Cambridge Healthtech’s Inaugural
Applications of Digital Pathology
Preparing for a Fully Digital Workflow
August 20-21, 2019
The Inaugural Applications of Digital Pathology conference will review three main areas of implementation - in primary diagnosis in the U.S. and abroad, in telepathology and in combination with AI and machine learning tools. Digital pathology is vibrant
with the influx of new technologies and the first FDA-approved platform, and the variety of hardware solutions and software tools is an indication that creativity and investment is transforming the pathology landscape. Progress in this field will
greatly improve the practice of medicine.
Final Agenda
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Scientific Advisor and Conference Chairman
Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
Recommended Short Course*
SC2: Discover How Machine Learning Can Complement Diagnoses through Medical Imagery
Helen Lam, Software Developer, Developer Advocate, IBM Watson
Nicholas Bourdakos, Software Developer, IBM Watson
In this hands-on session, learn how to train your own custom classifier using medical images to help augment your diagnoses. We will first cover the overview of available technologies for medical imagery in diagnosis, then will show examples by utilizing
Watson Machine Learning and Tensorflow, an open source software library for high performance numerical computation to create a custom model.
SC7: Digital Pathology from A to Z for Beginners
Matthew G. Hanna, MD, Clinical Instructor, Breast and Informatics, Department of Pathology, Memorial Sloan Kettering Cancer Center
Digital pathology is a disruptive technology in the laboratory workflow. It has tremendous potential to change the way pathologists, researchers, and other personnel interact with pathology data. It is an exciting era of potentially practice-changing
technology. Although digital pathology comes with significant promise, there are still numerous obstacles that stand in the way of becoming the next standard of care. Aside from clinical practice, digital pathology can be leveraged in the research
and education arms of the medical community. This course will cover the nuts and bolts for all related topics in digital pathology for those who are just wondering what all the hype is about, to those who want a little more depth in their understanding
of what digital pathology can and will do in the medical community.
*Separate registration required.
TUESDAY, AUGUST 20
7:30 am Registration and Morning Coffee
8:30 Chairperson’s Opening Remarks
Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
8:40 KEYNOTE PRESENTATION: Legal Aspects of Artificial Intelligence
Timothy Craig Allen,
MD, JD, FCAP, Professor and Chair, Department of Pathology, The University of Mississippi Medical Center
Artificial intelligence promises to increase healthcare efficiencies and accuracy and reduce cost. Its development, however, has been generally outside of any regulatory environment, and little legal scholarship about it currently exists. Successful artificial
intelligence regulation will require an evolving regulatory strategy that abandons traditional normative boundaries, and instead will require shared governmental and stakeholder involvement. Medical malpractice liability theory will also require careful
consideration and evolution as artificial intelligence evolves.
9:10 Searching Is Intelligence: AI Solutions for Medical Imaging
Hamid Tizhoosh,
PhD, Professor, Computer Science; Director, Kimia Lab, Faculty Affiliate, Vector Institute, University of Waterloo
Image search has emerged as a very promising application of artificial intelligence. We will talk about different challenges of digital pathology and what AI algorithms could offer. Whereas most papers focus on classification and segmentation, this talk
will attempt to shed light on challenges and opportunities of image search for retrieving useful information from large archives of histopathology images.
9:40 Augmented Human Intelligence and Transformation of Hematopathology Workflow
Mohamed E. Salama,
MD, Professor, Pathology and Laboratory Medicine, Mayo Clinic School of Medicine and Medical Director, Mayo Clinic Reference Laboratories
Hematopathologists are increasingly using digital imaging tools for a wide spectrum of practice settings. However, digital imaging associated with artificial intelligence applications for effective learning and diagnosis rendering are not yet routinely
incorporated in practice. We will share our experience in utilizing digital tools and will demonstrate methods and applications of digital imaging along with augmented human intelligence to effectively improve the workflow in the practice of hematopathology.
We will cover the essential elements as well as the pitfalls, advantages, challenges and opportunities in utilization of digital tools in practice.
