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PubMed1991

[Approach to differential diagnosis of clinically related forms of chromosomal pathology using computers].

Multiple congenital developmental abnormalities account for a considerable share in the structure of the childhood morbidity, mortality and disability. Still, the differential diagnosis of the above abnormalities presents considerable difficulties because of the diversity of the forms and genetic pleomorphism. Using the method of rarefied templates of the "case--description term" type tried previously, a study was made of the possibility of differentiating between the clinically related forms of the chromosomal pathology 9p- and 11q- on the basis of phenotypic differences. The template was made up of 40 cases of 9p- and 40 cases of 11q-, accounting for 720 traits altogether. The "phenotypic nuclei"--traits occurring at a rate of over 25% were revealed for each syndrome and compared. Two approaches to the differentiation between these syndromes were used, which may turn out instrumental for diagnosing the clinically related forms of multiple congenital developmental abnormalities of the non-chromosomal genesis. The potentialities and difficulties of the computer-aided differential diagnosis are under discussion.

Abnormalities, Multiple↗
PubMed1995

Computer-assisted pathology of intraepithelial adenocarcinoma and related lesions: 3-D distribution, structural aberration and discrimination.

To discriminate among intraepithelial neoplasms, we have been relying on tissue microscopy, but pathologists' subjectivity sometimes impairs diagnosis. Even an individual pathologist is sometimes unable to reproduce exactly his or her own previous diagnosis. Are various atypical lesions classifiable in a reproducible way, and if they are, how? The reliability of a diagnosis will be strengthened if we can define the "natural" categories inherent in cells and tissues. Morphometry and statistical analysis using a computer can provide answers. Atypia, a morphological feature of carcinoma, is essentially multivariate. Quantification of a tissue feature requires reducing it to a set of ten or more quantities, including size, shape and position of the nucleus, nucleolus, and the cell itself. The grade of aberration from the norm can be assessed only by a synthetic approach, using a computer for multivariate cluster analysis. This classification has been attempted in adenocarcinoma and related lesions of the lung and pancreas. The categories thus established are reproducible, because the lesions fall into divisions according to their forms. We can also examine the organ distribution of intraepithelial neoplasms by three dimensional (3-D) computer-assisted mapping. To reach a higher level of reliability, as many meaningful features as possible should be taken into account. Particularly, we emphasize the significance of architectural pattern as a biomarker for intraepithelial glandular neoplasms. Computer-aided 3-D structural analysis visualizes the basic skeleton of these neoplasms around which the cells adhere. Instead of the dichotomous tree pattern of normal glands, the tumors basically harbor a 3-D network, tubular or porous, which increasingly deviates from the norm along with the transition from adenoma to well to moderately to poorly differentiated adenocarcinoma. This structural aberration, if recognizable on 2-D sectional images, will serve as a surrogate endpoint biomarker for glandular tumors.

Algorithms↗
PubMed1988

Correlative investigations of craniospinal anatomy and pathology with computed tomography, magnetic resonance imaging and cryomicrotomy.

A correlative computed tomographic-anatomic method was applied to multiplanar anatomic studies. The method was particularly valuable for comparative anatomic investigations of complex regions of the central nervous system. The description of CT and MR anatomy in this thesis is based either on direct CT-anatomic correlation of the same specimen, or on indirect MR-anatomic correlation with cryosectional images from cadavers. In sagittal partial saturation MR images with short repetition times, the pituitary fossa in 41 normal volunteers appeared inhomogeneous. A postero-inferiorly located high intensity signal correlated with an intrasellar fat pad in sagittal cryosectional images. The height of the pituitary gland in 38 normal volunteers was usually less than 8 mm and its upper surface was flat or concave. The cavernous sinus anatomy was studied in coronal and axial MR planes in seven normal volunteers and 15 patients in correlation with cryosectional images. The intracavernous cranial nerves were best shown in the coronal plane, in partial saturation and inversion recovery sequences and displayed as foci of high signals intensity. MR signs of a parasellar mass included obliteration of intracavernous venous spaces, displacement of the intracavernous portion of the internal carotid artery and bulging of the lateral wall of the cavernous sinus. The topographic anatomy of the cervical neuroforamina was investigated in axial, sagittal, coronal and oblique planes in a correlative CT-anatomic investigation in 19 specimens. In four normal volunteers, the surface coil MR images of the cervical neuroforamina were correlated with cryosectional images. Surface coil MR images in a plane perpendicular to the cervical nerve roots allowed to determine their relationship to intraforaminal structures and the boundaries of the foramen. The dorsal and ventral nerve roots were demonstrated with both CT and MRI. They were located in the lower half of the foramen at and below the intervertebral disc space. The dorsal nerve roots were in contact with the superior articular process. The ventral nerve roots abutted the uncinate process and the inferior portion of the foramen. In a biomechanical cervical spinal trauma study, experimental fractures were studied with CT in axial and sagittal planes. Sagittal anatomic images showed the fractures and soft tissue injuries. Non-displaced and horizontal fractures were generally difficult to detect on axial CT scans alone. In two pathologic spine specimens CT scans in axial, sagittal and coronal planes were compared with reformatted scans and cryosectional images. Direct CT images revealed four cervical spinal fractures whereas the reformatted images only showed one displaced pedicle fracture.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2005

