NICE Diagnostics guidance [DG32] Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and the ZedScan I.
Published date:
This guidance replaces the NICE diagnostics guidance on adjunctive colposcopy technologies for examination of the uterine cervix – DySIS and the Niris Imaging System (DG4) and the NICE medtech innovation briefing on ZedScan as an adjunct to colposcopy in women with suspected cervical intra‑epithelial neoplasia (MIB20).
Read full guidance at: https://www.nice.org.uk/guidance/dg32
Showing posts with label pathology. Show all posts
Showing posts with label pathology. Show all posts
Friday, 27 April 2018
Monday, 5 February 2018
UHCW publication: distant metastasis in colorectal cancer
Novel digital tissue phenotypic signatures of distant metastasis in colorectal cancer
Korsuk Sirinukunwattana, David Snead, David Epstein, Zia Aftab, Imaad Mujeeb, Yee Wah Tsang, Ian Cree, and Nasir Rajpoot
[no publication details given]
Abstract
Distant metastasis is the major cause of death in colorectal cancer (CRC). Patients at high risk of developing distant metastasis could benefit from appropriate adjuvant and follow-up treatments if stratified accurately at an early stage of the disease. Studies have increasingly recognized the role of diverse cellular components within the tumor microenvironment in the development and progression of CRC tumors. In this paper, we show that a new method of automated analysis of digitized images from colorectal cancer tissue slides can provide important estimates of distant metastasis-free survival (DMFS, the time before metastasis is first observed) on the basis of details of the microenvironment. Specifically, we determine what cell types are found in the vicinity of other cell types, and in what numbers, rather than concentrating exclusively on the cancerous cells. We then extract novel tissue phenotypic signatures using statistical measurements about tissue composition. Such signatures can underpin clinical decisions about the advisability of various types of adjuvant therapy.
PDF full text available at https://arxiv.org/pdf/1801.07451.pdf
Korsuk Sirinukunwattana, David Snead, David Epstein, Zia Aftab, Imaad Mujeeb, Yee Wah Tsang, Ian Cree, and Nasir Rajpoot
[no publication details given]
Abstract
Distant metastasis is the major cause of death in colorectal cancer (CRC). Patients at high risk of developing distant metastasis could benefit from appropriate adjuvant and follow-up treatments if stratified accurately at an early stage of the disease. Studies have increasingly recognized the role of diverse cellular components within the tumor microenvironment in the development and progression of CRC tumors. In this paper, we show that a new method of automated analysis of digitized images from colorectal cancer tissue slides can provide important estimates of distant metastasis-free survival (DMFS, the time before metastasis is first observed) on the basis of details of the microenvironment. Specifically, we determine what cell types are found in the vicinity of other cell types, and in what numbers, rather than concentrating exclusively on the cancerous cells. We then extract novel tissue phenotypic signatures using statistical measurements about tissue composition. Such signatures can underpin clinical decisions about the advisability of various types of adjuvant therapy.
PDF full text available at https://arxiv.org/pdf/1801.07451.pdf
Wednesday, 24 January 2018
NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection
It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
Plasma EGFR mutation tests for adults with locally advanced or metastatic non-small-cell lung cancer [MIB 137}
New: Medtech innovation briefing
Epidermal growth factor receptor (EGFR) mutation tests are in vitro diagnostic (IVD) tests used to help identify adults with non-small-cell lung cancer (NSCLC) suitable for treatment with EGFR tyrosine kinase inhibitors (EGFR‑TKIs). The presence of specific EGFR mutations show how effective treatment with EGFR‑TKIs will be. As a result, the test is useful for oncologists for deciding personalised treatment options.
EGFR mutations occur in EGFR exons 18–21 and mutations in exons 18, 19 and 21 and indicate suitability for treatment with EGFR‑TKIs. Mutations in exon 20 (with the exception of a few mutations) show the tumours are EGFR‑TKI resistant and not suitable for treatment with EGFR‑TKIs.
Epidermal growth factor receptor (EGFR) mutation tests are in vitro diagnostic (IVD) tests used to help identify adults with non-small-cell lung cancer (NSCLC) suitable for treatment with EGFR tyrosine kinase inhibitors (EGFR‑TKIs). The presence of specific EGFR mutations show how effective treatment with EGFR‑TKIs will be. As a result, the test is useful for oncologists for deciding personalised treatment options.
EGFR mutations occur in EGFR exons 18–21 and mutations in exons 18, 19 and 21 and indicate suitability for treatment with EGFR‑TKIs. Mutations in exon 20 (with the exception of a few mutations) show the tumours are EGFR‑TKI resistant and not suitable for treatment with EGFR‑TKIs.
Point-of-care creatinine tests before contrast-enhanced imaging [MIB 136]
New: Medtech innovation briefing
POC creatinine tests allow rapid measurements of creatinine levels using very small samples of whole blood, serum, plasma or a combination of these. The devices used for these tests are either handheld or table-top and need blood from either finger-prick or venous/arterial samples. The method of analysis can vary with some devices using test cartridges and some using test strips.
