In this episode Dr. Aleks Zuraw sits down with Mariano De Socarraz, President of CorePlus and member of the board of directors at the Digital Pathology Association.

CorePlus is an anatomic and clinical pathology lab in Puerto Rico that has fully embraced digital pathology and AI.

Key Takeaways

• CorePlus converted to 100% whole slide imaging for primary diagnosis in January 2020, before the pandemic
• They are pioneering the use of AI algorithms from companies like IBEX, AlpenGlow, Artera and TechCyte for cancer detection and precision pathology
• Digital pathology increases efficiency by ~30% and enables benefits like remote reading, better ergonomics, and seamless sharing of cases
• AI helps detect missed lesions, reduce interoperator variability, and eliminate false negatives in prostate biopsies
• The future of pathology will involve predictive and prognostic information generated right from digital slides (histomics)

Making the Digital Transition

Mariano shares how CorePlus, as a technology-forward company, decided in 2018 to fully convert to digital pathology. They took 2019 to prepare, validate their processes following CAP guidelines, and get full buy-in from stakeholders. On January 1st, 2020 they were fully digital.

While acknowledging that glass slides have advantages in simplicity, Mariano believes the benefits of digital pathology for patients and pathologists are too great to ignore. His advice for other practices considering the digital transition:

• Focus on re-engineering your workflows first before choosing scanners
• Plan for IT redundancy to avoid any disruption
• Get full buy-in from your team
• Start focused and build successes in stages

Unlocking the Power of AI

After seeing a press release about UPMC and IBEX using AI to diagnose prostate cancer, CorePlus reached out to partner with them. They became the first site outside the UK to validate and implement IBEX's algorithm, running it on over 9500 cases as a QC tool.

The algorithm was able to alert pathologists to missed lesions in 73 patients that would have otherwise been false negatives. CorePlus has now moved the algorithm to the front-end to pre-screen and triage all prostate cases.

They are also partnering with other AI companies like AlpenGlow, Artera and TechCyte to bring these benefits to breast, GI, cytology and other subspecialties. Mariano sees AI generating predictive and prognostic insights right from slides.

The Future is Digital

Mariano believes medical education must quickly incorporate digital pathology and AI training to prepare the next generation of pathologists. The Digital Pathology Association is key in fostering collaboration to expand access, especially in underserved communities.

While going digital requires some reinvention, Mariano is excited to pioneer this space. He and CorePlus aim to be "missionaries" doing what's best for patients and the field of pathology.

THIS EPISODE'S RESOURCES:

• Digital Pathology Association
• IBEX website
• Alpenglow Biosciences website
• Epredia website
• CorePlus website
• Amazon Link for the Digital Pathology 101 Book

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Swarm Learning in Digital Pathology: Revolutionizing Cancer Histopathology

Today on the Digital Pathology Podcast my guest is Oliver Saldana, the first author of a significant Nature Medicine paper published in 2022 on 'Swarm Learning for Decentralized Artificial Intelligence in Cancer Histopathology'.

Oliver shares his journey from Mangalore, India, to Germany, where he pursued his master's and PhD, delving into histopathology and decentralized AI under the supervision of Professor Dr. Jakob Nicolas Kather.

The discussion explores the concept of swarm learning as a novel method for deep learning in histopathology, its advantages over centralized learning including compliance with data protection laws like GDPR, and its potential for global collaboration in medical research without sharing sensitive data.

Oliver emphasizes swarm learning’s ease of setup and its alignment with the FAIR principles for scientific data management. The podcast aims to shed light on the groundbreaking work being done in the convergence of pathology and computer science, urging researchers and pathology centers to digitize their slides and contribute to global swarm learning projects.

