Archives of pathology & laboratory medicine最新文献

{"title":"Standardization of Bone Marrow Reporting for Myelodysplastic Syndromes/Neoplasms on Behalf of the International Consortium for Myelodysplastic Syndromes/Neoplasms.","authors":"Savanah D Gisriel, Fnu Aakash, John M Bennett, Robert P Hasserjian, Sanam Loghavi, Amy E DeZern, Valeria Santini, Michael R Savona, Andrew M Brunner, Rena Buckstein, Andrew H Wei, Matteo G Della Porta, Rami S Komrokji, Uma M Borate, Mikkael A Sekeres, Uwe Platzbecker, Pierre Fenaux, Gail J Roboz, Arjan van de Loosdrecht, Amer M Zeidan, Mina L Xu","doi":"10.5858/arpa.2024-0322-RA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0322-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Standardized bone marrow reporting specifically for myelodysplastic syndromes/neoplasms (MDS) is currently lacking in the literature and much needed in practice.</p><p><strong>Objective.—: </strong>To propose a standardized approach to MDS evaluation in bone marrow specimens by (1) enhancing interinstitutional and intrainstitutional collaborations and clinical decision-making among hematopathologists and clinical hematologists and (2) allowing for efficient data extraction for clinical trials, institutional databases, and registry templates. This suggested approach is summarized in a modifiable, user-friendly template for hematopathologists to reference as they examine bone marrows (in the Supplemental Digital Content).</p><p><strong>Data sources.—: </strong>We built upon the bone marrow template reporting guideline outlined by the College of American Pathologists Pathology and Laboratory Quality Center for Evidence-Based Guidelines and gathered expert insight from hematopathologists and hematologists-oncologists who specialize in MDS.</p><p><strong>Conclusions.—: </strong>This proposed approach to MDS evaluation in the bone marrow standardizes reporting, which enhances communication among health care professionals and allows for efficient data extraction.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The State of Pathology Student Interest Groups in Allopathic and Osteopathic Medical Schools in the United States: Current Practices and Opportunities for Improvement.","authors":"Cullen M Lilley, Kamran M Mirza, Kalisha Hill","doi":"10.5858/arpa.2024-0279-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0279-OA","url":null,"abstract":"<p><strong>Context.—: </strong>With the gradual decline in pathology residency applicants during the past few decades, the successful recruitment of quality medical students into the field will rely on a multidimensional approach. One of the means by which medical students are exposed to and recruited into the field of pathology is through student interest groups (SIGs). Though SIGs have been cited as a successful method for recruitment, the strategies for running a successful SIG have not been fully explored.</p><p><strong>Objective.—: </strong>To assess the functioning of pathology SIGs and provide a cross-sectional analysis of the challenges pathology SIGs face, what resources are needed, and how national organizations can most effectively support their functioning.</p><p><strong>Design.—: </strong>A multi-institutional survey was developed and deployed in December 2023 via email to College of American Pathologists medical student members and Future Pathologist Champions.</p><p><strong>Results.—: </strong>Of the 125 responses elicited from medical student members and Future Pathologist Champions, 78% (n = 97) indicated their institution had a pathology SIG. Faculty members were noted to be an important aspect to the SIG's success, especially by providing guidance and mentorship. Respondents also touted the regular hosting of events as another key component to success. Importantly, when asked about funding, most of the 78 respondents reported that their pathology SIGs relied on funding from their institution (58%; n = 45), but a large minority also received funding through grants/scholarships (36%; n = 28) or sponsorships from external organizations (28%; n = 22).</p><p><strong>Conclusions.—: </strong>This study provides a first-of-its-kind quantitative and qualitative account of the establishment and maintenance of pathology SIGs from the personnel participating in their daily functioning.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation Versus Grade for Pancreatic Neuroendocrine Neoplasms.","authors":"Guido Rindi, Frediano Inzani","doi":"10.5858/arpa.2024-0410-RA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0410-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Pancreatic neuroendocrine neoplasia (panNEN) is a tumor disease with distinctive morphology and often poses diagnostic challenges.