The New Kid on the Block
Christian Salib, Assistant Professor, Hematopathology1
Julie Teruya-Feldstein M.D., Professor of Pathology, Molecular and Cell Based Medicine3
Mehrvash Haghighi, M.D. Assistant Professor of Pathology, Molecular and Cell Based Medicine 2
Eileen Scigliano, M.D. Associate Professor of Medicine, Hematology and Medical Oncology1
1Icahn School of Medicine at Mount Sinai, New York, NY,
2Mount Sinai Hospital, NEW YORK, NY,
3Mount Sinai Hospital Icahn School of Medicine, New York, NY
DISCLOSURE: The authors of this abstract have indicated that they have no conflicts of interest that relate to the content of the material being presented.
Digital pathology and artificial intelligence (AI) is a popular and rapidly growing field of Pathology. A growing number of institutes have integrated digital imaging into routine workflow, relying on AI algorithms for the detection of prostate cancer, mitotic figure enumeration and evaluating degree of glomerular disease.
Despite advances and increased use of Whole Slide Imaging (WSI) for tissue evaluation, the field of Hematopathology and Cytology has lagged behind other subspecialties. Moreover, during the current Sars-CoV-2 (COVID-19) pandemic, social distancing and contact precautions have posed challenges in colleague interaction, specimen handling and processing, resulting in overall segregations between healthcare colleagues.
We implemented a new Scopio Labs X100 digital imaging instrument, which provides high resolution oil-immersion level images of large scanned areas (https://scopiolabs.com/hematology/). Most striking is its ability to clearly and accurately detect single cells in body fluid smears with high fidelity.
To the best of our knowledge, we are first among a handful of institutions to implement the Scopio Labs X100 digital slide imaging for bone marrow aspirates (BMA), cytology and peripheral blood smears (PBS) for research and training purposes.
Data obtained was covered under an IRB waiver, HS#:12-00133 GCO#1:12-036(0001-08).
Representative PBS, BMA and cytology fluid smears were digitized and catalogued with Scopio Labs X100 Full Field Digital scanner. Scanned images were evaluated by Pathologists, Hematologists and medical trainees. To complement our PhilipsTM Whole Slide Imaging system, consult cases with bone marrow biopsies, lymph node and extranodal tissues were also scanned with Scopio’s instrument for archival purposes.
414 cases and representative slides were digitized at 100x magnification over 6 months duration, including PBS, BMA and cytology specimens (Figure 1). Various entities have been identified, including, acute myelomonocytic leukemia (AMML), hypersegmented neutrophils in COVID-19(+) patients, myelodysplastic syndrome (MDS), metastatic disease and COVID-19-related neutrophil hypersegmentation & atypical lymphocytes (Figure 2). Study sets for PBS were created for training purposes, including hemoglobinopathies, lymphoproliferative neoplasms and myelodysplastic changes.
The Scopio Labs X100 digital system provides an accurate, efficient and timely web-based digital tool and image bank to accommodate the social distancing challenges during the COVID-19 pandemic for Hematology, Hematopathology and Cytopathology medical students, clinical Hematology/Oncology and Pathology trainees. With its recent FDA-clearance, we aim to fully integrate Scopio Labs into our LIS and assess the full field PBS application to streamline our workflow.