Pathology, clinical

病理学, 临床
  • 文章类型: Journal Article
    传统的手工血涂片诊断方法耗时长,容易出错,通常在很大程度上依赖于临床实验室分析师的经验来保证准确性。随着神经网络和深度学习等关键技术的突破不断推动医疗领域的数字化转型,图像识别技术正越来越多地被利用来增强现有的医疗流程。近年来,计算机技术的进步通过使用图像识别技术提高了血液涂片中血细胞识别的效率。本文全面总结了利用图像识别算法诊断血涂片疾病的方法和步骤,重点是疟疾和白血病。此外,它为开发全面的血细胞病理检测系统提供了前瞻性的研究方向。
    Traditional manual blood smear diagnosis methods are time-consuming and prone to errors, often relying heavily on the experience of clinical laboratory analysts for accuracy. As breakthroughs in key technologies such as neural networks and deep learning continue to drive digital transformation in the medical field, image recognition technology is increasingly being leveraged to enhance existing medical processes. In recent years, advancements in computer technology have led to improved efficiency in the identification of blood cells in blood smears through the use of image recognition technology. This paper provides a comprehensive summary of the methods and steps involved in utilizing image recognition algorithms for diagnosing diseases in blood smears, with a focus on malaria and leukemia. Furthermore, it offers a forward-looking research direction for the development of a comprehensive blood cell pathological detection system.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:风险管理包括识别各种风险,评估发生的可能性,并评估其后果的严重性。由于临床实验室整体参与患者护理,在某些情况下,实验室的风险可能会带来严重后果。本研究旨在在临床实验室中利用简单的风险管理技术。
    方法:对某三级医院病理实验室的所有潜在风险进行鉴定,并将其分类为自然灾害,环境,与人力相关的,预分析,分析,分析后,和实验室危险相关的风险通过头脑风暴会议。根据部门和医院记录估计每种风险的发生概率。风险的可能影响(1-10分)被归类为灾难性的,关键,严肃,微不足道,和微不足道的。通过将发生概率和影响评分相乘来计算未加权风险评分。
    结果:样品与抗凝剂比例不足的发生概率最高(22.85%),其次是分析数量不足(7.30%)和实验室信息系统(LIS)细分(6.58%)。我们研究中最高的未加权风险评分是样本与抗凝剂比率不足(评分91.40),其次是标记不当的样本(得分为35.61),人力能力问题(32.88分),样本不足以进行分析(评分29.20),和LIS细分(得分26.30)。
    结论:我们发现在所有类别中,涉及分析前阶段的风险得分最高.其他重要风险包括人力能力问题,需要继续对工作人员进行在职培训作为降低风险的战略。头脑风暴和概率分析可以很容易地用于临床实验室的风险管理。
    BACKGROUND: Risk management includes identifying various risks, assessing the probability of occurrence, and evaluating the severity of their consequences. As clinical laboratories are integrally involved in patient care, risks in the laboratories could present grave consequences in some instances. This study aimed to utilize simple techniques for risk management in a clinical laboratory.
    METHODS: All potential risks in the pathology laboratory of a tertiary-level hospital were identified and classified into natural calamity, environmental, manpower-related, pre-analytical, analytical, post-analytical, and laboratory hazard-related risks through a brainstorming session. The probability of occurrence of each risk was estimated from departmental and hospital records. The possible impact of risk (score 1-10) was categorized into catastrophic, critical, serious, minor negligible, and insignificant. The unweighted risk score was calculated by multiplying the probability of occurrence and impact score.
    RESULTS: Inadequate sample-to-anticoagulant ratio had the highest probability of occurrence (22.85%), followed by quantity insufficient for analysis (7.30%) and laboratory information system (LIS) breakdown (6.58%). The highest unweighted risk score in our study was inadequate sample-to-anticoagulant ratio (score 91.40), followed by improperly labeled samples (score 35.61), manpower competency issues (score 32.88), sample insufficient for analysis (score 29.20), and LIS breakdown (score 26.30).
