FlexTileSource: An OpenSeadragon Extension for Efficient Whole-Slide Image Visualization

Computer-assisted diagnosis to improve diagnostic pathology: A review

ABSTRACT

With an increasing demand for accuracy and efficiency in diagnostic pathology, computer-assisted diagnosis (CAD) emerges as a prominent and transformative solution. This review aims to explore the practical applications, implications, strengths, and weaknesses of CAD applied to diagnostic pathology. A comprehensive literature search was conducted to include English-language studies focusing on CAD tools, digital pathology, and Artificial intelligence (AI) applications in pathology. The review underscores the transformative potential of CAD tools in pathology, particularly in streamlining diagnostic processes, reducing turnaround times, and augmenting diagnostic accuracy. It emphasizes the strides made in digital pathology, the integration of AI, and the promising prospects for prognostic biomarker discovery using computational methods. Additionally, ethical considerations regarding data privacy, equity, and trust in AI deployment are examined. CAD has the potential to revolutionize diagnostic pathology. The insights gleaned from this review offer a panoramic view of recent advancements. Ultimately, this review aims to guide future research, influence clinical practice, and inform policy-making by elucidating the promising horizons and potential pitfalls of integrating CAD tools in pathology.

Iris: A Next Generation Digital Pathology Rendering Engine

Digital pathology is a tool of rapidly evolving importance within the discipline of pathology. Whole slide imaging promises numerous advantages; however, adoption is limited by challenges in ease of use and speed of high-quality image rendering relative to the simplicity and visual quality of glass slides. Herein, we introduce Iris, a new high-performance digital pathology rendering system. Specifically, we outline and detail the performance metrics of Iris Core, the core rendering engine technology. Iris Core comprises machine code modules written from the ground up in C++ and using Vulkan, a low-level and low-overhead cross-platform graphical processing unit application program interface, and our novel rapid tile buffering algorithms. We provide a detailed explanation of Iris Core's system architecture, including the stateless isolation of core processes, interprocess communication paradigms, and explicit synchronization paradigms that provide powerful control over the graphical processing unit. Iris Core achieves slide rendering at the sustained maximum frame rate on all tested platforms (120 FPS) and buffers an entire new slide field of view, without overlapping pixels, in 10 ms with enhanced detail in 30 ms. Further, it is able to buffer and compute high-fidelity reduction-enhancements for viewing low-power cytology with increased visual quality at a rate of 100-160 μs per slide tile, and with a cumulative median buffering rate of 1.36 GB of decompressed image data per second. This buffering rate allows for an entirely new field of view to be fully buffered and rendered in less than a single monitor refresh on a standard display, and high detail features within 2-3 monitor refresh frames. These metrics far exceed previously published specifications, beyond an order of magnitude in some contexts. The system shows no slowing with high use loads, but rather increases performance due to graphical processing unit cache control mechanisms and is "future-proof" due to near unlimited parallel scalability.

[Digital transformation of a routine histopathology lab : Dos and don'ts!]

The implementation of digital histopathology in the laboratory marks a crucial milestone in the overall digital transformation of pathology. This shift offers a range of new possibilities, including access to extensive datasets for AI-assisted analyses, the flexibility of remote work and home office arrangements for specialists, and the expedited and simplified sharing of images and data for research, conferences, and tumor boards. However, the transition to a fully digital workflow involves significant technological and personnel-related efforts. It necessitates careful and adaptable change management to minimize disruptions, particularly in the personnel domain, and to prevent the loss of valuable potential from employees who may be resistant to change. This article consolidates our institute's experiences, highlighting technical and personnel-related challenges encountered during the transition to digital pathology. It also presents a comprehensive overview of potential difficulties at various interfaces when converting routine operations to a digital workflow.

Efficient Visualization of Whole Slide Images in Web-based Viewers for Digital Pathology

CONTEXT.—

Wide adoption of digital pathology requires efficient visualization and navigation in Web-based digital slide viewers, which is poorly defined.

OBJECTIVE.—

To define and quantify relevant performance metrics for efficient visualization of cases and slides in digital slide viewers.

DESIGN.—

With a universal slide viewer used in clinical routine diagnostics, we evaluated the impact of slide caching, compression type, tile, and block size of whole slide images generated from Philips, Leica, and 3DHistech scanners on streaming performance on case, slide, and field of view levels.

RESULTS.—

Two hundred thirty-nine pathologists routinely reviewed 60 080 whole slide images over 3 months. The median time to open a case's slides from the laboratory information system was less than 4 seconds, the time to change to a slide within the case was less than 1 second, and the time to render the adjacent field of view when navigating the slide was less than one-quarter of a second. A whole slide image's block size and a viewer tile size of 1024 pixels showed best performance to display a field of view and was preferrable over smaller tiles due to fewer mosaic effects. For Philips, fastest median slide streaming pace was 238 ms per field of view and for 3DHistech, 125 ms. For Leica, the fastest pace of 108 ms per field of view was established with block serving without decompression.

CONCLUSIONS.—

This is the first study to systematically assess user-centric slide visualization performance metrics for digital viewers, including time to open a case, time to change a slide, and time to change a field of view. These metrics help to improve the viewer's configuration, leading to an efficient visualization baseline that is widely accepted among pathologists using routine digital pathology.