Whole Slide Imaging: Current Applications and Future Directions

Foreword
Preface
Contents
Contributors
Introduction to Digital Pathology from Historical Perspectives to Emerging Pathomics
	Introduction
	Origins of the Virtual Microscope
	Development of Computational Frameworks and Software
	Frontiers of Computational Pathology and Pathology Informatics
	Conclusions
	References
Whole Slide Imaging Hardware, Software, and Infrastructure
	Introduction
	Whole Slide Imaging Technology
		Whole Slide Imaging Fundamentals
		WSI File Format
			DICOM in Whole Slide Imaging
	Whole Slide Imaging Systems: Hardware
		Whole Slide Imaging Devices
			Slide Capacity
			Slide Loading and Handling
				Slide Trays
				Slide Cassettes
			Slide Format
			Magnification and Spatial Resolution
			Scanning and Focus Strategy
			Scanning Speed
				Scan Times
				Z-Stacking and Extended Depth of Focus
			Image Modalities
		Workstations
		Displays
	Whole Slide Imaging: Software
		The Viewer
		Image Management Systems
			Clinical Image Management Systems
			Research and Education Image Management Systems
		Adding Value Through Software
	Whole Slide Imaging: Infrastructure
		Networking
		Storage
	Conclusions
	References
Whole Slide Imaging: Applications
	Introduction
	Regulation and Validation
	Applications of Whole Slide Imaging
	WSI in Education, Tumor Boards, Presentations, Quality Assurance, and Research
	WSI in Primary Frozen Section/Intraoperative Consultation/Diagnosis
	WSI in Routine Pathological Diagnosis
	WSI and Immunohistochemistry and Electron Microscopy
	WSI in Artificial Intelligence
		Education
		Quality Assurance
		Pathological Diagnosis
		Image Analysis
	Caveats and Challenges of WSI
		Cost
		Technological Issues
		Professional Barriers
		Regulatory Issues
	Conclusions
	References
Developing a Clinical Workflow That Fits Your Needs
	Remote Access
	Slide Archival
	Primary Diagnosis/Facilitate Clinical Sign Out
	Image Analysis
	Artificial Intelligence/Machine Learning
	External Consultation
	Education
	Stakeholder Engagement
	Selecting a System/Use Cases
	Conclusion
	References
Whole Slide Imaging: Applications in Education
	Introduction
	Building a Workflow for Enhancing Education
	Challenges and Barriers
	Use of Digital Pathology for Education: Advantages
		How Do Digital Slides Enhance Pathology Education
		Advantages with Presentations, Conferences, Tumor Boards, and Social Media
		Digital Pathology and Social Media
		Future of Pathology Education Using Digital Slides
	References
		Suggested Readings
Whole Slide Imaging and Primary Diagnosis
	Introduction
	Benefits of Large-Scale Digitisation for Primary Diagnosis
		Efficiency and Workflow
		Service Quality
		Workforce Optimisation
		Patient Safety
	The Evidence Base for Primary Diagnosis
		Technical Considerations
		IT Considerations
		Integration Is Key
	Barcoding and Tracking
		IT Network and Storage Capacity
		Pathologist Interface for Primary Diagnosis
	Laboratory Considerations
		Non-standard Slide Formats
		Scanning Magnification
		Primary Diagnosis Validation and Training
	General and Specific Training Points for Primary Digital Diagnosis
	Detection of Small Diagnostic and Prognostic Objects
		Dysplasia
		Mitotic Figure Counting
		Specific Diagnostic Items and Features
	Potential Pitfalls
		Continuing Surveillance and Audit
	Conclusion
	References
Whole Slide Imaging and Telepathology
	Introduction to Telepathology
		Definitions
			Telepathology
			Transmitting Site
			Receiving Site
			Store and Forward
			Primary Diagnosis
			Secondary Diagnosis
			Intraoperative Diagnosis
	A Brief History of Telepathology
		Drivers of Adoption for Telepathology
		Telepathology as a Use Case for WSI
	Comparison with Other Telepathology Modalities
		WSI Versus Static Image Telepathology
		WSI Versus Dynamic Telepathology
