Standardization of whole slide image morphologic assessment with definition of a new application: Digital slide dynamic morphometry

Giacomo Puppa; Mauro Risio; Kieran Sheahan; Michael Vieth; Inti Zlobec; Alessandro Lugli; Sara Pecori; Lai Mun Wang; Cord Langner; Hiroyuki Mitomi; Takatoshi Nakamura; Masahiko Watanabe; Hideki Ueno; Jacques Chasle; Carlo Senore; Stephen A Conley; Paulette Herlin; Gregory Y Lauwers

doi:10.4103/2153-3539.86830

TECHNICAL NOTE

Year : 2011 | Volume : 2 | Issue : 1 | Page : 48

Standardization of whole slide image morphologic assessment with definition of a new application: Digital slide dynamic morphometry

Giacomo Puppa¹, Mauro Risio², Kieran Sheahan³, Michael Vieth⁴, Inti Zlobec⁵, Alessandro Lugli⁵, Sara Pecori⁶, Lai Mun Wang⁷, Cord Langner⁸, Hiroyuki Mitomi⁹, Takatoshi Nakamura¹⁰, Masahiko Watanabe¹⁰, Hideki Ueno¹¹, Jacques Chasle¹², Carlo Senore¹³, Stephen A Conley¹⁴, Paulette Herlin¹⁵, Gregory Y Lauwers¹⁶
¹ Division of Pathology, G. Fracastoro, City Hospital, Verona; PhD Programme in 2 Experimental Medicine and Oncology, University of Insubria, Varese, Italy
² Unit of Pathology, Institute for Cancer Research and Treatment-IRCC, Candiolo, Torino, Italy
³ Centre for Colorectal Disease, St. Vincent's University Hospital School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
⁴ Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
⁵ Institute for Pathology, University Hospital Basel, Basel, Switzerland
⁶ Department of Pathology, Section of Anatomical Pathology, Policlinico G. B. Rossi, University of Verona, Italy
⁷ Department of Cellular Pathology, John Radcliffe Hospital, Headington, Oxford, United Kingdom
⁸ Institute of Pathology, Medical University of Graz, Graz, Austria
⁹ Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
¹⁰ Department of Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
¹¹ Department of Surgery, National Defense Medical College, Namiki, Tokorozawa, Saitama, Japan
¹² Department of Pathology, François Baclesse Comprehensive Cancer Center, Caen, France
¹³ AOUS Giovanni Battista - CPO Piemonte, SCDO Epidemiologia dei Tumori, Torino, Italy
¹⁴ Pathology Media Lab, Pathology Service, Massachusetts General Hospital, Boston, MA, USA
¹⁵ Groupe Régional d'Etudes sur le Cancer, University of Caen, François Baclesse Comprehensive Cancer Center, Caen, France
¹⁶ Gastrointestinal Pathology Service and Division of Surgical Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

Correspondence Address:
Giacomo Puppa
Division of Pathology, G. Fracastoro, City Hospital, Verona; PhD Programme in 2 Experimental Medicine and Oncology, University of Insubria, Varese
Italy

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/2153-3539.86830

Background: In histopathology, the quantitative assessment of various morphologic features is based on methods originally conceived on specific areas observed through the microscope used. Failure to reproduce the same reference field of view using a different microscope will change the score assessed. Visualization of a digital slide on a screen through a dedicated viewer allows selection of the magnification. However, the field of view is rectangular, unlike the circular field of optical microscopy. In addition, the size of the selected area is not evident, and must be calculated. Materials and Methods: A digital slide morphometric system was conceived to reproduce the various methods published for assessing tumor budding in colorectal cancer. Eighteen international experts in colorectal cancer were invited to participate in a web-based study by assessing tumor budding with five different methods in 100 digital slides. Results: The specific areas to be tested by each method were marked by colored circles. The areas were grouped in a target-like pattern and then saved as an .xml file. When a digital slide was opened, the .xml file was imported in order to perform the measurements. Since the morphometric tool is composed of layers that can be freely moved on top of the digital slide, the technique was named digital slide dynamic morphometry. Twelve investigators completed the task, the majority of them performing the multiple evaluations of each of the cases in less than 12 minutes. Conclusions: Digital slide dynamic morphometry has various potential applications and might be a useful tool for the assessment of histologic parameters originally conceived for optical microscopy that need to be quantified.

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