</p><p><strong>Objective.—: </strong>To present and discuss the current diagnostic criteria of PanNEN.</p><p><strong>Data sources.—: </strong>PanNENs are classified by the World Health Organization (WHO) criteria into well-differentiated neuroendocrine tumor (panNET) and poorly differentiated neuroendocrine carcinoma (panNEC) of large or small cell type. panNETs are graded as G1-G3 on the basis of their proliferation capacity by mitotic count and/or Ki-67 proliferation index. Differentiation and grading are overlapping tools essentially directed to the definition of tumor cell resemblance to the normal cell counterpart (differentiation) and its proliferation capacity (grading). Both tools aim at defining the panNEN malignant potential, and ultimately the overall and event-free survival. The 2 panNEN families mirror different molecular backgrounds. The panNET genotype consistently displays mutation/copy number variation of DAXX (death domain associated protein), ATRX (ATRX chromatin remodeler), and MEN1 (menin 1) genes, while in panNEC the usual cancer drivers TP53 (tumor protein 53), RB1 (RB transcriptional corepressor 1), and KRAS (KRAS proto-oncogene, GTPase) genes are mutated/abnormal. The more subtle differences measured by grade in panNET G1-G3 reflect a progressive gene disorder, with G3 often involving TP53. This rare genetic setting is usually associated with a difficult differential diagnosis between panNET G3 and panNEC. Immunohistochemistry for the informative genes DAXX, ATRX, TP53, RB1, P16 (cyclin-dependent kinase inhibitor 2A), and SST2 (somatostatin receptor 2) are the key to separating panNETG3 and panNEC; however, molecular investigation is often required and decisive. Nonetheless, ambiguous cases may remain unresolved.</p><p><strong>Conclusions.—: </strong>The WHO diagnostic criteria for panNEN are simple and effective tools for a clinically meaningful patient stratification. Areas of uncertainty remain and deserve further investigation.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The World Health Organization Reporting System for Pancreaticobiliary Cytopathology: Review and Comparison to the Papanicolaou Society of Cytopathology System.","authors":"Martha B Pitman","doi":"10.5858/arpa.2023-0411-RA","DOIUrl":"10.5858/arpa.2023-0411-RA","url":null,"abstract":"<p><strong>Context.—: </strong>The World Health Organization (WHO) Reporting System for Pancreaticobiliary Cytopathology (WHO System) is the product of a joint venture between the World Health Organization, the International Academy of Cytology, and the International Agency for Research on Cancer. The WHO System revises the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSC System) and replaces the 6-tiered system with a 7-tiered system.</p><p><strong>Objective.—: </strong>To explain the WHO System and the differences with the PSC System.</p><p><strong>Data sources.—: </strong>The WHO System and the PSC System of Reporting Pancreaticobiliary Cytopathology.</p><p><strong>Conclusions.—: </strong>The diagnostic categories of the WHO System are \"Insufficient/Inadequate/Nondiagnostic\"; \"Benign (Negative for Malignancy)\"; \"Atypical\"; \"Pancreaticobiliary Neoplasm, Low Risk/Low Grade (PaN-Low)\"; \"Pancreatic Neoplasm, High Risk/High Grade (PaN-High)\"; \"Suspicious for Malignancy\"; and \"Malignant.\" In the WHO System, the \"benign\" category includes both nonneoplastic and neoplastic lesions, so the \"Neoplastic: Benign\" category of the PSC system has been eliminated. Low-grade malignancies, pancreatic neuroendocrine tumors (PanNETs), and solid-pseudopapillary neoplasm (SPN) classified as \"Neoplastic: Other\" in the PSC System are classified as \"Malignant\" in the WHO System, leaving in the \"Neoplasm\" category intraductal lesions, which are divided into 2 new diagnostic categories: \"Pancreaticobiliary Neoplasm (PaN)-Low Risk/Grade\" and \"PaN-High Risk/Grade.\" As with the PSC System, the WHO System advocates close correlation with imaging and encourages incorporation of ancillary testing into the final diagnosis, such as biochemical (carcinoembryonic antigen [CEA] and amylase) and molecular testing. The WHO System includes risk of malignancy per category, and reporting and diagnostic management options that recognize the variations in resources of low- and middle-income countries.