Patel Ankush U, Shaker Nada, Mohanty Sambit, Sharma Shivani, Gangal Shivam, Eloy Catarina, Parwani Anil V
Mayo Clinic Department of Laboratory Medicine and Pathology, Rochester, MN 55905, USA.
Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH 43210, USA.
Diagnostics (Basel). 2022 Jul 22;12(8):1778. doi: 10.3390/diagnostics12081778.
Diagnostic devices, methodological approaches, and traditional constructs of clinical pathology practice, cultivated throughout centuries, have transformed radically in the wake of explosive technological growth and other, e.g., environmental, catalysts of change. Ushered into the fray of modern laboratory medicine are digital imaging devices and machine-learning (ML) software fashioned to mitigate challenges, e.g., practitioner shortage while preparing clinicians for emerging interconnectivity of environments and diagnostic information in the era of big data. As computer vision shapes new constructs for the modern world and intertwines with clinical medicine, cultivating clarity of our new terrain through examining the trajectory and current scope of computational pathology and its pertinence to clinical practice is vital. Through review of numerous studies, we find developmental efforts for ML migrating from research to standardized clinical frameworks while overcoming obstacles that have formerly curtailed adoption of these tools, e.g., generalizability, data availability, and user-friendly accessibility. Groundbreaking validatory efforts have facilitated the clinical deployment of ML tools demonstrating the capacity to effectively aid in distinguishing tumor subtype and grade, classify early vs. advanced cancer stages, and assist in quality control and primary diagnosis applications. Case studies have demonstrated the benefits of streamlined, digitized workflows for practitioners alleviated by decreased burdens.
在经历了几个世纪发展的临床病理学实践中,诊断设备、方法学途径和传统架构,在技术爆炸式增长以及其他(如环境等)变革催化剂的推动下,已发生了根本性的转变。数字成像设备和机器学习(ML)软件被引入现代检验医学领域,旨在应对诸如从业者短缺等挑战,同时让临床医生为大数据时代环境与诊断信息的新互联性做好准备。随着计算机视觉为现代世界塑造新架构并与临床医学相互交织,通过审视计算病理学的发展轨迹和当前范围及其与临床实践的相关性,来明晰我们的新领域至关重要。通过对众多研究的回顾,我们发现机器学习的发展努力正从研究转向标准化临床框架,同时克服了以前阻碍这些工具应用的障碍,如通用性、数据可用性和用户友好性。开创性的验证工作推动了机器学习工具的临床应用,这些工具能够有效帮助区分肿瘤亚型和分级、对癌症早期与晚期阶段进行分类,并协助质量控制和初步诊断应用。案例研究表明,简化的数字化工作流程减轻了从业者的负担,带来了诸多益处。