Adrenal masses falsely diagnosed as adenomas on unenhanced and delayed contrast-enhanced computed tomography: pathological correlation.

OBJECTIVES: To assess the accuracy of CT for the diagnosis of histologically confirmed adrenal adenoma and nonadenoma using CT numbers. MATERIALS AND METHODS: Our study included 91 adrenal masses in 83 patients; histopathological diagnoses were 45 adenomas, 31 pheochromocytomas, 6 hyperplasias, 4 metastasis, and 5 miscellaneous lesions. Unenhanced CT in 46 patients and unenhanced and delayed contrast-enhanced (DCE) CT in 37 patients were retrospectively reviewed to examine the correlation between CT findings and those on pathological examination and to obtain diagnostic accuracy. RESULTS: Sensitivity, specificity, and accuracy for adenoma were 40% (18/45), 91% (42/46), and 66% (60/91) with unenhanced CT, and 96% (24/25), 61% (11/18), and 81% (35/43) with DCE CT. Adrenal masses falsely diagnosed as adenoma on unenhanced CT included three hyperplasias and one endothelial cyst, and those falsely diagnosed as adenoma on DCE CT were five pheochromocytomas, one oncocytic cortical tumor, and one primary pigmented nodular adrenocortical dysplasia. Twenty-five lipid-poor adenomas were falsely diagnosed as nonadenomas on unenhanced CT and one degenerated adenoma both on unenhanced CT and on DCE CT. CONCLUSION: Diagnosing adenoma merely on CT numbers can lead to misdiagnosis. The lower specificity than expected is due to pheochromocytomas presenting as false positives.

Adenoma↗
PubMed1987

Magnetic resonance imaging of the solitary hepatic mass: direct correlation with pathology and computed tomography.

Magnetic resonance images (MRI) of the liver were obtained using a combination of short time inversion recovery (STIR) and spin echo (SE) sequences. These were correlated with comparable tissue slices generated from resected specimens obtained at partial hepatectomy. All 10 cases appeared to have solitary masses on contrast enhanced computed tomography (CT). Histological examination revealed five primary tumours (two hepatocellular carcinomas, two haemangiomas and one cholangiocarcinoma) and five metastatic tumours. The STIR images demonstrated a high signal intensity in all areas of viable tumour involvement and reduced signal intensity in regions of confluent necrosis with superimposed haemorrhage or calcification. This sequence also demonstrated additional areas of high signal intensity adjacent to several lesions which were not visible on CT. Microscopy of these regions in the specimens demonstrated no tumour involvement or steatosis and their precise cause remains obscure. All the lesions demonstrated on the CT images were visible on MRI and no additional lesions were discovered on detailed microscopical examination of the specimens. Delineation of the extent of the cholangiocarcinoma was a problem with both techniques. MRI showed no major advantage over CT except for a higher contrast of the lesion compared with normal liver and also a better delineation of the tumour mass.

Adenoma, Bile Duct↗
PubMed1982

[The brain of Paul Broca (1824-1880). Correlation of pathological and computed tomography findings (author's transl)].

