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Diagnostic Pathology

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Open Access 01-12-2008 | Research

Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology)

Authors: Klaus Kayser, Jürgen Görtler, Torsten Goldmann, Ekkehard Vollmer, Peter Hufnagl, Gian Kayser

Published in: Diagnostic Pathology | Issue 1/2008

Abstract

Background

Progress in automated image analysis, virtual microscopy, hospital information systems, and interdisciplinary data exchange require image standards to be applied in tissue-based diagnosis.

Aims

To describe the theoretical background, practical experiences and comparable solutions in other medical fields to promote image standards applicable for diagnostic pathology.

Theory and experiences

Images used in tissue-based diagnosis present with pathology – specific characteristics. It seems appropriate to discuss their characteristics and potential standardization in relation to the levels of hierarchy in which they appear. All levels can be divided into legal, medical, and technological properties. Standards applied to the first level include regulations or aims to be fulfilled. In legal properties, they have to regulate features of privacy, image documentation, transmission, and presentation; in medical properties, features of disease – image combination, human – diagnostics, automated information extraction, archive retrieval and access; and in technological properties features of image acquisition, display, formats, transfer speed, safety, and system dynamics. The next lower second level has to implement the prescriptions of the upper one, i.e. describe how they are implemented. Legal aspects should demand secure encryption for privacy of all patient related data, image archives that include all images used for diagnostics for a period of 10 years at minimum, accurate annotations of dates and viewing, and precise hardware and software information. Medical aspects should demand standardized patients' files such as DICOM 3 or HL 7 including history and previous examinations, information of image display hardware and software, of image resolution and fields of view, of relation between sizes of biological objects and image sizes, and of access to archives and retrieval. Technological aspects should deal with image acquisition systems (resolution, colour temperature, focus, brightness, and quality evaluation procedures), display resolution data, implemented image formats, storage, cycle frequency, backup procedures, operation system, and external system accessibility. The lowest third level describes the permitted limits and threshold in detail. At present, an applicable standard including all mentioned features does not exist to our knowledge; some aspects can be taken from radiological standards (PACS, DICOM 3); others require specific solutions or are not covered yet.

Conclusion

The progress in virtual microscopy and application of artificial intelligence (AI) in tissue-based diagnosis demands fast preparation and implementation of an internationally acceptable standard. The described hierarchic order as well as analytic investigation in all potentially necessary aspects and details offers an appropriate tool to specifically determine standardized requirements.

Kayser K: Introducing diagnostic pathology. Diagn Pathol. 2006, 1 (1): 1-10.1186/1746-1596-1-1.PubMedCentralCrossRefPubMed

Kayser K, Kayser G: Virtual Microscopy and Automated Diagnosis in Virtual Microscopy and Virtual Slides in Teaching, Diagnosis and Research. Edited by: Gu J, Ogilvie R. 2006, Taylor Francis: Boca Raton

Kayser K, Molnar B, Weinstein R: Virtual Microscopy: Fundamentals, Applications, Perspectives of Electronic Tissue-based Diagnosis. 2006, Berlin: VSV Interdisciplinary Medical Publishing

Kayser K, Radziszowski D, Bzdyl P, Sommer R, Kayser G: Digitized pathology: theory and experiences in automated tissue-based virtual diagnosis. Rom J Morphol Embryol. 2006, 47 (1): 21-8.PubMed

Kayser K: Telepathology in Europe. Its practical use. Arch Anat Cytol Pathol. 1995, 43 (4): 196-9.PubMed

Kayser K, Beyer M, Blum S, Kayser G: Telecommunication – a new tool for quality assurance and control in diagnostic pathology. Folia Neuropathol. 2000, 38 (2): 79-83.PubMed

Kayser K, Kayser G: Basic aspects of and recent developments in telepathology in Europe, with specific emphasis on quality assurance. Anal Quant Cytol Histol. 1999, 21 (4): 319-28.PubMed

Leong FJ, Nicholson AG, McGee JO: Robotic telepathology: efficacy and usability in pulmonary pathology. J Pathol. 2002, 197 (2): 211-7. 10.1002/path.1112.CrossRefPubMed

Settakorn J, Kuakpaetoon T, Leong FJ, Thamprasert K, Ichijima K: Store-and-forward diagnostic telepathology of small biopsies by e-mail attachment: a feasibility pilot study with a view for future application in Thailand diagnostic pathology services. Telemed J E Health. 2002, 8 (3): 333-41. 10.1089/15305620260353225.CrossRefPubMed

10.