00:00 Introduction to Swarm Learning and Its Applications
00:50 Intro
01:17 Meet Oliver Saldana: A Trailblazer in Decentralized AI for Cancer Histopathology
03:57 Exploring the Concept of Decentralized AI and Its Importance
06:52 Understanding Centralized vs. Decentralized Learning
08:47 The Revolutionary Approach of Swarm Learning
10:38 Blockchain's Role in Enhancing Histopathology with Swarm Learning
14:50 Addressing Preprocessing and Generalizability in Swarm Learning
21:26 Swarm Learning's Compliance with GDPR and Data Protection
25:05 Exploring Swarm Learning in Medical Data Analysis
25:34 Prototype Study and Real Cohorts in Swarm Learning
27:01 Comparing Swarm Learning with Centralized Models
27:44 The Role of Bare Metal Servers in Swarm Learning
30:01 Centralized Slide Repositories vs. Swarm Learning
44:11 Commercializing Swarm Learning Models
47:07 FAIR Principles and Swarm Learning
51:11 Global Ambitions and the Future of Swarm Learning

THIS EPISODES RESOURCES

📝 Swarm Learning for decentralized and confidential clinical machine learning
🔗 https://www.nature.com/articles/s41586-021-03583-3

📝The FAIR Guiding Principles for scientific data management and stewardship
🔗https://www.nature.com/articles/sdata201618

🎧BIGPICTURE – THE LARGEST WHOLE SLIDE REPOSITORY FOR AI MODEL DEVELOPMENT IN PATHOLOGY. WHERE DO WE STAND AT MONTH 15/72?
🔗https://digitalpathologyplace.com/podcast/bigpicture-the-largest-whole-slide-repository-for-ai-model-development-in-pathology-where-do-we-stand-at-month-15-72/

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Navigating Ethical Challenges in AI-Powered Pathology

This episode is a webinar recording.
It delves into the complex ethical considerations of incorporating artificial intelligence (AI) in pathology.

Dr. Zuraw begins by exploring the fundamentals of ethics and moves on to discuss the impact of AI in pathology, focusing on:

• ethical dilemmas,
• data diversity issues,
• biases, and
• the importance of maintaining professional and societal ethical standards in the wake of AI integration.

The session touches upon the ethical guidelines and regulatory frameworks guiding ethical decision-making in healthcare, alongside the role of regulatory agencies like the FDA.

It also highlights the significance of data diversity and mitigation strategies to address potential ethical pitfalls in AI utilization.

The webinar emphasizes the constant balance between advancing technology and ethical responsibility, underlining the need for transparency, governance, and accountability in deploying AI tools in pathology.

00:00 Introduction to Ethics in AI-Powered Pathology
00:30 Exploring the Ethical Dilemmas in Healthcare
00:36 Webinar Overview and Digital Pathology Insights
01:05 Defining Ethics and Its Importance in AI Pathology
02:05 Interactive Webinar Engagement and Audience Participation
03:25 Deep Dive into Ethics: Definitions and Applications
09:31 Ethical Considerations in Biomedical Research
10:34 Navigating Ethical Dilemmas: A Practical Example
13:57 Understanding Ethical Principles in Decision Making
17:14 AI Bias and Representation in Pathology
20:52 Frameworks and Guidelines for Ethical Oversight
25:02 AI Applications in Pathology: Ethical Perspectives
27:21 Exploring AI in Research and Its Capabilities
29:22 AI's Role in Medical Imaging and Diagnostics
33:11 Ethical Considerations and AI in Pathology
34:04 Addressing AI Challenges: Bias, Interpretability, and Security
44:26 AI as a Medical Device: Regulatory Perspectives and Future Directions
49:16 Concluding Thoughts and Audience Engagement


THIS EPISODES RESOURCES:

• Interested in getting the slides from this presentation, click here
• AI in Pathology: What could possibly go wrong (Paper)
• Ethics of AI in Pathology: Current Paradigms and Emerging Issues (Paper)
• Guardrails for the use of generalist AI in cancer care (Nature commentary)
• No more microscopes. How close are we to glassless pathology? W/ Dr. Richard Levenson, US Davis Health (Podcast episode)

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Become a Digital Pathology Trailblazer and See you inside the club: Digital Pathology Club Membership