    CONCLUSIONS: We found that among all the categories, risks involving the pre-analytical phase had the highest risk scores. The other important risks included manpower competency issues requiring continued on-the-job training of staff as a risk reduction strategy. Brainstorming and probability analysis could be easily used for risk management in a clinical laboratory.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    使用高分辨率扫描仪对病理载玻片进行全载玻片成像(WSI),使人工智能(AI)在病理学中的大规模应用成为可能,为了支持疾病的检测和诊断,有可能提高组织诊断的效率和准确性。尽管有AI的承诺,它有局限性。“脆性”或对输入变化的敏感性需要使用大量数据进行训练。AI通常根据来自不同扫描仪的数据进行训练,但通常不会通过跨扫描仪复制相同的幻灯片。利用多个WSI仪器来生成相同幻灯片的数字副本将生成更全面的数据集,并可能提高AI算法的鲁棒性和泛化性,并降低AI训练的整体数据要求。为此,国家病理成像合作社(NPIC)已经建立了AIFORGE(促进强大的通用数据仿真的机会),嵌入NHS临床站点的独特多扫描仪设施,以(1)比较扫描仪性能,(2)跨WSI系统复制数字病理图像数据集,(3)支持临床AI算法的评估。NPICAIFORGE目前包括来自9家制造商的15台扫描仪。它每天可以生成大约4,000个WSI图像(大约7TB的图像数据)。本文描述了规划和建造这样一个设施所遵循的过程。©2024作者(S)。由JohnWiley&SonsLtd代表英国和爱尔兰病理学会出版的病理学杂志。
    Whole slide imaging (WSI) of pathology glass slides using high-resolution scanners has enabled the large-scale application of artificial intelligence (AI) in pathology, to support the detection and diagnosis of disease, potentially increasing efficiency and accuracy in tissue diagnosis. Despite the promise of AI, it has limitations. \'Brittleness\' or sensitivity to variation in inputs necessitates that large amounts of data are used for training. AI is often trained on data from different scanners but not usually by replicating the same slide across scanners. The utilisation of multiple WSI instruments to produce digital replicas of the same slides will make more comprehensive datasets and may improve the robustness and generalisability of AI algorithms as well as reduce the overall data requirements of AI training. To this end, the National Pathology Imaging Cooperative (NPIC) has built the AI FORGE (Facilitating Opportunities for Robust Generalisable data Emulation), a unique multi-scanner facility embedded in a clinical site in the NHS to (1) compare scanner performance, (2) replicate digital pathology image datasets across WSI systems, and (3) support the evaluation of clinical AI algorithms. The NPIC AI FORGE currently comprises 15 scanners from nine manufacturers. It can generate approximately 4,000 WSI images per day (approximately 7 TB of image data). This paper describes the process followed to plan and build such a facility. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    OpenAI开发的被大肆宣传的人工智能(AI)模型ChatGPT可以为医生带来巨大的好处。尤其是病理学家,通过节省时间,以便他们可以将时间用于更重要的工作。生成AI是一类特殊的AI模型,它使用从现有数据中学习的模式和结构,并可以创建新数据。在病理学中利用ChatGPT提供了许多好处,包括患者记录的总结及其在数字病理学中的有希望的前景,以及它对这一领域的教育和研究的宝贵贡献。然而,需要处理某些障碍,例如将ChatGPT与图像分析集成在一起,这将通过提高诊断的准确性和准确性来成为病理学领域的一场革命。使用ChatGPT的挑战包括来自其训练数据的偏见,需要充足的输入数据,与偏见和透明度相关的潜在风险,以及不准确的内容生成引起的潜在不利结果。从文本信息中生成有意义的见解,这将有效地处理不同类型的图像数据,比如医学图像,和病理幻灯片。应适当考虑道德和法律问题,包括偏见。