10:10 Coffee Break in the Exhibit Hall with Poster Viewing
11:00 KEYNOTE PRESENTATION: Rules of Engagement of Academia with Industry: Lessons for Digital Pathology Collaborations
Michael J. Becich,
MD, PhD, Associate Vice-Chancellor for Informatics in the Health Sciences; Chairman and Distinguished University Professor, Department of Biomedical Informatics (DBMI), University of Pittsburgh School of Medicine
Academic Industry Partnerships (AIPs) are key to successful “innovation cycles” within academic health systems (AHCs). This keynote describes the rules of engagement for faculty innovators and AHCs to evolve “best practices” for
AIPs. Keys to successful efforts involve basic/translational researchers, technology transfer and university/health systems offices of research/compliance as well as industry relations officers. Guidelines for innovators establishing AIPs and appropriate
management of conflict of interest policies will be discussed.
11:30 Digital Pathology for Primary Diagnosis: FDA Regulatory Review Process
Shyam Kalavar, MPH,
CT(ASCP), Senior Scientific Reviewer, Molecular Pathology and Cytology Branch, Division of Molecular Genetics and Pathology, Center for Devices and Radiological Health, Office of In Vitro Diagnostics and Radiological Health, U.S. Food and Drug Administration
FDA authorized the first digital pathology whole slide imaging system for primary diagnosis in 2017. This talk will provide a brief overview of the FDA regulatory review process for a marketing application for this type of a device and provide information
about the types of studies and validation data needed to support the performance of the device. This talk will also briefly discuss regulatory perspective of issues such as interoperability and artificial intelligence as applicable to digital pathology.
12:00 pm PANEL DISCUSSION: Barriers for AI Adoption in Clinical Practice
Moderator: Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
Panelists: Timothy Craig Allen, MD, JD, FCAP, Professor and Chair, Department of Pathology, The University of Mississippi Medical Center
Hamid Tizhoosh, PhD, Professor, Computer Science; Director, Kimia Lab, Faculty Affiliate, Vector Institute, University of Waterloo
Mohamed E. Salama, MD, Professor, Pathology and Laboratory Medicine, Mayo Clinic School of Medicine and Medical Director, Mayo Clinic Reference Laboratories
Michael J. Becich, MD, PhD, Associate Vice-Chancellor for Informatics in the Health Sciences; Chairman and Distinguished University Professor, Department of Biomedical Informatics (DBMI), University of Pittsburgh School of Medicine
12:30 Luncheon Presentation: Evolving AI to Enable the Next Generation of Digital Pathology
Joe Corrigan, Head, Technology, Medical Technology, Cambridge Consultants
The development of AI tools and their integration into diagnostics systems present an opportunity to transform digital pathology. This transformation will not be restricted to whole slide imaging and evaluation steps of digital pathology. Instead,
it will impact most of its aspects - from sample collection to diagnosis. In this talk, we will use our expertise from delivering AI enabled systems on behalf of our clients and we will explore the challenges of materialising the vision for
next-generation digital pathology. Moreover, we will highlight the opportunities and underline the technological advantages which will catalyse this transformation.
1:00 Cookie & Refreshment Break in the Exhibit Hall with Poster Viewing
1:30 Chairperson’s Remarks
Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
1:35 Implementing Telepathology Worldwide: The Cleveland Clinic Experience
Bin Yang, MD, PhD, Professor of Pathology, Co-Director of ePathology (International); Director of International Business and Collaboration, Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic Lerner College of Medicine
Digital pathology provides an emerging role in telepathology consultations both domestically and internationally. Through innovational approaches, we have established a scanner-independent telepathology platform in our institution for eConsults
to Chinese pathologists, patients and clinicians to offer guidance on diagnostic and prognostic findings to assist in therapeutic decision-making for international patients.
2:05 Challenges to Building International Digital Pathology Networks
Michael
Riben, MD, Director of Informatics, MD Anderson Cancer Center
Collaborative digital pathology has been enhanced by commercial software solutions and has made tremendous progress in recent years. Many have even successfully developed connections between domestic and/or International partners. However,
these implementations have been primarily point-to-point connections for the sharing of the images in isolation of pathology information or medical record information. Building a Digital pathology network for sharing both whole slide images
and clinical information still faces many challenges, particularly if you wish to scale this to international partners. This talk will address the challenges that must be overcome for an international digital pathology network to be successful
and highlight lessons learned along the way of planning such a network.