Weinstein RS, Descour MR, Liang C, Barker G, Scott KM, Richter L, Krupinski EA, Bhattacharyya AK, Davis JR, Graham AR, Rennels M, Russum WC, Goodall JF, Zhou P, Olszak AG, Williams BH, Wyant JC, Bartels PH: An array microscope for ultrarapid virtual slide processing and telepathology. Design, fabrication, and validation study. Hum Pathol. 2004, 35 (11): 1303-14. 10.1016/j.humpath.2004.09.002.CrossRefPubMed

11.

Dietel M, Nguyen-Dobinsky TN, Hufnagl P: The UICC Telepathology Consultation Center. International Union Against Cancer. A global approach to improving consultation for pathologists in cancer diagnosis. Cancer. 2000, 89 (1): 187-91. 10.1002/1097-0142(20000701)89:1<187::AID-CNCR25>3.0.CO;2-X.CrossRefPubMed

12.

Oberholzer M, Fischer HR, Christen H, Gerber S, Bruhlmann M, Mihatsch M, Famos M, Winkler C, Fehr P, Bachthold L: Telepathology with an integrated services digital network – a new tool for image transfer in surgical pathology: a preliminary report. Hum Pathol. 1993, 24 (10): 1078-85. 10.1016/0046-8177(93)90187-L.CrossRefPubMed

13.

Kayser G, Radziszowski D, Bzdyl P, Sommer R, Kayser K: Theory and implementation of an electronic, automated measurement system for images obtained from immunohistochemically stained slides. Anal Quant Cytol Histol. 2006, 28 (1): 27-38. [http://194.25.216.25:8080/amp/]PubMed

14.

Kayser K, Radziszowski D, Bzdyl P, Sommer R, Kayser G: Towards an automated virtual slide screening: theoretical considerations and practical experiences of automated tissue-based virtual diagnosis to be implemented in the Internet. Diagn Pathol. 2006, 1: 10-10.1186/1746-1596-1-10.PubMedCentralCrossRefPubMed

15.

Bloomquist AK, Yaffe MJ, Pisano ED, Hendrick RE, Mawdsley GE, Bright S, Shen SZ, Mahesh M, Nickoloff EL, Fleischman RC, Williams MB, Maidment AD, Beideck DJ, Och J, Seibert JA: Quality control for digital mammography in the ACRIN DMIST trial: part I. Med Phys. 2006, 33 (3): 719-36. 10.1118/1.2163407.CrossRefPubMed

16.

Cannavo M: Fastest is always best and other PACS fallacies. Health Manag Technol. 1995, 16 (12): 27-8.PubMed

17.

Kuhl C: The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice. Radiology. 2007, 244 (2): 356-78. 10.1148/radiol.2442051620.CrossRefPubMed

18.

Wallis M, Tardivon A, Helbich T, Schreer I: Guidelines from the European Society of Breast Imaging for diagnostic interventional breast procedures. Eur Radiol. 2007, 17 (2): 581-8. 10.1007/s00330-006-0408-x.CrossRefPubMed

19.

Boochever SS: HIS/RIS/PACS integration: getting to the gold standard. Radiol Manage. 2004, 26 (3): 16-24. quiz 25–7.PubMed

20.

Schnall MD, Blume J, Bluemke DA, DeAngelis GA, DeBruhl N, Harms S, Heywang-Kobrunner SH, Hylton N, Kuhl CK, Pisano ED, Causer P, Schnitt SJ, Thickman D, Stelling CB, Weatherall PT, Lehman C, Gatsonis CA: Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology. 2006, 238 (1): 42-53. 10.1148/radiol.2381042117.CrossRefPubMed

21.

Ikeda DM, Hylton NM, Kinkel K, Hochman MG, Kuhl CK, Kaiser WA, Weinreb JC, Smazal SF, Degani H, Viehweg P, Barclay J, Schnall MD: Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studies. J Magn Reson Imaging. 2001, 13 (6): 889-95. 10.1002/jmri.1127.CrossRefPubMed

22.

Baak JP: The framework of pathology: good laboratory practice by quantitative and molecular methods. J Pathol. 2002, 198 (3): 277-83. 10.1002/path.1233.CrossRefPubMed

23.

