Pathology Visions 2008 Pathology 2.0

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Slide 1 :

3/17/2009 Pathology Visions 2008 New Applications in Whole Slide ImagingFuture Clinical Solutions Keith J. Kaplan, MD Associate Professor of Pathology Department of Pathology and Laboratory Medicine Mayo Clinic

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3/17/2009 2 Pathology Visions 2008 Digital Pathology Digital Data Set/Whole slide image Telepathology Image analysis & CAD Research Education Imaging & Archiving Virtual microscopy PACS signout Virtual IHC Consultation Diagnosis Consultation Targeted therapies Image based searches Reporting Links to images Digital archive Undergraduate GME/CME TMA Comparative analysis HSI Rare event detection

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3/17/2009 3 Pathology Visions 2008

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3/17/2009 4 Pathology Visions 2008

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3/17/2009 5 Pathology Visions 2008

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3/17/2009 6 Pathology Visions 2008

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3/17/2009 7 Pathology Visions 2008

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3/17/2009 8 Pathology Visions 2008

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3/17/2009 9 Pathology Visions 2008

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3/17/2009 10 Pathology Visions 2008

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3/17/2009 11 Pathology Visions 2008

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3/17/2009 12 Pathology Visions 2008

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3/17/2009 13 Pathology Visions 2008

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3/17/2009 14 Pathology Visions 2008

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3/17/2009 15 Pathology Visions 2008

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3/17/2009 16 Pathology Visions 2008

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3/17/2009 17 Pathology Visions 2008 Telepathology at Mayo Clinic Intramural practice Extramural practice

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3/17/2009 18 Pathology Visions 2008

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3/17/2009 19 Pathology Visions 2008 December 2, 1905 JAMA December 28, 2005 JAMA

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3/17/2009 20 Pathology Visions 2008

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3/17/2009 21 Pathology Visions 2008

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3/17/2009 22 Pathology Visions 2008

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3/17/2009 23 Pathology Visions 2008

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3/17/2009 24 Pathology Visions 2008 Extramural cases Informal market research suggests about 25 clients interested in sending cases using telepathology Clients purchasing systems and inquiring about practice Real-time consultation (FS) or discussion Retain original material (cytology)

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3/17/2009 25 Pathology Visions 2008 Digital Pathology WG Telepathology WG formed March 2008 Name changed to Digital Pathology WG Primary vs. Consultation Real-time vs. Consultation remote access Whole slide images > dynamic > static FedEx argument Types of cases/deferrals Workflow – accessioning, reporting, billing

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3/17/2009 26 Pathology Visions 2008

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3/17/2009 27 Pathology Visions 2008 NCCTG Clinical Trials

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3/17/2009 28 Pathology Visions 2008 Hyperspectral Imaging

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3/17/2009 29 Pathology Visions 2008

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3/17/2009 30 Pathology Visions 2008 General Image Capture Problems Fundamental problem of large background illumination levels that need to be removed from data Due to a weak reflection off glass slide Off-axis illumination improved problem Lamp stability across image and over time Improved with off-axis illumination and increased integration time of the camera Switch to filament lamp improved stability Use of 12-bit camera limited dynamic range

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3/17/2009 31 Pathology Visions 2008

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3/17/2009 32 Pathology Visions 2008 Spectral Signature Matching Counts per second AKA: “fingerprint identification”

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3/17/2009 33 Pathology Visions 2008 Signature Matching Known Samples are measured, labeled and stored in the Spectral Signature Library An unknown sample is tested… And then the spectral signature compared against those stored in the analyzer’s Signature Library.

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3/17/2009 34 Pathology Visions 2008

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3/17/2009 Pathology Visions 2008 35 Medicine 2.0 and Digital Pathology

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3/17/2009 36 Pathology Visions 2008 What is Medicine 2.0? Web 2.0 + Medicine Web 1.0 – users follow content Web 2.0 – users comment, edit and create content

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3/17/2009 37 Pathology Visions 2008 Web 1.0 ? Web 2.0 Source: What Is Web 2.0 - Tim O'Reilly, modified

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3/17/2009 38 Pathology Visions 2008 Harnessing Collective Intelligence and Keeping it Simple Yahoo (index catalog) ? Google (page rank) Directory of links ? Uses link structure Barnes and Noble ? Amazon Same inventory ? Multitude of reader reviews, “most popular”, real-time stats of purchases and 1-click ordering Digital pathology no different Best content immediately available By users for users

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3/17/2009 39 Pathology Visions 2008 Digital Pathology and Medicine 2.0

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3/17/2009 40 Pathology Visions 2008 Patient report Specialist report Pathology report 1 2 3 4 PDF E-mail Web-enabled RSS

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3/17/2009 41 Pathology Visions 2008

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3/17/2009 42 Pathology Visions 2008

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3/17/2009 43 Pathology Visions 2008

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3/17/2009 44 Pathology Visions 2008

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3/17/2009 45 Pathology Visions 2008

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3/17/2009 46 Pathology Visions 2008

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3/17/2009 47 Pathology Visions 2008

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3/17/2009 48 Pathology Visions 2008

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3/17/2009 49 Pathology Visions 2008

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3/17/2009 50 Pathology Visions 2008 Why is this important? Mayo Clinic website receives about 1 million hits per month Daily Kos has nearly that many page views on an average day About 10-15% of users become patients Getting the word out for Centers of Excellence Attracting e-consumers to patients

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3/17/2009 51 Pathology Visions 2008

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3/17/2009 52 Pathology Visions 2008

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3/17/2009 53 Pathology Visions 2008

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3/17/2009 54 Pathology Visions 2008 Thank you

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3/17/2009 55 Pathology Visions 2008

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