2:35 What You Need to Know About Performing Frozen Sections by Digital Scans
Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
The use of telepathology for frozen sections (intraoperative consultations) has been increasing due to limited time and availability of pathologists, and the demand for increased access to pathology subspecialists in difficult cases. However,
frozen sections can be difficult to handle remotely due to time constraints and artifacts. This talk will address the challenges, suitable IT solutions, practice tips and business aspects of performing remote frozen sections by telepathology.
3:05 PANEL DISCUSSION: The Business Use Case for Teleconsultation
Moderator: Mohamed E. Salama, MD, Professor, Pathology and Laboratory Medicine, Mayo Clinic School of Medicine and Medical Director, Mayo Clinic Reference Laboratories
Panelists: Bin Yang, MD, PhD, Professor of Pathology, Co-Director of ePathology (International); Director of International Business and Collaboration, Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic Lerner College
of Medicine
Michael Riben, MD, Director of Informatics, MD Anderson Cancer Center
Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
3:35 Refreshment Break in the Exhibit Hall with Poster Viewing
4:25 Chairperson’s Remarks
Anil Parwani, MD, PhD, MBA, Professor of Pathology and Biomedical Informatics, Vice Chair of Anatomic Pathology, Director of Pathology Informatics; Director, Digital Pathology Shared Resources, Wexner Medical Center - Department of Pathology,
The Ohio State University
4:30 Implementing A Digital Pathology Workflow for Primary Diagnosis: A 2-Year Report Card
Anil
Parwani, MD, PhD, MBA, Professor of Pathology and Biomedical Informatics, Vice Chair of Anatomic Pathology, Director of Pathology Informatics; Director, Digital Pathology Shared Resources, Wexner Medical Center - Department of Pathology,
The Ohio State University
In recent years, whole slide imaging (WSI) has been increasingly used to digitize large numbers of slides automatically, rapidly and at high resolution. Some of the applications include education, quality assurance, clinical and image
analysis. In our institution, we have validated and implemented WSI for multiple applications including primary diagnosis. This talk will address our experiences with implementing WSI for primary diagnosis and discuss technology, workflow,
quality and financial opportunities.
5:00 Whitepapers of Digital Pathology from the Digital Pathology Association
Douglas Joseph Hartman, MD, Associate Professor of Pathology and Director of Pathology Informatics, University of Pittsburgh Medical Center
The first approval of a digital pathology system has begun the transition of pathology from analog to digital. This process is being led by the Digital Pathology Association. To that end, the Digital Pathology Association and its members
have been publishing whitepapers on the conversion of the discipline of pathology to a digital format. This talk will review the topics presented in these recent whitepapers.
5:30 PANEL DISCUSSION: Update from the DPA – What’s Next on the Horizon for Digital Pathology?
Moderator: Liron Pantanowitz, MD, Professor, Pathology & Biomedical Informatics, University of Pittsburgh Medical Center
Anil Parwani, MD, PhD, MBA, Professor of Pathology and Biomedical Informatics, Vice Chair of Anatomic Pathology, Director of Pathology Informatics; Director, Digital Pathology Shared Resources, Wexner Medical Center - Department of Pathology, The Ohio State University
Douglas Joseph Hartman, MD, Associate Professor of Pathology and Director of Pathology Informatics, University of Pittsburgh Medical Center
6:00 Wine & Cheese Pairing Welcome Reception in the Exhibit Hall with Poster Viewing
7:00 Close of Day
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WEDNESDAY, AUGUST 21
7:15 am Registration
Independence B-E and Foyer
7:30 Problem Solving Breakout Discussions with Continental Breakfast
Impact of Digitization on the Practice Pathology
Moderator: Juan Antonio Retamero, MD, Staff Pathologist, Department of Anatomical Pathology, Hospital Campus de la Salud
- Impact of digitization on the practice of the profession
- The future of pathology: Digital and computational tools
- Clearing roadblocks on the adoption of digital pathology
Image Analysis Challenges of Digital Pathology: What do Pathologists Need?
