Whole Slide Image Cytometry: a Novel Method for the Detection and Quantification of Abnormal DNA Contents in Barrett’s Oesophagus

Background: Barrett's oesophagus (BO) is a well recognized precursor of the majority of cases of oesophageal adenocarcinoma (OAC). Endoscopic surveillance of BO patients is frequently undertaken in an attempt to detect early OAC, high grade dysplasia (HGD) or low grade dysplasia (LGD). However histological interpretation and grading of dysplasia is subjective and poorly reproducible. The alternative flow cytometry and cytology-preparation image cytometry techniques require large amounts of tissue and specialist expertise which are not widely available for frontline health care.
Methods: This study has combined whole slide imaging with DNA image cytometry, to provide a novel method for the detection and quantification of abnormal DNA contents. 20 cases were evaluated, including 8 Barrett's specialised intestinal metaplasia (SIM), 6 LGD and 6 HGD. Feulgen stained oesophageal sections (1µm thickness) were digitally scanned in their entirety and evaluated to select regions of interests and abnormalities. Barrett’s mucosa was then interactively chosen for automatic nuclei segmentation where irrelevant cell types are ignored. The combined DNA content histogram for all selected image regions was then obtained. In addition, histogram measurements, including 5c exceeding ratio (xER-5C), 2c deviation index (2cDI) and DNA grade of malignancy (DNA-MG), were computed.
Results: The histogram measurements, xER-5C, 2cDI and DNA-MG, were shown to be effective in differentiating SIM from HGD, SIM from LGD, and LGD from HGD. All three measurements discriminated SIM from HGD cases successfully with statistical significance (pxER-5C=0.0041, p2cDI=0.0151 and pDNA-MG=0.0057). Statistical significance is also achieved differentiating SIM from LGD samples with pxER-5C=0.0019, p2cDI=0.0023 and pDNA-MG=0.0030. Furthermore the differences between LGD and HGD cases are statistical significant (pxER-5C=0.0289, p2cDI=0.0486 and pDNA-MG=0.0384).
Conclusion: Whole slide image cytometry is a novel and effective method for the detection and quantification of abnormal DNA content in BO. Compared to manual histological review, this proposed method is more objective and reproducible. Compared to flow cytometry and cytology-preparation image cytometry, the current method is low cost, simple to use and only requires a single 1µm tissue section. Whole slide image cytometry could assist the routine clinical diagnosis of dysplasia in BO, which is relevant for future progression risk to OAC.

Digital slide viewing for primary reporting in gastrointestinal pathology: a validation study

Despite the increasing availability of digital slide viewing, and numerous advantages associated with its application, a lack of quality validation studies is amongst the reasons for poor uptake in routine practice. This study evaluated primary digital pathology reporting in the setting of routine subspecialist gastrointestinal pathology, commonplace in most tissue pathology laboratories and representing one of the highest volume specialties in most laboratories. Individual digital and glass slide diagnoses were compared amongst three pathologists reporting in a gastrointestinal subspecialty team, in a prospective series of 100 consecutive diagnostic cases from routine practice in a large teaching hospital laboratory. The study included a washout period of at least 6 months. Discordant diagnoses were classified, and the study evaluated against recent College of American Pathologists (CAP) recommendations for evaluating digital pathology systems for diagnostic use. The study design met all 12 of the CAP recommendations. The 100 study cases generated 300 pairs of diagnoses, comprising 100 glass slide diagnoses and 100 digital diagnoses from each of the three study pathologists. 286 of 300 pairs of diagnoses were concordant, representing intraobserver concordance of 95.3 %, broadly comparable to rates previously published in this field. In ten of the 14 discordant pairs, the glass slide diagnosis was favoured; in four cases, the digital diagnosis was favoured, but importantly, the 14 discordant intraobserver diagnoses were considered to be of minor clinical significance. Interobserver, or viewing modality independent, concordance was found in 94 of the total of 100 study cases, providing a comparable baseline discordance rate expected in any second viewing of pathology material. These overall results support the safe use of digital pathology in primary diagnostic reporting in this setting

Canadian Niagara Power Glass Slide - Group of men walking through the hydro tunnel

Four men (unidentified) walking in tunnel wearing hard hats and carrying flashlights.

Canadian Niagara Power Glass Slide - Engineer Drawing of Sections of Discharge Tunnel

Consulting Engineer drawing of Sections of the Discharge Tunnel. Included in the drawing is the "cross section of tunnel with timbering" and "longitudinal section showing Timber in straight tunnel". Dated October 1902.

Canadian Niagara Power Glass Slide - Engineer Drawing Hydro Station

Appears to be an engineer's drawing of the Hydro Station. It is a cross-section view of the interior.

Canadian Niagara Power Glass Slide - Plan and Profile of Discharge Tunnel

Plan and profile of discharge tunnel along Niagara River. The horizontal scale is 1 inch = 100 feet, the vertical scale is 1 inch = 40 feet. The drawing is dated November 7, 1902.

Canadian Niagara Power Glass Slide - Sketch Showing Proposed Masonry Lining Near Portal of Tunnel

Drawing by consulting engineer dated October 19, 1901. Scale is noted as 1/4 inch = 1 foot.

Canadian Niagara Power Glass Slide - Drawing: Section thru Wheelpit

Drawing of "Section thru Wheelpit" dated September 1925. Shows unit no.1 through unit no.11, power house floor and water surface.

Canadian Niagara Power Glass Slide - Engineer Drawing (untitled)

Engineer drawing (untitled), some of the labels read "exciter chamber", "fore bay", "power house floor".

Canadian Niagara Power Glass Slide - Men in Tunnel

Four men (unknown) standing in the tunnel wearing hard hats.

Canadian Niagara Power Glass Slide - Large Group in Tunnel

A large group of men in hard hats in the tunnel. The names of the men are unknown.

Canadian Niagara Power Glass Slide - Four Men in Tunnel

Four men standing in hydro tunnel.

Slide - Inniskillin Hall at Brock University

Mr. Ziraldo was instrumental in establishing the Cool Climate Oenology and Viticulture Institute (CCOVI) at Brock University which focuses on excellence in winemaking. Brock University named the building that houses CCOVI, Inniskillin Hall. The hall opened in the year 1999.