Morphology in the Digital Age: Integrating High-Resolution Description of Structural Alterations With Phenotypes and Genotypes

Abstract

Conventional light microscopy (CLM) has been used to characterize and classify renal diseases, evaluate histopathology in studies and trials, and educate renal pathologists and nephrologists. The advent of digital pathology, in which a glass slide can be scanned to create whole slide images (WSI) for viewing and manipulating on a computer monitor, provides real and potential advantages over CLM. Software tools such as annotation, morphometry and image analysis can be applied to WSIs for studies or educational purposes, and the digital images are globally available to clinicians, pathologists and investigators. New ways of assessing renal pathology with observational data collection may allow better morphologic correlations and integration with molecular and genetic signatures, refinements of classification schema, and understanding of disease pathogenesis. In multicenter studies, WSI, which require additional quality assurance steps, provide efficiencies by reducing slide shipping and consensus conference costs, and allowing anytime anywhere slide viewing. While validation studies for the routine diagnostic use of digital pathology still are needed, this is a powerful tool currently available for translational research, clinical trials and education in renal pathology.

Reproducibility of the NEPTUNE descriptor-based scoring system on whole-slide images and histologic and ultrastructural digital images

“…14 Furthermore, it is critical to design and implement classification systems for clinical research that are more meaningful with regard to novel renal biomarkers, prognosis, and treatment approaches. 1 The use of such morphologic observations requires concordance of pathologic analysis across diseases, level of training and experience.…”

“…The NEPTUNE Digital Pathology Protocol documents the whole-slide images-based scoring protocol, including selection of specific structures (eg, glomeruli) and the application of the NEPTUNE Digital Pathology Scoring System for comprehensive scoring of glo-merular, vascular and tubulointerstitial morphologic features (descriptors). 13,14 …”

Digital pathology in nephrology clinical trials, research, and pathology practice

“…3) [2 ▪▪ ]. Highly granular data collection allows for the identification of previously unutilized or underrecognized parameters to generate and test new disease categories [39], to change historical paradigms for disease categorization, and to explore new predictors of molecular mechanisms and outcome. For example, utilizing patient cluster analysis models based on frequency of descriptors, outcome can be used to establish which of these patient clusters are clinically significant and test whether common pathways and gene expression are activated [40 ▪ ].…”

The topology of vitronectin: A complementary feature for neuroblastoma risk classification based on computer‐aided detection

“…These approaches did not consider the spatial relationship between its components or were restricted to nuclei . However, morphometric techniques assure the standardization of all measurements and minimize interobserver differences . Understanding how biopsy elements are organized is important to find potential new markers for improving treatment strategies and outcome prediction.…”