    The much-hyped artificial intelligence (AI) model called ChatGPT developed by Open AI can have great benefits for physicians, especially pathologists, by saving time so that they can use their time for more significant work. Generative AI is a special class of AI model, which uses patterns and structures learned from existing data and can create new data. Utilizing ChatGPT in Pathology offers a multitude of benefits, encompassing the summarization of patient records and its promising prospects in Digital Pathology, as well as its valuable contributions to education and research in this field. However, certain roadblocks need to be dealt like integrating ChatGPT with image analysis which will act as a revolution in the field of pathology by increasing diagnostic accuracy and precision. The challenges with the use of ChatGPT encompass biases from its training data, the need for ample input data, potential risks related to bias and transparency, and the potential adverse outcomes arising from inaccurate content generation. Generation of meaningful insights from the textual information which will be efficient in processing different types of image data, such as medical images, and pathology slides. Due consideration should be given to ethical and legal issues including bias.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Editorial
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:技术不仅彻底改变了直接患者护理,而且彻底改变了诊断护理流程。这项研究评估了在多站点学术机构中从载玻片显微镜到数字病理学(DP)的转变,使用混合方法来了解用户对数字化的看法和实践变化的关键生产力指标。
    方法:参与者包括皮肤病理学家,病理报告专家,和临床医生。电子调查和个人或团体访谈包括与技术舒适度相关的问题,对DP的信任,以及采用DP的理由。病例量和周转时间从2020年第4季度至2023年第1季度(含)的电子健康记录中提取。数据进行了描述性分析,而访谈采用内容分析法进行分析。
    结果:34名工作人员完成了调查,22人参加了面试。在实施时间表期间或之后,整个机构的病例量和诊断周转时间没有差异(分别为p=0.084;p=0.133)。82.5%(28/34)的员工认为DP改善了签出体验,具有可达性,人体工程学,和注释功能被描述为关键因素。临床医生报告了DP对患者安全和跨学科合作的积极影响。
    结论:我们的研究表明,DP具有很高的接受率,不会对生产力产生不利影响,并可以改善患者安全和护理合作。
    BACKGROUND: Technology has revolutionized not only direct patient care but also diagnostic care processes. This study evaluates the transition from glass-slide microscopy to digital pathology (DP) at a multisite academic institution, using mixed methods to understand user perceptions of digitization and key productivity metrics of practice change.
    METHODS: Participants included dermatopathologists, pathology reporting specialists, and clinicians. Electronic surveys and individual or group interviews included questions related to technology comfort, trust in DP, and rationale for DP adoption. Case volumes and turnaround times were abstracted from the electronic health record from Qtr 4 2020 to Qtr 1 2023 (inclusive). Data were analyzed descriptively, while interviews were analyzed using methods of content analysis.
    RESULTS: Thirty-four staff completed surveys and 22 participated in an interview. Case volumes and diagnostic turnaround time did not differ across the institution during or after implementation timelines (p = 0.084; p = 0.133, respectively). 82.5% (28/34) of staff agreed that DP improved the sign-out experience, with accessibility, ergonomics, and annotation features described as key factors. Clinicians reported positive perspectives of DP impact on patient safety and interdisciplinary collaboration.
