Digital Pathology

15 Fig.5 Digital pathology integrated in the routine workflow processes. Imaging of the grossing, different slide stainings are combined into one digital case, which is then later evaluated on a digital pathology workplace. The quantitative analysis is an integrated part of the digital pathology report simple tasks managed through a computer. All these, of course, need advanced IT, inclu- ding high speed computers, massive storage capacity, safe data handling using backup storage, and wide-range internet access and dedicated software tools with a user- friendly graphic interface. Molecular pathology visualisation Fluorescence microscopy detects fluoro- phores used to label molecules in cells and tissues with the techniques of molecular morphology. Fluorophores are activated at UV or visible wavelength to emit light of lo- wer frequency, usually in blue, green or red, which can be collected through emission fil- ters in a dark background. Samples targeted with fluorescing labels, particularly genomic FISH, must be studied within a short time-frame to avoid false ne- gative results due to rapid signal fading (fa- ding artefacts). In addition, small signals of a few hundred nm size, such as those of gene and chromo- some probes in FISH, or those of its chro- mogenic version (CISH), are randomly placed throughout the whole 3-8 μm thickness of tissue sections, or cells, and thus some re- main hidden from conventional single focus photography. These signals can only be re- vealed with confidence by scanning several focal planes through the sample (z-stacking, or extended focus) for proper quantification of gene/chromosome gain, such as that of HER2 on chromosome17 (CEP17) in breast cancer (Fig. 4A-F); or for the fine spatial lo- calisation of signals proving gene-transloca- tions, such as that of t (9;22) resulting in the BCR-ABL gene fusion in a case of chro- nic myeloid leukaemia. Gene abnormalities may determine a specific diagnosis and the concomitant treatment options in an increa- sing number of malignant tumours. Digital pathology within rou- tine sign out processes Once the digital slide scanners digitise the hematoxilin eosin, surgical pathology speci- men, and then immunohistochemical se- cond round and FISH third round slides are also available in the slide holder/server so- lution, a pathologist can evaluate them from the laboratory’s digital workplace. (Fig. 5) In addition to slide viewing, the software supports quantification of identified altera- tions. The digital report can be signed out with detailed image and quantitative data. BELA MOLNAR Thursday, May 26th • 12:15 PM–12:35 PM • Room: Robert Koch • Digital pathology for and in the routine:new generation systems B. Molnár, Budapest, Hungary

Pages Overview