This historical study briefly recalls the circumstances of Broca's death, and reports some new data concerning his autopsy, and an analysis of macroscopic, microscopic, and computed tomography appearances of his brain following its discovery by Huard. The authenticity of the origin of the brain was established, and the hypothesis the Broca's death was due to rupture of a vascular malformation or a cerebrovascular accident was confirmed.

Brain↗
PubMed1988

Computed tomography and pathologic correlations of thymic lesions.

Computed tomographic and pathologic correlations of the thymus gland were assessed in 69 patients. The sensitivity of computed tomography (CT) for undifferentiated thymic pathology is 87.1%; the specificity is 85.7%. The sensitivity of CT for neoplasm or mass is 97.1%, the specificity is 97.1%. The sensitivity of CT for lymphoid follicular hyperplasia (LFH) is 71.4%, the specificity is 97.6%. Therefore, a normal-sized thymus gland on CT does not exclude LFH. Completely preserved fat planes between thymic mass and adjacent structures on CT usually indicate a benign (noninvasive) neoplasm; completely absent fat planes usually indicate a malignant (invasive) neoplasm; partially preserved fat planes are indeterminate in assessing invasiveness. CT is also useful in showing recurrence or remnants of thymic tissue in patients who have had a previous thymectomy.

Adolescent↗
PubMed1986

[Computerized records in vascular pathology. V. Computer-assisted management of records in venous pathology].

Computerized processing of data from patients with venous disease concerns mainly those with chronic venous insufficiency and venous thromboembolic disease. It is of particular interest for epidemiologic studies of venous disease, explorations (functional, phlebographic) and proposed therapies. Progress in these 3 sectors requires computerized processing of data from case-reports and standardization of the noting of these data.

Computers↗
PubMed1986

[Computerized records in vascular pathology. II. Computer-assisted management of records in cerebrovascular pathology].

Computerized processing of data from patients with cerebro-vascular disease should improve interpretation of results of complementary examinations by allowing their comparison with arteriography and operative findings. It should also allow comparison of postoperative clinical and angiographic findings in order to analyse results obtained in an identical manner, and to provide a basis for discussion of therapeutic indications. Spontaneous evolution of atheromatous lesions can finally be compared with the course after surgery.

Cerebral Angiography↗
PubMed1981

Pineal region tumors: computed tomographic-pathologic spectrum.

While several computed tomographic (CT) studies of posterior third ventricular neoplasms have included descriptions of pineal tumors, few reports have concentrated on these uncommon lesions. Some authors have asserted that the CT appearance of many pineal tumors is virtually pathognomonic. A series of nine biopsy-proved pineal gland and eight other presumed tumors is presented that illustrates their remarkable heterogeneity in both histopathologic and CT appearance. These tumors included germinomas, teratocarcinomas, hamartomas, and other varieties. They had variable margination, attenuation, calcification, and suprasellar extension. Germinomas have the best response to radiation therapy. Biopsy of pineal region tumors is now feasible and is recommended for treatment planning.

Adolescent↗
PubMed1995

Selection and implementation of a laboratory computer system.

The process of selection of a pathology computer system has become increasingly complex as there are an increasing number of facilities that must be provided and stringent performance requirements under heavy computing loads from both human users and machine inputs. Furthermore, the continuing advances in software and hardware technology provide more options and innovative new ways of tackling problems. These factors taken together pose a difficult and complex set of decisions and choices for the system analyst and designer. The selection process followed by the Microbiology Department at Heidelberg Repatriation Hospital included examination of existing systems, development of a functional specification followed by a formal tender process. The successful tenderer was then selected using predefined evaluation criteria. The successful tenderer was a software development company that developed and supplied a system based on a distributed network using a SUN computer as the main processor. The software was written using Informix running on the UNIX operating system. This represents one of the first microbiology systems developed using a commercial relational database and fourth generation language. The advantages of this approach are discussed.

Clinical Laboratory Information Systems↗
PubMed1990

[Computed tomographic-pathologic correlation of centriacinar emphysema].

