IMPACT : Integrating Microscopy for Pathology Activities and Computer Technology

Abstract

In this paper, we present a new appronch to a computerized microscope to assist puthologists and cytotechnicians in routine exanzlnntions. The HOME workstutlon (Highly Optinzizeci Mici oscope Environnzent) i s conzyosed of a standui-ti light irzicroscoye .fitled with objective and stage encoders, iind N built-in high lasolution computer display which supei-rtiiyoses di-awrngs und messages onto the opticcil nzrci-oscope inzage. The so~flwure runs Windows 3.x und pi-ovrdes intermtrve facilities such as accurate localization and relocation of zone of interest, nzorphonzeti I C and densitometric nzeusurenzents, putient duta uccess unci quality conti-o I processes. THE IMPACT PROJECTThe diagnosis and prognosis of most severe diseases require microscopic examinations of slide-mounted specimens in order to evaluate the deviation of cell (cytology) and/or tissues (histology) from normal. In spite of the essential role of pathology in health care, this medical activity remains almost untouched by recent technological development : the routine clinical examinations are still cai-ried out by cytotechinicians or pathologists in a strictly manual mode and are qualitative, context-dependent and poorly reproducible. Quantitative microscopy (counting, stereology, morphometry and densitometry) is one approach to improving the quality of the diagnosis [ 11. The impact of this approach on pathology practice still remains limited because of low cost-effectiveness and poor user-friendliness.The IMPACT project is undertaken within the framework of the AIM (Advanced Informatics in Medicine) programme of the European Communities and involves several research laboratories, hospital pathology laboratories and industrial partners. The project specifically addresses the integration of computer teclmologies into the medical examinations performed at the microscope in cy t opa tho1 og y , 11 is t opa t h 0 1 og y ;in d cytogenetics hospital laboratories by designing and developing a microscope workstation based on a new concept named HOME (Highly Optimized Microscope Environment). HOME puts the emphasis on man-machine cornmunication and ergonomy for routine examinations in pathology. The HOME workstation has been designed to fulfil, given the constraints of the medical routine real world, the following requirements : -The user is more or less computer-innocent. Thus, the interactions between the U the computer should be le as possible and d by a unique means of namely, a mouse driven graphics interface. -The user should access a command environment split into four basic modules : (i) Data access : to perform the examination, the user needs access to differe information such as patient and specimen cl result of previous examinations, (ii) Measurements : accurate graphic tools should be available to mark and count relevant objects and to measure significant features (shape, area, length, densitometry, ratios), (iii) Control : the consistency between clinical data, current diagnosis and the adequacy of the operating features (size of the scanned...