Moderator: Hamid Tizhoosh, PhD, Professor, Computer Science; Director, Kimia Lab, Faculty Affiliate, Vector Institute, University of Waterloo, Canada
- Image segregation
- Image classification
- Image search
- Tissue recognition
- Survivability prediction
8:25 Chairperson’s Remarks
Douglas Joseph Hartman, MD, Associate Professor of Pathology and Director of Pathology Informatics, University of Pittsburgh Medical Center
8:30 Complete Digital Pathology for Routine Histopathology Diagnosis: Three Years’ Experience at Granada University Hospitals, Spain
Juan
Antonio Retamero, MD, Staff Pathologist, Department of Anatomical Pathology, Hospital Campus de la Salud
Granada University Hospitals comprises two teaching and two district general hospitals integrated in the public health system in southern Spain. We report on the transition to full digital pathology for primary histopathology diagnosis
and our experiences since its implementation in September 2016.
9:00 Application of AI Tools in Routine Digital Workflow: The Catania Experience
Filippo Fraggetta, MD, Head of the Pathology Department, Cannizzaro Hospital
At Cannizzaro Hospital in Catania, Italy, we use e-slides for primary diagnosis since 2017. Using a Laboratory Information System centric approach to the workflow, we integrated Artificial Intelligence tools in our routine digital workflow
to facilitate automated tumor detection (in prostate and breast cancer) and detection microorganisms (Helicobacter pylori). We discuss results of this new approach as well as difficulties and solutions to the implementations of these
tools.
9:30 Building the Foundation of Digital Pathology in the Diagnostic Setting: Guiding Principles and Practical Issues
Chee Leong Cheng, MBBS, FRCPath, FRCPASingapore, Senior Consultant, Anatomical Pathology; Director, Computational and Digital Pathology, Singhealth Pathology ACP; Department of Anatomical Pathology, Singapore General Hospital
Digital pathology with application of whole slide imaging (WSI) in the diagnostic setting demands the integration of WSI process into the diagnostic workflow. The key considerations include integration with laboratory information system,
end-to-end accountability of specimen assets and derivatives, thorough view of electronic information flow closely correlated with the workflow, sound validation planning and execution, and continuous monitoring and sustainability
by building a “digital pathology service” in the laboratory.
10:00 Integrated Specimen Management, AI Algorithms, and Companion Diagnostics: How BxLink has Transformed Our Practice
Todd Randolph, MD, Digital Pathology Consultant, Medical Director, Consultant Intermountain Healthcare, Urologic Institute
10:30 Coffee Break in the Exhibit Hall with Poster Viewing
Constitution A&B
11:30 Plenary Keynote Session
11:30 Chairperson’s Remarks
Charles Mathews, Principal, ClearView Healthcare Partners
11:40 NEW: Plenary Keynote Presentation: FDA Updates: Now and Looking to the Future
Katherine Donigan, PhD, Acting Director of Personalized Medicine, Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health, U.S. Food and Drug Administration
Introduction and background of the new Office Director of OIR and updates on precision medicine and other initiatives at the FDA.
12:10-1:05 pm Plenary Keynote Discussion: Proposals and Solutions for Diagnostic Reform Including Oversight of Laboratory Developed Tests (LDTs)
Moderator:
Cynthia A. Bens, Senior Vice President, Public Policy, Personalized Medicine Coalition
- How are stakeholders influencing congressional activity on the Verifying Accurate Leading-edge IVCT Development (VALID) Act?
- How will the VALID Act change the current oversight landscape for diagnostics, including LDTs?
- How are policymakers addressing the role of CMS and CLIA in the VALID Act?
- How will increased regulatory and oversight activities at the FDA affect the diagnostics industry?
- What impact will changes in diagnostics regulation and oversight have on patient care?
Panelists:
Julie Khani, MPA, President, American Clinical Laboratory Association (ACLA)
Donald E. Horton, Jr., Senior Vice President, Global Government Relations & Public Policy, Laboratory Corporation of America
Holdings
Susan Van Meter, Executive Director, AdvaMedDx
Tara Burke,
PhD, Senior Director, Public Policy & Advocacy, Association for Molecular Pathology (AMP)
1:05 Enjoy Lunch on Your Own
1:35 End of Applications of Digital Pathology
Recommended Short Course*
SC13: Data-Driven Process Development in the Clinical Laboratory
Robert Young, CGMBS, MS Bioinformatics, Owner, Principal Consultant, Lab Insights, LLC
The modern clinical laboratory utilizes complex, data-rich computer systems. In this course, you will learn how to leverage your laboratory information systems to build data-driven processes, create data-driven process improvements,
and make data-driven business decisions.
*Separate registration required.
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