text: Whole Slide Imaging (WSI) has become an important topic during the last decade. Even though significant progress in both medical image processing and computational resources has been achieved, there are still problems in WSI that need to be solved. A major challenge is the scan size. The dimensions of digitized tissue samples may exceed 100,000 by 100,000 pixels causing memory and efficiency obstacles for real-time processing. The main contribution of this work is representing a WSI by selecting a small number of patches for algorithmic processing (e.g., indexing and search). As a result, we reduced the search time and storage by various factors between ( @math ), while losing only a few percentages in the patch retrieval accuracy. A self-organizing map (SOM) has been applied on local binary patterns (LBP) and deep features of the KimiaPath24 dataset in order to cluster patches that share the same characteristics. We used a Gaussian mixture model (GMM) to represent each class with a rather small ( @math ) portion of patches. The results showed that LBP features can outperform deep features. By selecting only @math of all patches after SOM clustering and GMM patch selection, we received @math accuracy for retrieval of the best match, while the maximum accuracy (using all patches) was @math .
  @cite_19: Pathology is a medical subspecialty that practices the diagnosis of disease. Microscopic examination of tissue reveals information enabling the pathologist to render accurate diagnoses and to guide therapy. The basic process by which anatomic pathologists render diagnoses has remained relatively unchanged over the last century, yet advances in information technology now offer significant opportunities in image-based diagnostic and research applications. Pathology has lagged behind other healthcare practices such as radiology where digital adoption is widespread. As devices that generate whole slide images become more practical and affordable, practices will increasingly adopt this technology and eventually produce an explosion of data that will quickly eclipse the already vast quantities of radiology imaging data. These advances are accompanied by significant challenges for data management and storage, but they also introduce new opportunities to improve patient care by streamlining and standardizing diagnostic approaches and uncovering disease mechanisms. Computer-based image analysis is already available in commercial diagnostic systems, but further advances in image analysis algorithms are warranted in order to fully realize the benefits of digital pathology in medical discovery and patient care. In coming decades, pathology image analysis will extend beyond the streamlining of diagnostic workflows and minimizing interobserver variability and will begin to provide diagnostic assistance, identify therapeutic targets, and predict patient outcomes and therapeutic responses.
  @cite_9: Abstract With the rise in whole slide scanner technology, large numbers of tissue slides are being scanned and represented and archived digitally. While digital pathology has substantial implications for telepathology, second opinions, and education there are also huge research opportunities in image computing with this new source of “big data”. It is well known that there is fundamental prognostic data embedded in pathology images. The ability to mine “sub-visual” image features from digital pathology slide images, features that may not be visually discernible by a pathologist, offers the opportunity for better quantitative modeling of disease appearance and hence possibly improved prediction of disease aggressiveness and patient outcome. However the compelling opportunities in precision medicine offered by big digital pathology data come with their own set of computational challenges. Image analysis and computer assisted detection and diagnosis tools previously developed in the context of radiographic images are woefully inadequate to deal with the data density in high resolution digitized whole slide images. Additionally there has been recent substantial interest in combining and fusing radiologic imaging and proteomics and genomics based measurements with features extracted from digital pathology images for better prognostic prediction of disease aggressiveness and patient outcome. Again there is a paucity of powerful tools for combining disease specific features that manifest across multiple different length scales. The purpose of this review is to discuss developments in computational image analysis tools for predictive modeling of digital pathology images from a detection, segmentation, feature extraction, and tissue classification perspective. We discuss the emergence of new handcrafted feature approaches for improved predictive modeling of tissue appearance and also review the emergence of deep learning schemes for both object detection and tissue classification. We also briefly review some of the state of the art in fusion of radiology and pathology images and also combining digital pathology derived image measurements with molecular “omics” features for better predictive modeling. The review ends with a brief discussion of some of the technical and computational challenges to be overcome and reflects on future opportunities for the quantitation of histopathology.
  @cite_5: Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation; however, little is known about pathologists’ practice patterns or perceptions regarding WSI. A national sample (N = 252) of pathologists from New Hampshire, Vermont, Washington, Oregon, Arizona, Alaska, Maine, and Minnesota were surveyed in this cross-sectional study (2011–2013). The survey included questions on pathologists’ experience, WSI practice patterns, and perceptions using a six-point Likert scale. Agreement was summarized with descriptive statistics to characterize pathologists’ use and perceptions of WSI. The majority of participating pathologists were males (63 ) between 40 and 59 years of age (70 ) and not affiliated with an academic medical center (72 ). Experience with WSI was reported by 49 . Types of use reported included CME board exams teaching (28 ), tumor board clinical conference (22 ), archival purposes (6 ), consultative diagnosis (4 ), research (4 ), and other uses (12 ). Most respondents (79 ) agreed that accurate diagnoses can be made with this technology, and that WSI is useful for obtaining a second opinion (88 ). However, 78 of pathologists agreed that digital slides are too slow for routine clinical interpretation. Fifty-nine percent agreed that the benefits of WSI outweigh concerns. The respondents were equally split as to whether they would like to adopt WSI (51 ) or not (49 ). About half of pathologists reported experience with the WSI technology, largely for CME, licensure board exams, and teaching. Positive perceptions regarding WSI slightly outweigh negative perceptions. Understanding practice patterns with WSI as dissemination advances may facilitate concordance of perceptions with adoption of the technology.
summary: Tissue examination under a microscope reveals important information to render accurate diagnosis and thus, provide effective treatment for different diseases @cite_19 . DP offers several opportunities and also presents challenges to the image processing architectures @cite_9 . Presently, only a small fraction of glass slides are digitized @cite_5 , but even if WSI was more widely available, there are a number of technical issues that would need to be addressed for their effective usage. One of the main challenges is data management and storage @cite_19 . Most importantly, the large dimensions of the WSI files require a large amount of memory and a expensive computational power.