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e39-e46"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Bronchoscopy for the Diagnosis of Lung Lesions: Experience With the Use of Frozen Sections as an Aid to Confirm the Localization of Lesions During the Procedure.","authors":"Manita Kanathanavanich, Xiaomo Li, Bernadette Boac, Shikha Bose, Ann E Walts, Taryne Imai, George Chaux, Andrew Brownlee, Alberto M Marchevsky","doi":"10.5858/arpa.2023-0458-RA","DOIUrl":"10.5858/arpa.2023-0458-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Robotic-assisted navigation bronchoscopy (R-ANB) is used to target peripheral pulmonary nodules that are difficult to biopsy using conventional approaches. Frozen sections are requested to confirm that these lesions have been localized and/or to diagnose neoplasms that can be immediately resected.</p><p><strong>Objective.—: </strong>To estimate diagnostic concordance between frozen section diagnosis (FSD) and formalin-fixed tissue diagnosis (FFTD) in biopsies obtained with R-ANB, calculate the sensitivity and specificity of FSD and FFTD for a diagnosis of malignancy, and evaluate whether the residual tissue that can be fixed in formalin after frozen section still has sufficient material for molecular studies.</p><p><strong>Data sources.—: </strong>The results of consecutive FSD rendered on biopsies performed with R-ANB during a 30-month period were used to calculate the metrics listed above. FFTD and/or the diagnoses rendered on computed tomography-guided core biopsy subsequently performed in patients with negative R-ANB and/or lung resections in patients with malignancies were used as true-positive results. The overall concordance between FSD and FFTD in 226 lesions from 203 patients was 72%. Frozen section diagnosed 76 of 123 malignancies with 100% specificity and 68% sensitivity. Adequate material was available in 92% of biopsies where next-generation sequencing and other molecular studies were requested.</p><p><strong>Conclusions.—: </strong>Intraoperative consultations are helpful to diagnose a variety of lung lesions and help surgeons confirm that targets have been accurately reached by R-ANB. Malignancies can be diagnosed with 100% specificity but only 68% sensitivity. The performance of frozen section did not interfere with the subsequent analysis of tissue with molecular studies in most cases.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"288-292"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate Laboratory Testing: Significant Waste Quantified by a Large-Scale Year-Long Study of Medicare and Commercial Payer Reimbursement.","authors":"Dave Smart, Jeff Schreier, Ila R Singh","doi":"10.5858/arpa.2023-0486-OA","DOIUrl":"10.5858/arpa.2023-0486-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Laboratory testing, beyond what is essential for managing health, is considered low-value care, posing patient risks and wasting resources. Measuring excess testing on a national level is crucial to identify waste and optimize healthcare resource allocation for maximum impact.</p><p><strong>Objective.—: </strong>To measure inappropriate laboratory testing and its cost across Medicare and many US commercial payers.</p><p><strong>Design.—: </strong>A retrospective analysis on 2019 claims data measured the frequency of 4 commonly used laboratory tests among 64 million individuals with Medicare and 168 million with commercial insurance. Tests included 25-hydroxy vitamin D, prostate-specific antigen, lipid panel, and hemoglobin A1c. Clinical guidelines, medical literature, and payer recommendations were used to determine appropriate testing frequencies. Costs of excessive testing were calculated using the 2019 clinical lab fee schedule. A targeted analysis of 2022 data confirmed 2019 trends.</p><p><strong>Results.—: </strong>Analysis of ∼84 million tests from ∼1 billion outpatient test claim records revealed that 7% to 51% of tests exceeded recommended frequencies, with some egregious overuse: for example, hemoglobin-A1c or prostate-specific antigen every week. The conservative cost estimate for 4 excess tests surpassed $350 million.</p><p><strong>Conclusions.—: </strong>This extensive study, involving 232 million people, found that 14.4 million of 60.5 million individuals (23.8%) tested had undergone excessive laboratory testing, with likely little benefit and possible harm. Extrapolating findings to all laboratory testing suggests that Medicare alone may have incurred direct excess expenses from $1.95 to $3.28 billion in 2019, without factoring the hidden costs of excessive testing (eg, downstream care). Addressing unnecessary testing is crucial to lowering costs and redirecting resources for greater patient benefit.