Enhanced Imaging Workflow IP

1. Proposed Workitem: Enhanced Imaging Workflow for Anatomic Pathology

• Editor: Thomas Schrader

The development of slide scanners offers the possibility to digitize glass slides in Pathology and this is the beginning of a new paradigm in this medical domain. New terms were created: Digital Pathology or Collaborativ Pathology expressing the new potentials in the diagnostic process.
Not only digital patient data but also Whole Slide Images (WSI) are available now and can be used for
- support of diagnostic process
- analysis of images
- further analysis of clinical data.
With digitalization of glass slides two different discussions begun:
1. How to integrate the digitalization process into the general diagnostic process in a Pathology Department?
2. How to integrate efficiently image analysis into the diagnostic process?
Meanwhile different scanning technologies are avialable and can be used to evaluate different diagnostic questions e.g. multispectral images allow an enhancement in image quality and analysis.
--Tschrade 03:26, 17 August 2011 (CDT)

2. The Problem

At least two problems exist in integrating digialization and image analysis into the pathology processes:
1. Image analysis can be done at various process steps during the diagnostic process and have different purposes: An explorative image analysis before the microscopic evaluation by the pathologist can extract regio of interests, enhance image quality or count some basic data such as lymph nodes. An analysis step after or during the microscopic evaluation is more specific: regio of interests can be marked very specifically. The results of such analysis can answer questions e.g. about mitosis rate, form factors of tumor cells, expression of tumor markers and much more.
2. Different scanning technologies can be used to digitize glass slides: bright field scanning, multispectral scanning, immunfluoreszence scanning, high resolution scanning (oil immersion). New scanning technologies will be developed. The application of these technologies depends on various factors and are influenced by specimen, and diagnostic question.
--Tschrade 03:48, 17 August 2011 (CDT)

3. Key Use Case

In the following figure the complete process of general pathology is presented. At the moment the digitalization of glass slide is not integrated in the routine processes.

The general diagnostic pathology process:

alt text

For cytology a slight different process was modeled:

alt text

The used technology of scanning depends on various factors:

• Staining method: e.g. regulary staining, fluorescence staining
• Kind of specimen: e.g. high resolution (60x, 100x oil immersion) for cytology
• Analysis tasks

--TSchrader 15:17, 23 August 2011 (CDT)