An old presentation from IADP 2014 in Boston, MA, but still relevent, now that the paper has been published at https://pubmed.ncbi.nlm.nih.gov/28982110/ . The presentation is a good illustration of how digital pathology can facilitate international collaboration efficiently.

1. Using a novel whole slide imaging software platform for an
international multi-center validation study to assess the
histological growth pattern of liver metastases
Yves Sucaet, Wim Waelput, Peter Vermeulen and Gert Van den Eynden
Also on behalf of the Liver Metastasis Research Network (www.lmrn.org)

2. Introduction
• ‘Growth pattern’ of primary tumours and their
metastases is heterogeneous
• Growth pattern
– = the histological result/image of the way
malignant tumours interact with the pre-existing
normal tissue in their host organ
– Integrative histological parameter, which is the
result of all involved interactions
– Easy to assess by a pathologist using a (simple) HE
staining and a microscope

3. G. Van den Eynden et al., Cancer Research 2013

4. Clinically Relevant ?
Eefsenetal.JOncol.2012;Epub2012Aug2.
Van den Eynden G., Bird N et al. Clin Exp Metastasis 2012
Unpublished

5. To organize an international multi-center validation
study on the assessment of the histological growth
pattern of liver metastases of solid tumours
1. Teaching part
2. Validation part
Aim

6. International Multicenter Validation Study
Within the Liver Metastasis Research Network
>10 Institutions
8 countries
> 30 participants (Pathologists, Clinicians, Researchers)
Aim (con’t)

7. The traditional approach
• Select physical slides
– Pass them from one site to the next
• Problems with this approach
– Order of passing slides along
• Who goes first, who goes last?
– Expensive shipping costs
• Also: slow, built-in lag
– Difficulty to annotate
• Disconnect between material and instructions
– Audit trailing
• Have people actually *looked* at the slides?

8. Digital pathology as an alternative
CHALLENGES SOLUTION(S)
International
Logistic
(Geographic – Time)
Webbased Platform for
Digital Pathology
Multi-Center
Pathological Sections
(Teaching and validation set)
Only one HE section of
interesting cases
Teaching set
Giving
Instructions/explanation
Validation set Data gathering

9. Portal website

10. Timeline
Original proposed timeline
• 26/3/2014: Initiation project
with Pathomation©.
• 5/2014: Platform adaptations
finished/platform ready for
LMRN project.
• 7/2014: Open teaching set for
participants.
• 8/2014: Open validation set
for particpants.
Actual timeline*
• 1/2014: First contact
Pathomation©.
• 26/3/2014: Initiation project
with Pathomation©.
• 5/2014: Platform adaptations
finished/platform ready for
LMRN project.
• 14/9/2014 : Open teaching set
for participants.
• 1/11/2014: Open validation
set for participants.
* All ‘delay’ due to organizational reasons, not related to digital platform

11. Problems encountered
Technical
• Some smaller bugs during
development
Organizational
• Digitalization of histological
slides (scanner availability)
• Centralization of digital images
(transfer of large files from
one server to another)
• Selection of slides/images to
be included in different sets
• ‘Last minute’ inclusion of cases
• Participants struggle to meet
‘deadlines’

12. The solution: Pathomation platform
PathoCore tile server (IMS)
OpenSlide
MRXS SVS NDPI BIF
ZVI, SCN,
, VSI,
TIFF...
PathoCore tile server (IMS)
JavaScript / JSON
SymPatho
web-
based
viewer
PathoVue
desktop
viewer
SOAP / REST
Software
plugins
PHP Python Perl
Custom digital pathology
project

13. The solution architecture
Tile server (IMS) available over the
Web with administrator interface
Type 1
slides
Type 2
slides
Type 3
slides
Monitored
folders
Viewer for annotationCustom website

14. Workflow (why three sites?)
• Step 1: Organize virtual slides
Type 1 / type 2 / type 3
(different file formats, too)

15. Workflow (why three sites?)
• Step 2: Annotate slides

16. Workflow (why three sites?)
• Step 3: Define users, send out notifications

17. Workflow (why three sites?)
• Step 4: setting up the front-end portal

18. Repeat for other scenarios (type 2 / 3)
Annotate
slides
Present to
participant
Organize
files (IMS)

19. How much effort did it take?
• 68 hours spent total on software installation,
setup, and website customization

20. Conclusions
• DP is a good way to organize ring-studies
• Some problems are technical
– First vendor was unable to meet requirements
• Most problems are organizational
– Not specific or related to digital pathology

21. Putting things in perspective

22. Translational Cancer Research Unit
POST-DOCTORAL RESEARCHERS
Dr. Luc Dirix, M.D., Ph.D.
Dr. Peter Vermeulen, M.D., Ph.D.
Prof. dr. Steven Van Laere, MSc., Ph.D.
Dr. Gert Van den Eynden, M.D., Ph.D.
Dr. Peter van Dam, M.D., Ph.D.
Prof. Dr. Karin Haustermans, M.D., Ph.D.
Dr. Cecile Colpaert, M.D., Ph.D.
Dr. Roberto Salgado, M.D., Ph.D.
dr. Pharm. Ina Benoy, Ph.D.
PhD STUDENTS
Dr. Dieter Peeters, M.D.
drs. Leen Sas, MSc.
drs. Melike Marsan, MSc.
drs. Eleni Van Schooneveld, MSc.
drs. Bram De Laere, MSc.
Dr. Eugenia Pastushenko, M.D.
ADMINISTRATIVE COORDINATOR
Hilde Maes
MLT’s
Christel Verbruggen, Lt.
Katrien Coen, MSc.
Liver Metastasis Research Network
Prof. dr. P. Brodt
Prof. Dr. A. Majeed
Prof. Dr. N. Bird
Prof. Dr. G. Hoyer-Hansen
Dr. M. Illemann
Dr. R. Eefsen
Prof. Dr. A. Reynolds