Lesson from the COVID-19 pandemic: pathologists need to build their confidence on working in a digital microscopy environment

Montironi, Rodolfo; Cimadamore, Alessia; Liu, Cheng; López-Beltrán, Antonio; Scarpelli, Marina

doi:10.1007/s00428-021-03123-4

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…[ 17 , 18 ] As noted by Montironi et al ., the COVID-19 pandemic has accelerated the need for and application of digital pathology. [ 19 ] According to a study on the current state of digital cytopathology by Yao et al . in 2022, DIA was first used for cervical cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Comparison of FNA-based conventional cytology specimens and digital image analysis in assessment of pancreatic lesions

Khozeymeh,

Ariamanesh,

Roshan

et al. 2023

Cytojournal

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Objectives: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is one of the most important diagnostic tools for investigation of suspected pancreatic masses, although the interpretation of the results is controversial. In recent decades, digital image analysis (DIA) has been considered in pathology. The aim of this study was to assess the DIA in the evaluation of EUS-FNA based cytopathological specimens of pancreatic masses and comparing it with conventional cytology analysis by pathologist. Material and Methods: This study was performed using cytological slides related to EUS-FNA samples of pancreatic lesions. The digital images were prepared and then analyzed by ImageJ software. Factors such as perimeter, circularity, area, minimum, maximum, mean, median of gray value, and integrated chromatin density of cell nucleus were extracted by software ImageJ and sensitivity, specificity, and cutoff point were evaluated in the diagnosis of malignant and benign lesions. Results: In this retrospective study, 115 cytology samples were examined. Each specimen was reviewed by a pathologist and 150 images were prepared from the benign and malignant lesions and then analyzed by ImageJ software and a cut point was established by SPSS 26. The cutoff points for perimeter, integrated density, and the sum of three factors of perimeter, integrated density, and circularity to differentiate between malignant and benign lesions were reported to be 204.56, 131953, and 24643077, respectively. At this cutting point, the accuracy of estimation is based on the factors of perimeter, integrated density, and the sum of the three factors of perimeter, integrated density, and circularity were 92%, 92%, and 94%, respectively. Conclusion: The results of this study showed that digital analysis of images has a high accuracy in diagnosing malignant and benign lesions in the cytology of EUS-FNA in patients with suspected pancreatic malignancy and by obtaining cutoff points by software output factors; digital imaging can be used to differentiate between benign and malignant pancreatic tumors.

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Section: Discussionmentioning

confidence: 99%

Comparison of FNA-based conventional cytology specimens and digital image analysis in assessment of pancreatic lesions

Khozeymeh,

Ariamanesh,

Roshan

et al. 2023

Cytojournal

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“…Recent student surveys regarding digital education were also satisfying and approximately 87% students supported digital platforms in terms of the ease of use, image quality, and an appropriate learning tool [19]. The COVID-19 pandemic is a great lesson for us to realize the importance of virtual platforms and implementing digital microscopy during residency training and to utilize WSI in building up the confidence of future pathologists [20] so they can continue to provide accurate diagnosis and efficient services in adversities as well as in developing countries. More and more residency training programs throughout the world are implementing whole slide imaging (WSI) sessions during daily educational conferences and tumor boards [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic is a great lesson for us to realize the importance of virtual platforms and implementing digital microscopy during residency training and to utilize WSI in building up the confidence of future pathologists [20] so they can continue to provide accurate diagnosis and efficient services in adversities as well as in developing countries. More and more residency training programs throughout the world are implementing whole slide imaging (WSI) sessions during daily educational conferences and tumor boards [18][19][20][21]. It is therefore recommended to come up with an international and standardized plan to incorporate free virtual electives, digital work-shops, and WSI sessions, especially for students and resident trainees in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Digital Pathology Implementation can Help Alleviate Limited Pathology Services in Developing Countries

2022

IJOR

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This short communication highlights lack of resources in Pathology in developing countries which ultimately affects pathology residency training as well as routine practice of lab medicine. There are a few recommendations to help alleviate pathology manpower in resource limited countries including digitization of teaching resources, integration of pathology education into systems-based curriculum, concept of virtual electives, specialization within pathology practices beyond the academic centers and competency-based certification. Opportunities like digital pathology, virtual trainings and online courses can play an important role in pathology education and for covering all kind of curricula. These changes will also implement a standardized education system of international quality. The digital world has a lot to offer in terms of training and there are extensive learning options if we learn to utilize them properly. More and more remote platforms are becoming available in the form of elective opportunities and online teaching sessions. It is important to promote these platforms as they do not have border restrictions and they are a perfect example of how education should be free and accessible to everyone around the world. Keywords: Digital pathology; Virtual training; Electives; Pathology education; Manpower; Competen

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“…This specific limitation can also be viewed as the identification of an important evidence gap that can be addressed in carefully designed follow-up studies. There are other COVID-19–related temporary regulatory deviations that enabled, for example, adoption of digital pathology, 3 , 51 , 58 , 59 , 60 and even a federal notice proposing to make all regulatory changes permanent (86 FR 4088); although the outcome of the former deviations is still pending, the latter was withdrawn (86 FR 20174).…”

Section: Discussionmentioning

confidence: 99%

Temporary Regulatory Deviations and the Coronavirus Disease 2019 (COVID-19) PCR Labeling Update Study Indicate What Laboratory-Developed Test Regulation by the US Food and Drug Administration (FDA) Could Look Like

Marble

Bard

Mizrachi

et al. 2021

The Journal of Molecular Diagnostics

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The coronavirus disease 2019 (COVID-19) response necessitated innovations and a series of regulatory deviations that also affected laboratory-developed tests (LDTs). To examine real-world consequences and specify regulatory paradigm shifts, legislative proposals were aligned on a common timeline with Emergency Use Authorization (EUA) of LDTs and the US Food and Drug Administration (FDA)-orchestrated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) labeling update study. The initial EUA adoption by LDT developers shows that the FDA can have oversight over LDTs. We used efficiency-corrected microcosting of our EUA PCR assay to estimate the national cost of the labeling update study to $0.3 to $1.4 million US dollars. Labeling update study performance data showed lower average detection limits in commercial in vitro diagnostic (IVD) assays versus LDTs (32,000 ± 75,000 versus 71,000 ± 147,000 nucleic acid amplification tests/mL; P = 0.04); however, comparison also shows that FDA review of IVD assays and LDTs did not prevent differences between initial and labeling update performance (IVD assay, P < 0.0001; LDT, P = 0.003). The regulatory shifts re-emphasized that both commercial tests and LDTs rely heavily on laboratory competence and procedures; however, lack of performance data on authorized tests, when clinically implemented, precludes assessment of the benefit related to regulatory review. Temporary regulatory deviations during the pandemic and regulatory science tools (ie, reference material) have generated valuable real-world evidence to inform pending legislation regarding LDT regulation.

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Lesson from the COVID-19 pandemic: pathologists need to build their confidence on working in a digital microscopy environment

Cited by 6 publications

References 10 publications

Comparison of FNA-based conventional cytology specimens and digital image analysis in assessment of pancreatic lesions

Comparison of FNA-based conventional cytology specimens and digital image analysis in assessment of pancreatic lesions

Digital Pathology Implementation can Help Alleviate Limited Pathology Services in Developing Countries

Temporary Regulatory Deviations and the Coronavirus Disease 2019 (COVID-19) PCR Labeling Update Study Indicate What Laboratory-Developed Test Regulation by the US Food and Drug Administration (FDA) Could Look Like

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