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"253-261"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Frozen Section Evaluation of Pancreatic Specimens and Related Liver Lesions.","authors":"Jennifer Vazzano, Wei Chen, Wendy L Frankel","doi":"10.5858/arpa.2023-0359-RA","DOIUrl":"10.5858/arpa.2023-0359-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Frozen sections are essential in the surgical management of patients, especially those with pancreatic masses, because frozen sections can provide answers intraoperatively and aid in treatment decisions. Pancreas frozen sections are challenging because of the small tissue size, processing artifacts, neoadjuvant treatment effects, and concurrent pancreatitis-like obstructive changes. The authors present a review of intraoperative evaluation of pancreatic specimens.</p><p><strong>Objective.—: </strong>To provide an approach to the diagnosis of pancreatic adenocarcinoma on frozen sections and to discuss commonly encountered pitfalls. Indications for pancreas frozen sections and specific margin evaluation will be discussed. We will also review frozen section diagnosis of subcapsular liver lesions and tumors other than metastases of pancreatic ductal adenocarcinoma.</p><p><strong>Data sources.—: </strong>Data sources included a literature review and the personal experiences of the authors.</p><p><strong>Conclusions.—: </strong>The features for diagnosis of pancreatic adenocarcinoma include disordered architecture, glands at abnormal locations, and atypical cytology. It is important to be aware of the pitfalls and clues on frozen section. The evaluation of resection margins can be challenging, and in the setting of the resection of cystic tumors, the key is the diagnosis of high-grade dysplasia or cancer. Finally, it is vital to remember the differential diagnosis for subcapsular liver lesions because not all lesions will be metastases of adenocarcinomas or bile duct adenomas. Frozen sections remain a useful tool for the intraoperative management of patients with pancreatic tumors.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e63-e71"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assurance Model for Breast Cancer Prognostication Using the Modified Magee Equations.","authors":"Ian Lagerstrom, Daniel Neelon, Nena Wendzel, Stanley Lipkowitz, Joel T Moncur, Stella F Uiterwaal, Justin Wells","doi":"10.5858/arpa.2023-0576-OA","DOIUrl":"10.5858/arpa.2023-0576-OA","url":null,"abstract":"<p><strong>Context.—: </strong>The Oncotype DX recurrence score (RS) is a widely used test that provides prognostic information on the likelihood of disease recurrence and predictive information on the benefit of chemotherapy in early-stage, hormone receptor-positive breast cancer. Despite its widespread use, quality assurance of the RS does not receive the same level of scrutiny as other tests, such as human epidermal growth factor receptor 2 (HER2) immunohistochemistry.</p><p><strong>Objective.—: </strong>To use modified Magee equations to calculate the Magee score (MS) as a quality check of RS.</p><p><strong>Design.—: </strong>The MS is an easily accessible prognostic model that uses histopathologic and immunohistochemical criteria. We identified cases where the RS and MS differed by 10 points or more or were in different risk categories. These instances were considered significant discordances. MS was presented along with RS at multidisciplinary tumor boards, and all discrepancies were discussed to determine clinical significance and appropriate next steps.</p><p><strong>Results.—: </strong>Twenty-five of 155 cases (16.1%) had discrepancies between RS and MS. Of these 25 cases, 3 (12%) had problems with either the RS or the histopathologic interpretation. Among the cases with concordant RS and MS, no RS or interpretive problems were identified.</p><p><strong>Conclusions.—: </strong>Use of the MS as a quality control check for the RS can help ensure appropriate treatment decisions in breast cancer patients. Pathologists can play a key role in ensuring the quality of molecular-based prognostic scores by using histopathologic models to ensure accurate risk stratification and improve clinical outcomes.