    CONCLUSIONS: Our study demonstrates that DP has a high acceptance rate, does not adversely impact productivity, and may improve patient safety and care collaboration.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    该手稿全面概述了人工智能(AI)在肺部病理学中的应用,特别是在肺癌的诊断中。它讨论了旨在支持病理学家和临床医生的各种AI模型。支持病理学家的AI模型是标准化诊断,评分PD-L1状态,支持肿瘤细胞计数,并表明病理判断的可解释性。几种模型预测病理诊断以外的结果,并预测临床结果,如患者的生存和分子改变。手稿强调了AI提高病理学准确性和效率的潜力,同时也解决了将人工智能融入临床实践的挑战和未来方向。
    This manuscript provides a comprehensive overview of the application of artificial intelligence (AI) in lung pathology, particularly in the diagnosis of lung cancer. It discusses various AI models designed to support pathologists and clinicians. AI models supporting pathologists are to standardize diagnosis, score PD-L1 status, supporting tumor cellularity count, and indicating explainability for pathologic judgements. Several models predict outcomes beyond pathologic diagnosis and predict clinical outcomes like patients\' survival and molecular alterations. The manuscript emphasizes the potential of AI to enhance accuracy and efficiency in pathology, while also addressing the challenges and future directions for integrating AI into clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    数字病理学提出了独特的计算挑战,作为标准的千兆像素幻灯片可以包括成千上万的图像tiles1-3。以前的模型通常会对每张幻灯片的一小部分瓷砖进行二次采样,因此缺少重要的幻灯片级别context4。这里我们介绍Prov-GigaPath,整个幻灯片病理学基础模型在来自普罗维登斯的171,189个完整幻灯片中的13亿个256×256个病理学图像图块上进行了预训练,一个由28个癌症中心组成的大型美国卫生网络。载玻片来自涵盖31种主要组织类型的30,000多名患者。要预先训练Prov-GigaPath,我们提出了GigaPath,一种用于训练前千兆像素病理学幻灯片的新型视觉变压器架构。为了扩展GigaPath,使用数万个图像块进行幻灯片级学习,GigaPath使新开发的LongNet5方法适应数字病理学。要评估Prov-GigaPath,我们构建了一个数字病理学基准,包括9个癌症亚型任务和17个病理组学任务,使用普罗维登斯和TCGA数据6。通过大规模的预训练和超大型环境建模,Prov-GigaPath在26个任务中的25个中获得了最先进的性能,在18个任务上比第二好的方法有了显著的改进。通过纳入病理报告,我们进一步证明了Prov-GigaPath在病理7,8的视觉语言预训练中的潜力。总之,Prov-GigaPath是一个开放权重的基础模型,可在各种数字病理学任务上实现最先进的性能,展示真实世界数据和整体幻灯片建模的重要性。
    Digital pathology poses unique computational challenges, as a standard gigapixel slide may comprise tens of thousands of image tiles1-3. Prior models have often resorted to subsampling a small portion of tiles for each slide, thus missing the important slide-level context4. Here we present Prov-GigaPath, a whole-slide pathology foundation model pretrained on 1.3 billion 256 × 256 pathology image tiles in 171,189 whole slides from Providence, a large US health network comprising 28 cancer centres. The slides originated from more than 30,000 patients covering 31 major tissue types. To pretrain Prov-GigaPath, we propose GigaPath, a novel vision transformer architecture for pretraining gigapixel pathology slides. To scale GigaPath for slide-level learning with tens of thousands of image tiles, GigaPath adapts the newly developed LongNet5 method to digital pathology. To evaluate Prov-GigaPath, we construct a digital pathology benchmark comprising 9 cancer subtyping tasks and 17 pathomics tasks, using both Providence and TCGA data6. With large-scale pretraining and ultra-large-context modelling, Prov-GigaPath attains state-of-the-art performance on 25 out of 26 tasks, with significant improvement over the second-best method on 18 tasks. We further demonstrate the potential of Prov-GigaPath on vision-language pretraining for pathology7,8 by incorporating the pathology reports. In sum, Prov-GigaPath is an open-weight foundation model that achieves state-of-the-art performance on various digital pathology tasks, demonstrating the importance of real-world data and whole-slide modelling.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:目前国家或地区浸润性乳腺癌病理报告指南在某些方面存在差异,导致报告做法不同,数据缺乏可比性。在这里,我们报告了一个新的国际数据集,用于乳腺浸润性癌切除标本的病理学报告。该数据集是在国际癌症报告合作组织(ICCR)的主持下制作的,主要(跨)国家病理学和癌症组织的全球联盟。
    结果:遵循已建立的数据集开发ICCR流程。由乳腺病理学家组成的国际专家小组,外科医生,肿瘤学家根据对当前证据的批判性审查和讨论,准备了一套核心和非核心数据项草案。对每个数据项提供了评注,以解释选择它作为核心或非核心元素的理由,其临床相关性,并强调潜在的分歧或缺乏证据的领域,在这种情况下,形成了共识立场。经过国际公众咨询,该文件已定稿并获得批准,和数据集,其中包括天气报告指南,已在ICCR网站上发布。
    结论:这是第一个针对浸润性乳腺癌的国际数据集,旨在促进高质量的乳腺癌,标准化病理报告。它的广泛采用将提高报告的一致性,促进多学科交流,增强数据的可比性,所有这些都将有助于改善浸润性乳腺癌患者的管理。
    OBJECTIVE: Current national or regional guidelines for the pathology reporting on invasive breast cancer differ in certain aspects, resulting in divergent reporting practice and a lack of comparability of data. Here we report on a new international dataset for the pathology reporting of resection specimens with invasive cancer of the breast. The dataset was produced under the auspices of the International Collaboration on Cancer Reporting (ICCR), a global alliance of major (inter-)national pathology and cancer organizations.