Becker RL: Standardization and quality control of quantitative microscopy in pathology. J Cell Biochem Suppl. 1993, 17G: 199-204. 10.1002/jcb.240531137.CrossRefPubMed

24.

Demichelis F, Della Mea V, Forti S, Dalla Palma P, Beltrami CA: Digital storage of glass slides for quality assurance in histopathology and cytopathology. J Telemed Telecare. 2002, 8 (3): 138-42. 10.1258/135763302320118979.CrossRefPubMed

25.

Kayser K, Schwarzmann P: Aspects of standardization in telepathology. Zentralbl Pathol. 1992, 138 (6): 389-92.PubMed

26.

Smith MD, Baeten D, Ulfgren AK, McInnes IB, Fitzgerald O, Bresnihan B, Tak PP, Veale D: Standardisation of synovial tissue infiltrate analysis: how far have we come? How much further do we need to go?. Ann Rheum Dis. 2006, 65 (1): 93-100. 10.1136/ard.2005.036905.PubMedCentralCrossRefPubMed

27.

Suvarna SK, Ansary MA: Histopathology and the 'third great lie'. When is an image not a scientifically authentic image?. Histopathology. 2001, 39 (5): 441-6. 10.1046/j.1365-2559.2001.01312.x.CrossRefPubMed

28.

Thunnissen FB, Ellis IO, Jutting U, Burger G: Interlaboratory comparison of DNA image analysis. Management group report of internal quality assurance programme in the CAAC breast cancer project. Zentralbl Pathol. 1994, 139 (6): 443-7.PubMed

29.

Zwonitzer R, Kalinski T, Hofmann H, Roessner A, Bernarding J: Digital pathology: DICOM-conform draft, testbed, and first results. Comput Methods Programs Biomed. 2007, 87 (3): 181-8. 10.1016/j.cmpb.2007.05.010.CrossRefPubMed

30.

Cruz D, Valenti C, Dias A, Seixas M, Schmitt F: Digital image documentation for quality assessment. Arch Pathol Lab Med. 2001, 125 (11): 1430-5.PubMed

31.

Molnar B, Berczi L, Diczhazy C, Tagscherer A, Varga SV, Szende B, Tulassay Z: Digital slide and virtual microscopy based routine and telepathology evaluation of routine gastrointestinal biopsy specimens. J Clin Pathol. 2003, 56 (6): 433-8. 10.1136/jcp.56.6.433.PubMedCentralCrossRefPubMed

32.

Riley RS, Ben-Ezra JM, Massey D, Slyter RL, Romagnoli G: Digital photography: a primer for pathologists. J Clin Lab Anal. 2004, 18 (2): 91-128. 10.1002/jcla.20009.CrossRefPubMed

33.

Ambros IM, Benard J, Boavida M, Bown N, Caron H, Combaret V, Couturier J, Darnfors C, Delattre O, Freeman-Edward J, Gambini C, Gross N, Hattinger CM, Luegmayr A, Lunec J, Martinsson T, Mazzocco K, Navarro S, Noguera R, O'Neill S, Potschger U, Rumpler S, Speleman F, Tonini GP, Valent A, Van Roy N, Amann G, De Bernardi B, Kogner P, Ladenstein R, Michon J, Pearson AD, Ambros PF: Quality assessment of genetic markers used for therapy stratification. J Clin Oncol. 2003, 21 (11): 2077-84. 10.1200/JCO.2003.03.025.CrossRefPubMed

34.

Haroske G, Dimmer V, Meyer W, Kunze KD: DNA histogram interpretation based on statistical approaches. Anal Cell Pathol. 1997, 15 (3): 157-73.CrossRefPubMed

35.

Haroske G, Meyer W, Oberholzer M, Bocking A, Kunze KD: Competence on demand in DNA image cytometry. Pathol Res Pract. 2000, 196 (5): 285-91.CrossRefPubMed

36.

Haroske G, Meyer W, Theissig F, Kunze KD: Increase of precision and accuracy of DNA cytometry by correcting diffraction and glare errors. Anal Cell Pathol. 1995, 9 (1): 1-12.PubMed

37.

Puech M, Giroud F: Standardisation of DNA quantitation by image analysis: quality control of instrumentation. Cytometry. 1999, 36 (1): 11-7. 10.1002/(SICI)1097-0320(19990501)36:1<11::AID-CYTO2>3.0.CO;2-T.CrossRefPubMed

38.

