Augmentiqs CEO Gabe Siegel and University of Michigan pathologist Dr. Liron Pantanowitz


Augmented Reality Microscopy: Clinical Applications and Future Predictions

The 25 minute talk by Dr. Pantanowitz and Gabe Siegel will focus on the background of ARM, the technology, clinical applications and future predictions. As per the virtual setup of the show, the talk has been pre-recorded for the virtual attendees of Pathology Visions 2020, and a live online Q&A session will take place on October 29th.


Augmented reality refers to technology that combines reality and digital information. This is created by superimposing computer-generated digital information onto an object or user’s view of the “real world.” Recently, augmented reality microscopy (ARM) technology has become commercially available for users. ARM converts the traditional light microscope into a digital pathology platform that can be used to perform real-time computer-assisted diagnostics, avoiding the need to first photograph or digitize slides. An augmented reality microscope is a modified (“smart”) microscope that includes a small computer unit inserted between the microscope’s objective lenses and eyepiece unit. It incorporates a built-in camera to capture high-quality and full field of view images. The images acquired by this unit occur in real time and can be displayed on an attached computer monitor. In addition, if the end user looks through the eyepieces of the microscope, they can see computer-generated output such as annotations, morphometrics or image analysis output, being projected as an overlay directly on the optical view of the glass slide. ARM thereby permits real-time image analysis and AI algorithms to be performed on glass slides with the output of the algorithm superimposed on the slide. The aim of this presentation is to educate participants about ARM, explain this novel technology, compare this tool to other digital pathology platforms such as such as whole slide imaging, illustrate several applications, and offer future predictions for using this bridging technology in training AI algorithms and supporting pathology workflow.

The topic and invitation to speak comes as a result of the groundbreaking study of ARM technology conducted by Dr. Pantanoqwitz at UPMC, where Ki-67 was scored with different modalities, including ARM.

UPMC Study Abstract

BACKGROUND: The Ki-67 index is important for grading neuroendocrine tumors (NETs) in cytology. However, different counting methods exist. Recently, augmented reality microscopy (ARM) has enabled real-time image analysis using glass slides. The objective of the current study was to compare different traditional Ki-67 scoring methods in cell block material with newer methods such as ARM. METHODS: Ki-67 immunostained slides from 50 NETs of varying grades were retrieved (39 from the pancreas and 11 metastases). Methods with which to quantify the Ki-67 index in up to 3 hot spots included: 1) “eyeball” estimation (EE); 2) printed image manual counting (PIMC); 3) ARM with live image analysis; and 4) image analysis using whole-slide images (WSI) (field of view [FOV] and the entire slide). RESULTS: The Ki-67 index obtained using the different methods varied. The pairwise kappa results varied from no agreement for image analysis using digital image analysis WSI (FOV) and histology to near-perfect agreement for ARM and PIMC. Using surgical pathology as the gold standard, the EE method was found to have the highest concordance rate (84.2%), followed by WSI analysis of the entire slide (73.7%) and then both the ARM and PIMC methods (63.2% for both). The PIMC method was the most time-consuming whereas image analysis using WSI (FOV) was the fastest method followed by ARM. CONCLUSIONS: The Ki-67 index for NETs in cell block material varied by the method used for scoring, which may affect grade. PIMC was the most time-consuming method, and EE had the highest concordance rate. Although real-time automated counting using image analysis demonstrated inaccuracies, ARM streamlined and hastened the task of Ki-67 quantification in NETs. Cancer Cytopathol 2020;0:1-10. © 2020 American Cancer Society.

What Advantages Does a Pathologist Need from Digital Pathology

While Dr. Pantanowitz will focus on the clinical and pre-clinical applications of ARM, Gabe will focus more on technology, integration with the lab and future predictions.

Pathology Visions 2020 Speaker Discussion

Augmentiqs was founded on the belief that the advantages of the microscope cannot be surpassed, and we must complement these advantages in place of supplanting them.

Augmentiqs bridges the existing microscope with digital pathology, transforming the existing microscope into a platform for the deployment of digital pathology applications – directly from the existing pathology workflow. In so doing, we maintain the microscopes:

  • Speed of viewing specimens
  • Superior image quality
  • Ability to adjust the microscope’s fine and coarse magnification
  • Depth perception & eye-brain connection
  • Avoidance of computer-vision syndrome

To bridge the benefits of digitization with the glass slide, Augmentiqs introduced to the world the concept of microscope-based digital pathology. Our novel approach for multi-directional communication between the microscope and PC, including augmented reality microscopy (ARM), brings to pathology microscopes the benefits of digital pathology.

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