		WSI Versus Robotic Telepathology
			Hybrid WSI Scanners
	Technical Considerations for WSI Telepathology
		Network Quality
			Throughput
			Latency
		Network Firewalls
		Approaches to Transmitting WSI Data for Telepathology
			Traditional Client-Server Solutions
			Cloud-Based Solutions
		Telepathology and Cybersecurity
		Telepathology Network Topology
			Hub and Spoke Model
			Reverse Hub and Spoke Model
			Mixed Model
	Regulatory and Legal Aspects of WSI Telepathology
		Telepathology and In Vitro Device Regulation
			Whole Slide Imaging, the FDA, and CLIA
		Laboratory Accreditation and Telepathology
			Telepathology Accreditation Standards
			Laboratory Validation of Telepathology Systems
			Laboratory Validation of Whole Slide Imaging Systems
			Image Retention and Telepathology
		Medical Licensure
			Interstate Medical Licensure Compact
		Privileging and Credentialing
		Liability, Malpractice, and Malpractice Insurance
		Reimbursement
		COVID-19 and Telepathology
	Summary
	References
Whole Slide Imaging: Remote Consultations/Second Opinions
	Introduction
	Importance of Consultation for Second Opinions
	Shortage of Pathologists in General Around the World
		Worldwide Initiatives
		Some Examples of a Work Already in Progress
	Digital Pathology as a Window into Computational Pathology
	Telepathology and COVID-19 Pandemic
	Conclusions
	References
Quality Assurance and Quality Improvement Enabled by Whole Slide Imaging
	Introduction
	WSI in the Pre-analytical Phase of Testing
		WSI and Patient/Specimen Identification
	Case Assignment and Distribution
	Quality Assurance of Physical Glass Slides with Histology and Immunohistochemistry
	Quality Assurance of Digital Images
	WSI in the Analytical Phase of Testing
		Intramural and Extramural Consultation
	Intradepartmental Quality Assurance Programs
	Increased Diagnostic Efficiency
	WSI in the Post-analytical Phase of Testing
	WSI and Quality Assurance: Future Considerations with Computational Pathology
	References
Whole Slide Imaging in Cytopathology
	Introduction
	Challenges of WSI in Cytopathology
		Focus
		Magnification and Resolution
		Cytopathology Workflow
	Clinical Applications
		Primary Diagnosis
		Secondary Diagnosis
		Rapid on-Site Evaluation (ROSE)
	Non-clinical Applications
		Education
		Proficiency Testing
		Quality Assurance
		Cytology Slide Archiving
		Conclusion
	References
Whole Slide Imaging and Research Applications
	Analog vs Digital
	Manual Methods
	Clinical and Research Applications for Biomarkers
	Multiplexing Techniques
	Immunofluorescence
	Other Techniques
	Tissue Microarrays (TMAs)
	Summary
	References
Whole Slide Image Analysis
	Regulatory
	WSI Scanner as a Medical Device
	Economics
	Digital Images Dissected
	RGB Space
	Pixels in Digital Detectors
	Pixels in Digital Files
	Pixels in Digital Displays
	WSI Images vs Other Images
	Image Analysis Benefits
	Image Analysis Concerns
	Parallel Processing
	Tiling
	Annotations
	Image Analysis Tools
	Pixel-Based Methods
	Object-Based Methods
	Architecture-Based Methods
	Future Directions
	Conclusion
	References
Whole Slide Imaging: Deep Learning and Artificial Intelligence
	Introduction
	Challenges in Implementing Convolutional Neural Networks in Digital Pathology
	Data Quality and Transformation
		Sample Size
		Image Format
		Color Space, Transformation, and Contrast
		Tiling and Filtering the Image
		Normalization
		Stain Deconvolution
	Annotation and Labeling
		Annotation
		Clinical and Histopathologic Labels
	Convolutional Neural Networks
		Anatomy of a CNN
		Hidden Layers
	Further Steps for Fine-Tuning the CNN
		Feature Identification
		Validation and Performance
	Applications of AI in WSI
		Detection and Segmentation
		Artifact Discovery
		Classification (Diagnosis and Grading)
	Summary
	References
Index