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e72-e77"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Microfluidic, Multi-Antibody Cell Capture Method to Evaluate Tumor Cells in Cerebrospinal Fluid in Patients With Suspected Leptomeningeal Metastases.","authors":"Nathan T Sweed, Hao-Ching Hsiao, Barbara Blouw, Tony J Pircher, Deanna Fisher, Katrina Rose Naluz, Julie Ann Mayer, Michael C Dugan, Akanksha Sharma, Jose Carrillo, Santosh Kesari","doi":"10.5858/arpa.2023-0295-OA","DOIUrl":"10.5858/arpa.2023-0295-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Leptomeningeal disease (LMD) is a clinical sequela of central nervous system metastasis involving the cerebrospinal fluid (CSF), often seen in late-stage solid tumors. It has a grave prognosis without urgent treatment. Standard of care methodologies to diagnose LMD include CSF cytology, magnetic resonance imaging, and clinical evaluation. These methods offer limited sensitivity and specificity for the evaluation of LMD. Here, we describe the analytic performance characteristics of a microfluidic-based tumor cell enrichment and detection assay optimized to detect epithelial cells in CSF using both contrived samples as well as CSF from patients having suspected or confirmed LMD from carcinomas.</p><p><strong>Objective.—: </strong>To demonstrate the feasibility of using a microfluidic, multi-antibody cell capture assay to identify and quantify tumor cells in CSF.</p><p><strong>Design.—: </strong>An artificial CSF solution was spiked with 34 different human carcinoma cell lines at different concentrations and assayed for the ability to detect tumor cells to assess analytic accuracy. Two cell lines were selected to assess linearity, intra-assay precision, interinstrument precision, and sample stability. Clinical verification was performed on 65 CSF specimens from patients. Parameters assessed included the number of tumor cells, coefficient of variation percentage, and percentage of tumor cell capture (TCC).</p><p><strong>Results.—: </strong>Among contrived samples, average tumor cell capture ranged from 50% to 82% (261 of 522; 436 of 531), and coefficients of variation ranged from 7% to 67%. The cell capture assay demonstrated a sensitivity of 92% and a specificity of 95% among clinical samples.</p><p><strong>Conclusions.—: </strong>This assay demonstrated the ability to detect and enumerate epithelial cells in contrived and clinical specimens in an accurate and reproducible fashion. The use of cell capture assays in CSF may be useful as a sensitive test for the diagnosis and longitudinal monitoring of LMD from solid tumors.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"242-252"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Clinical-Computational Transparency Gap in Digital Pathology.","authors":"Qiangqiang Gu, Ankush Patel, Matthew G Hanna, Jochen K Lennerz, Chris Garcia, Mark Zarella, David McClintock, Steven N Hart","doi":"10.5858/arpa.2023-0250-RA","DOIUrl":"10.5858/arpa.2023-0250-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Computational pathology combines clinical pathology with computational analysis, aiming to enhance diagnostic capabilities and improve clinical productivity. However, communication barriers between pathologists and developers often hinder the full realization of this potential.</p><p><strong>Objective.—: </strong>To propose a standardized framework that improves mutual understanding of clinical objectives and computational methodologies. The goal is to enhance the development and application of computer-aided diagnostic (CAD) tools.</p><p><strong>Design.—: </strong>This article suggests pivotal roles for pathologists and computer scientists in the CAD development process. It calls for increased understanding of computational terminologies, processes, and limitations among pathologists. Similarly, it argues that computer scientists should better comprehend the true use cases of the developed algorithms to avoid clinically meaningless metrics.</p><p><strong>Results.—: </strong>CAD tools improve pathology practice significantly. Some tools have even received US Food and Drug Administration approval. However, improved understanding of machine learning models among pathologists is essential to prevent misuse and misinterpretation. There is also a need for a more accurate representation of the algorithms' performance compared to that of pathologists.</p><p><strong>Conclusions.—: </strong>A comprehensive understanding of computational and clinical paradigms is crucial for overcoming the translational gap in computational pathology. This mutual comprehension will improve patient care through more accurate and efficient disease diagnosis.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"276-287"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}