Centriacinar emphysema (CAE) is in principle defined and diagnosed pathologically. However, recently, computed tomography (CT) has been advocated in the diagnosis of emphysema because of the high degree of anatomic details it can provide. In order to assess the reliability and detectionability of CT in CAE detection, as well as evaluation of the severity, a CT-pathologic correlative study of CAE was performed. To study direct one-to-one CT (in vivo)-pathologic correlation, 20 lung lobes with CAE from autopsies and resections were inflated and fixed by the method of Heitzman et al and then sectioned along the plane equivalent to the CT images. The degree of CAE was graded pathologically by the point-counting method. The CT scans were assessed visually for low-attenuation areas by 3 independent physicians. A significant correlation was found between the CT and pathologic scores of the studied lobes (r = 0.94). Detectionability of CAE on lung slices by CT were 74%, 91%, and 100% for mild, moderate, and severe cases respectively. The smallest size of the diameter of emphysematous spaces which could be detected by CT with 10 mm collimation was 3-4 mm. We concluded that CT extremely useful in assessing the extent of CAE, however there are limitation in the diagnosis of mild cases. Moreover, visual scoring of low-attenuation areas on CT images was found to be clinically useful in the quantitative evaluation of CAE.

Aged↗
PubMed2026

A multi-modal survival prediction framework with group-based batch training and structural consistency alignment.

OBJECTIVE: Integrating whole-slide images (WSIs) with transcriptomic profiles is pivotal for enhancing cancer survival prediction. However, the intrinsic gigapixel resolution and variable sequence lengths of WSIs create a fundamental trade-off between training efficiency and the preservation of data heterogeneity in existing frameworks. Furthermore, substantial statistical and structural discrepancies between histological and genomic modalities often impede effective cross-modal alignment and fusion, thereby limiting prognostic accuracy. METHODS: We propose PRISM, an efficient multi-modal learning framework for integrating WSIs with transcriptomic profiles. To reconcile training efficiency with full data heterogeneity, PRISM first stochastically partitions variable-length WSI sequences into a main subset and a complementary residual subset, both of which are packed into fixed-length groups for batch training. The main subset is processed in the main branch, utilizing isolation masking to maintain intra-group sequence independence. Simultaneously, the residual subset is consolidated into "hyperslides" within a residual branch that leverages tailored supervision, effectively capturing inter-slide correlations. Furthermore, PRISM integrates an Informative Token Aggregation (ITA) module to reduce redundancy in WSIs and employs Cross-batch Structural Consistency Alignment (CBSCA) mechanism to enhance inter-modal structural connectivity. Finally, efficient cross-modal feature interaction is achieved through a Low-rank Bilinear Gated Fusion (LBGF) module. Code is available at https://github.com/Alisa2080/PRISM. RESULTS: Compared with existing methods, PRISM achieves the best overall C-index across five TCGA cohorts. On the larger TCGA-BRCA dataset, PRISM requires only 6 hours of training time, substantially reducing computational cost relative to strong multimodal baselines. Furthermore, comprehensive evaluations demonstrate that PRISM achieves the best overall IBS ranking and favorable time-dependent AUC performance at 1, 3, and 5 years, thereby delivering a more favorable trade-off between prognostic performance and computational efficiency. CONCLUSION: PRISM provides a favorable balance between predictive performance, calibration quality, and computational efficiency, highlighting its potential for practical deployment in multimodal survival modeling for computational pathology.

Humans↗
PubMed1979

Computer analysis and integration of animal pathology data.

Computer storage of data from toxicology, biochemistry, haematology and pathology has been found necessary in our Laboratory in order to handle the vast amount of information generated by animal toxicology studies. The value of the system to pathology is enormous and its potential has not been exhausted. All finding, from organ weights and macroscopic observations made at autopsy, to the final histopathological diagnosis made by the pathologist are computerized. A modified version of the American College of Pathologists' systematized nomenclature of pathology is used. The pathologist recordtor whose role in the system is indispensable. The designation of a pathologist with special responsibility for supervising the computerisation and its scientific validity ensures its smooth running. The integration of data from haematology and clinical chemistry as a profile for each animal is available to the pathologist when making the final diagnosis. The system has resulted in a standardisation of pathological terminology, greater speed and improved accuracy in report formulation, the establishment of a readily retrievable in-house data bank and an enormous saving in the time of pathologists and secretaries.

Humans↗