated image capture within the existing workflow. The system also allows morphometric measurements, annotations and other tools when needed.

Design: The pathologist reviewed 10 histological specimens of colonic tumors (premalignant, malignant and normal controls) immunohistochemical stained, each case containing 4 slides. The image sensor was commanded to automatically capture images according to the methodology of the pathologist during the review, and a score would be given based on preset parameters. The image score was set to rise according to length of time pathologist stopped movement of the stage, changing of the magnification and use of available morphometric tools.

Results: The review of the slides lasted under 30 minutes and resulted in 348 images. Images varied in score, such that a majority had a low score indicating a brief stop of stage movement, while the regions of tissue containing relevant clinical data had a higher score indicating a longer stopping of the microscope stage. The pathologist reported no slowdown of workflow.

Conclusion: It is feasible to automatically capture images of tissue during the routine pathology workflow, and to provide scores to images where regions of interest are likely to be found based on the methodology of the pathology review. Captured images can be combined with specific case data and other metadata from the pathology workflow to further enhance image value.

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