Haroske G, Giroud F, Kunze KD, Meyer W: A telepathology based Virtual Reference and Certification Centre for DNA image cytometry. Anal Cell Pathol. 2000, 21 (3–4): 149-59.CrossRefPubMed

39.

Gortler J, Berghoff M, Kayser G, Kayser K: Grid technology in tissue-based diagnosis: fundamentals and potential developments. Diagn Pathol. 2006, 1: 23-10.1186/1746-1596-1-23.PubMedCentralCrossRefPubMed

40.

Kayser K, Metze K, Radziszowski D, Amir-Hoshang S, Goldmann T, Kosjerina Z, Mireskandari M, Kayser G: Texture and object related automated information analysis in histological still images of various organs. AQCH. 2008,

41.

Mireskandari M, Kayser G, Hufnagl P, Schrader T, Kayser K: Teleconsultation in diagnostic pathology: experience from Iran and Germany with the use of two European telepathology servers. J Telemed Telecare. 2004, 10 (2): 99-103. 10.1258/135763304773391549.CrossRefPubMed

42.

Glatz-Krieger K, Glatz D, Mihatsch MJ: [Virtual microscopy: first applications]. Pathologe. 2006, 27 (6): 469-76. 10.1007/s00292-005-0782-1.CrossRefPubMed

43.

Le Bozec C, Henin D, Fabiani B, Schrader T, Garcia-Rojo M, Beckwith B: Refining DICOM for pathology – progress from the IHE and DICOM pathology working groups. Medinfo. 2007, 12 (Pt 1): 434-8.

44.

Tuomari DL, Kemp RK, Sellers R, Yarrington JT, Geoly FJ, Fouillet XL, Dybdal N, Perry R: Society of Toxicologic Pathology position paper on pathology image data: compliance with 21 CFR Parts 58 and 11. Toxicol Pathol. 2007, 35 (3): 450-5. 10.1080/01926230701284509.CrossRefPubMed

45.

Wells WA, Barker PE, MacAulay C, Novelli M, Levenson RM, Crawford JM: Validation of novel optical imaging technologies: the pathologists' view. J Biomed Opt. 2007, 12 (5): 051801-10.1117/1.2795569.CrossRefPubMed

46.

Yagi Y, Gilbertson JR: Digital imaging in pathology: the case for standardization. J Telemed Telecare. 2005, 11 (3): 109-16. 10.1258/1357633053688705.CrossRefPubMed

47.

Baker CF, Rudnisky CJ, Tennant MT, Sanghera P, Hinz BJ, De Leon AR, Greve MD: JPEG compression of stereoscopic digital images for the diagnosis of diabetic retinopathy via teleophthalmology. Can J Ophthalmol. 2004, 39 (7): 746-54.CrossRefPubMed

48.

Guillaud M, Cox D, Malpica A, Staerkel G, Matisic J, Van Niekirk D, Adler-Storthz K, Poulin N, Follen M, MacAulay C: Quantitative histopathological analysis of cervical intra-epithelial neoplasia sections: methodological issues. Cell Oncol. 2004, 26 (1–2): 31-43.PubMed

49.

Williams BH, Hong IS, Mullick FG, Butler DR, Herring RF, O'Leary TJ: Image quality issues in a static image-based telepathology consultation practice. Hum Pathol. 2003, 34 (12): 1228-34. 10.1016/S0046-8177(03)00429-5.CrossRefPubMed

50.

Robertson J: Image Dissemination and Archiving. Clin Tech Small Anim Pract. 2007, 22: 138-44. 10.1053/j.ctsap.2007.05.008.CrossRefPubMed

51.

Burthem J, Brereton M, Ardern J, Hickman L, Seal L, Serrant A, Hutchinson CV, Wells E, McTaggart P, De la Salle B, Parker-Williams J, Hyde K: The use of digital 'virtual slides' in the quality assessment of haematological morphology: results of a pilot exercise involving UK NEQAS(H) participants. Br J Haematol. 2005, 130 (2): 293-6. 10.1111/j.1365-2141.2005.05597.x.CrossRefPubMed

52.

Klossa J, Cordier JC, Flandrin G, Got C, Hemet J: A European de facto standard for image folders applied to telepathology and teaching. Int J Med Inform. 1998, 48 (1–3): 207-16. 10.1016/S1386-5056(97)00127-5.CrossRefPubMed

53.