    RESULTS: The established ICCR process for dataset development was followed. An international expert panel consisting of breast pathologists, a surgeon, and an oncologist prepared a draft set of core and noncore data items based on a critical review and discussion of current evidence. Commentary was provided for each data item to explain the rationale for selecting it as a core or noncore element, its clinical relevance, and to highlight potential areas of disagreement or lack of evidence, in which case a consensus position was formulated. Following international public consultation, the document was finalized and ratified, and the dataset, which includes a synoptic reporting guide, was published on the ICCR website.
    CONCLUSIONS: This first international dataset for invasive cancer of the breast is intended to promote high-quality, standardized pathology reporting. Its widespread adoption will improve consistency of reporting, facilitate multidisciplinary communication, and enhance comparability of data, all of which will help to improve the management of invasive breast cancer patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    随着机器学习在越来越多的应用中的应用,机器学习中的可解释性变得越来越重要。包括那些具有高风险后果的人,例如医疗保健,其中可解释性被认为是成功采用机器学习模型的关键。然而,在通过深度学习模型进行预测时使用混杂/不相关的信息,即使是可解释的,对他们的临床接受提出了严峻的挑战。这最近引起了研究人员的关注,不仅仅是对深度学习模型的解释。在本文中,我们首先研究一个固有的可解释的基于原型的体系结构的应用,被称为ProtoPNet,数字病理学中的乳腺癌分类,并强调其在此应用中的缺点。然后,我们提出了一种新方法,该方法使用更多的医学相关信息,并做出更准确和可解释的预测.我们的方法利用了聚类概念,并隐式地增加了训练数据集中的类的数量。所提出的方法在没有任何像素级注释数据的情况下学习更多相关的原型。为了进行更全面的评估,除了分类准确性,我们根据一组熟练的病理学家的意见,定义了一个新的指标来评估可解释性程度.在BreakHis数据集上的实验结果表明,该方法有效地将分类准确率和可解释性分别提高了8%和18%。因此,所提出的方法可以看作是实现可解释的深度学习模型的步骤,用于使用组织病理学图像检测乳腺癌。
    Interpretability in machine learning has become increasingly important as machine learning is being used in more and more applications, including those with high-stakes consequences such as healthcare where Interpretability has been regarded as a key to the successful adoption of machine learning models. However, using confounding/irrelevant information in making predictions by deep learning models, even the interpretable ones, poses critical challenges to their clinical acceptance. That has recently drawn researchers\' attention to issues beyond the mere interpretation of deep learning models. In this paper, we first investigate application of an inherently interpretable prototype-based architecture, known as ProtoPNet, for breast cancer classification in digital pathology and highlight its shortcomings in this application. Then, we propose a new method that uses more medically relevant information and makes more accurate and interpretable predictions. Our method leverages the clustering concept and implicitly increases the number of classes in the training dataset. The proposed method learns more relevant prototypes without any pixel-level annotated data. To have a more holistic assessment, in addition to classification accuracy, we define a new metric for assessing the degree of interpretability based on the comments of a group of skilled pathologists. Experimental results on the BreakHis dataset show that the proposed method effectively improves the classification accuracy and interpretability by respectively 8 % and 18 % . Therefore, the proposed method can be seen as a step toward implementing interpretable deep learning models for the detection of breast cancer using histopathology images.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号