The Highly Optimized Microscope Environment (HOME) is a computerized microscope designed to assist pathologists and cytotechnicians in clinical routine tasks. The prototype system consists of a IBM-PC compatible computer and a light microscope in which a built-in highresolution computer display image is superimposed on the optical image of the specimen. Also, a manually operated encoding stage and objective turret encoder are used to provide continuous monitoring of the stage coordinates and microscope magnification to the computer. This allows any position on a slide to be uniquely defined and makes it possible to measure interactively lengths and areas larger than the size of the microscope field. Software, written in the C language and operating under the MS-DOSMS-Windows environment, is controlled by means of a mouse-driven cursor moving over menu light-buttons displayed on the microscope image. The HOME microscope workstation is potentially useful in a wide range of applications such as i) tagging information on particular cells and tissue structures that can thus be accurately located and relocated, ii) performing morphometric measurement, differential counting, and stereological assessment of biological specimens, and iii) training and educating laboratory personnel. Finally, HOME will offer in the near future a userfriendly interface for automatic image processing of cells and tissue entities in interactively selected specimen areas.Key terms: Microscopy, image cytometry, image histometry, computerized microscopy In modern hospitals, the pathology laboratory plays a n essential role in the diagnosis and prognosis of most serious diseases, and therefore in the subsequent medical decision-making and health care for the patient. In spite of this essential role, pathology practice has to date remained relatively untouched by recent developments in information technology: routine pathology is still carried out largely by microscopic examination of specimens by the pathologist, followed by the reporting of his opinion concerning the appearance of the specimen back to the requesting clinician. While this is satisfactory for the majority of specimens, for most types of pathological sample there is a "grey area" containing some specimens for which the result is not clear and is therefore subjective, unreliable, and poorly reproducible [lo].One approach to improving the diagnosis for such specimens is the introduction of quantitative analysis. Counting is the first quantitative approach which has been used extensively in haematology (differential white blood cell count), tumour pathology (mitotic index), and hormonal cytology (pycnotic index). Several other quantitative techniques for pathology have been investigated extensively for many years. Interactive computer morphometry, in which the user can delineate lengths and areas on a projected microscope image using a digital tablet or similar instrument, has been found to be diagnostically useful in many types of tumour pathology, bone pathology, and muscle patholo...
Summary A major practical advantage of the HOME (highly optimized microscope environment) computerized microscope is the facility for relocating cells or other microscopic objects. Features can be marked directly on the microscope image using a mouse‐driven cursor, and an interactive finder can then be used to relocate the marked features. Tests on a prototype HOME microscope have shown that positions can be relocated with an accuracy of standard deviation (SD) < 7 μm. The marked features could also be relocated on a second HOME microscope, although with somewhat reduced accuracy (standard deviations of < 17 μm). The system provides a very user‐friendly environment for tasks requiring relocation of microscopic objects.
Aims-To describe a systematic investigation of interobserver differences in interpretation of nuclear morphology in preparations of small cell lung cancer (SCLC). Methods-The screening/reviewing facility on the highly optimised microscope environment was used to individually tag 127 nuclei, chosen to reflect the spectrum of morphological appearances in nuclear preparations from three biopsy specimens of SCLC. Each nucleus was reviewed and labelled as control (lymphocyte), malignant or unsatisfactory by each of four observers. DNA histograms were plotted for each specimen using the nuclei identified as malignant by each participant. The histograms were compared in terms of identification of DNA stemlines and by calculation of a 5c exceeding rate (5cER).Results-Interobserver variation in assessment ofmorphology was seen in 55-1% of nuclei. Disagreement occurred most frequently in the malignant/unsatisfactory category. Differences in morphological classification had little influence on histogram assessment by means of visual inspection but did show an effect on 5cER. Conclusions-There are significant interobserver differences in subjective assessment of nuclear morphology in cytometric preparations. This effect may seriously influence cytometric meas- The highly optimised microscope environment (HOME) system is a new concept in microscopy and image analysis involving projection of a computer overlay on to microscope slides.3 An observer can "interact" with the visual image using a mouse attachment. The HOME has a screening/reviewing program which permits highly accurate cell marking and relocation. A variety of computer generated markers (symbols) may be attached to a given object and subsequently relocated by another observer. We decided to use this system to test interobserver variation in nuclear categorisation in image cytometry and the effect of any variation on tumour DNA ploidy estimation. MethodsIn our laboratory we have an interest in cytometric measurement in lung cancer. We therefore decided to assess the problem of nuclear identification in SCLC. Nuclear preparations were made from paraffin wax embedded blocks of three cases of SCLC using the protocol of Hedley et al. 4 The nuclei were spun on to slides and stained in a standard Feulgen reaction with acid hydrolysis in 4N HCI at 27-5°C for 55 minutes. The slides were initially screened by a single observer (FAC) on the HOME microscope (AxioHOME, Zeiss, Germany) and a sample of approximately 40 nuclei per case were marked and stored on the computer. The sample was chosen so as to be representative of the spectrum of nuclear appearances present in each specimen and so that no more than a single nucleus was selected from any one high power ( x 400) field. The slides were subsequently reviewed by each of four observers (two experienced pathologists, a trainee pathologist and a clinician with a research interest in cytometry). All had some experience in cytometry, were familiar with the cytological features of SCLC and appreciated the importance of e...
HOME is a new computerized microscope designed to assist pathologists and cytotechnicians in routine examinations. The HOME workstation is composed of a standard light microscope fitted with objective and stage encoders, and a built-in high resolution computer display which superimposes dialog, drawing, and messages onto the optical microscope image. The software runs under Windows 3.x and provides interactive facilities such as accurate localization and relocation of zones of interest, morphometric measurements, patient data access, and quality control processes.
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