O'Brien MJ, Takahashi M, Brugal G, Christen H, Gahm T, Goodell RM, Karakitsos P, Knesel EA, Kobler T, Kyrkou KA, Labbe S, Long EL, Mango LJ, McGoogan E, Oberholzer M, Reith A, Winkler C: Digital imagery/telecytology. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial. Acta Cytol. 1998, 42 (1): 148-64.CrossRefPubMed

54.

Goethals L, Perneel C, Debucquoy A, De Schutter H, Borghys D, Ectors N, Geboes K, McBride WH, Haustermans KM: A new approach to the validation of tissue microarrays. J Pathol. 2006, 208 (5): 607-14. 10.1002/path.1934.CrossRefPubMed

55.

Jacquemier J, Ginestier C, Charafe-Jauffret E, Bertucci F, Bege T, Geneix J, Birnbaum D: [Small but high throughput: how "tissue-microarrays" became a favorite tool for pathologists and scientists]. Ann Pathol. 2003, 23 (6): 623-32.PubMed

56.

Brox GA, Huston JL: The application of the MPEG-4 standard to telepathology images for electronic patient records. J Telemed Telecare. 2003, 9 (Suppl 1): S19-21. 10.1258/135763303322196204.CrossRefPubMed

57.

Foran DJ, Meer PP, Papathomas T, Marsic I: Compression guidelines for diagnostic telepathology. IEEE Trans Inf Technol Biomed. 1997, 1 (1): 55-60. 10.1109/4233.594046.CrossRefPubMed

58.

Marcelo A, Fontelo P, Farolan M, Cualing H: Effect of image compression on telepathology. A randomized clinical trial. Arch Pathol Lab Med. 2000, 124 (11): 1653-6.PubMed

59.

Okumura A, Suzuki J, Furukawa I, Ono S, Ashihara T: Signal analysis and compression performance evaluation of pathological microscopic images. IEEE Trans Med Imaging. 1997, 16 (6): 701-10. 10.1109/42.650867.CrossRefPubMed

60.

Biesterfeld S, Kraus HL, Reineke T, Muys L, Mihalcea AM, Rudlowski C: Analysis of the reliability of manual and automated immunohistochemical staining procedures. A pilot study. Anal Quant Cytol Histol. 2003, 25 (2): 90-6.PubMed

61.

Bibbo M: How technology is reshaping the practice of nongynecologic cytology: frontiers of cytology symposium. Acta Cytol. 2007, 51 (2): 123-52.CrossRefPubMed

62.

Chung GG, Zerkowski MP, Ghosh S, Camp RL, Rimm DL: Quantitative analysis of estrogen receptor heterogeneity in breast cancer. Lab Invest. 2007, 87 (7): 662-9. 10.1038/labinvest.3700543.CrossRefPubMed

63.

Namati E, De Ryk J, Thiesse J, Towfic Z, Hoffman E, McLennan G: Large image microscope array for the compilation of multimodality whole organ image databases. Anat Rec (Hoboken). 2007, 290 (11): 1377-87.CrossRef

64.

Bartels PH, Wied GL: Automated screening for cervical cancer: diagnostic decision procedures. Acta Cytol. 1997, 41 (1): 6-10.PubMed

65.

Iregui M, Gomez F, Romero E: Strategies for efficient virtual microscopy in pathological samples using JPEG2000. Micron. 2007, 38 (7): 700-13. 10.1016/j.micron.2007.04.008.CrossRefPubMed

66.

Schrader T, Niepage S, Leuthold T, Saeger K, Schluns K, Hufnagl P, Kayser K, Dietel M: The diagnostic path, a useful visualisation tool in virtual microscopy. Diagn Pathol. 2006, 1: 40-10.1186/1746-1596-1-40.PubMedCentralCrossRefPubMed

67.

Grimes GJ, McClellan SA, Goldman J, Vaughn GL, Conner DA, Kujawski E, McDonald J, Winokur T, Fleming W: Applications of virtual reality technology in pathology. Stud Health Technol Inform. 1997, 39: 319-27.PubMed

Title: Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology)
Authors: Klaus Kayser
Jürgen Görtler
Torsten Goldmann
Ekkehard Vollmer
Peter Hufnagl
Gian Kayser
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Diagnostic Pathology / Issue 1/2008
Electronic ISSN: 1746-1596
DOI: https://doi.org/10.1186/1746-1596-3-17

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology)

Abstract

Background

Aims

Theory and experiences

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aims

Theory and experiences

Conclusion

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