The focus of this briefing is POC creatinine testing to assess kidney function in people who are scheduled to have contrast-enhanced imaging. Testing is important because contrast materials such as iodine or gadolinium can cause kidney injury, particularly in high-risk patients and those with known kidney dysfunction. If patients do not have a recent creatinine measurement, their imaging may be cancelled and rescheduled. Alternatively, they may have unenhanced imaging – which is less reliable – or the planned contrast agent may be given, risking kidney injury. Current practice varies; a recent UK survey estimated that up to 20% of hospitals only check creatinine levels before imaging in people known to be at high risk of kidney injury (Harris et al. 2016).
POC creatinine tests allow rapid measurements of creatinine levels using very small samples of whole blood, serum, plasma or a combination of these. The devices used for these tests are either handheld or table-top and need blood from either finger-prick or venous/arterial samples. The method of analysis can vary with some devices using test cartridges and some using test strips.
The focus of this briefing is POC creatinine testing to assess kidney function in people who are scheduled to have contrast-enhanced imaging. Testing is important because contrast materials such as iodine or gadolinium can cause kidney injury, particularly in high-risk patients and those with known kidney dysfunction. If patients do not have a recent creatinine measurement, their imaging may be cancelled and rescheduled. Alternatively, they may have unenhanced imaging – which is less reliable – or the planned contrast agent may be given, risking kidney injury. Current practice varies; a recent UK survey estimated that up to 20% of hospitals only check creatinine levels before imaging in people known to be at high risk of kidney injury (Harris et al. 2016).
Wednesday, 17 January 2018
NIHR Signal Blood test reduces mortality and shortens antibiotic use among adults with chest infection
It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier.
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people in every 1,000 who had their management guided by the blood test would be expected to survive the first month, compared with those receiving standard care without this test.
From the NIHR Dissemination Centre
Friday, 12 January 2018
SaBTO microbiological safety guidelines 2017
Guidance from the Department of Health and Social Care on the microbiological safety of human organs, tissues and cells used in transplantation.
Tuesday, 9 January 2018
Newborn blood spot screening: code of practice for residual spots
Guidance from Public Health England which Provides the code of practice for the retention and storage of residual spots after newborn blood spot testing.
Monday, 8 January 2018
The cutting edge — Micro-CT for quantitative toolmark analysis of sharp force trauma to bone
Forensic Science International, Volume 283, Issue null, Pages 156-172
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible.
UHCW Research: B. Burnett
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible.
UHCW Research: B. Burnett
Tuesday, 19 December 2017
QuantiFERON®: test guidelines and order form
Guidelines from Public Health England on blood collection, storage and transportation. Includes order form for blood collection tubes.
National mycobacterium reference laboratory: user manual
Guidance from Public Health England on how to label, package and submit specimens to the laboratory for diagnostic testing.
Sickle cell and thalassaemia screening: handbook for laboratories
These documents from Public Health England set out policy and standards for laboratories working with the sickle cell and thalassaemia (SCT) screening programme. They have recently been updated.
Monday, 11 December 2017
Glandular Morphometrics for Objective Grading of Colorectal Adenocarcinoma Histology Images
Scientific reports Vol. 7, Iss. 1, (December 4, 2017): 16852.
Determining the grade of colon cancer from tissue slides is a routine part of the pathological analysis. In the case of colorectal adenocarcinoma (CRA), grading is partly determined by morphology and degree of formation of glandular structures. Achieving consistency between pathologists is difficult due to the subjective nature of grading assessment. An objective grading using computer algorithms will be more consistent, and will be able to analyse images in more detail. In this paper, we measure the shape of glands with a novel metric that we call the Best Alignment Metric (BAM). We show a strong correlation between a novel measure of glandular shape and grade of the tumour. We used shape specific parameters to perform a two-class classification of images into normal or cancerous tissue and a three-class classification into normal, low grade cancer, and high grade cancer. The task of detecting gland boundaries, which is a prerequisite of shape-based analysis, was carried out using a deep convolutional neural network designed for segmentation of glandular structures. A support vector machine (SVM) classifier was trained using shape features derived from BAM. Through cross-validation, we achieved an accuracy of 97% for the two-class and 91% for three-class classification.
UHCW Research: Snead, David
Determining the grade of colon cancer from tissue slides is a routine part of the pathological analysis. In the case of colorectal adenocarcinoma (CRA), grading is partly determined by morphology and degree of formation of glandular structures. Achieving consistency between pathologists is difficult due to the subjective nature of grading assessment. An objective grading using computer algorithms will be more consistent, and will be able to analyse images in more detail. In this paper, we measure the shape of glands with a novel metric that we call the Best Alignment Metric (BAM). We show a strong correlation between a novel measure of glandular shape and grade of the tumour. We used shape specific parameters to perform a two-class classification of images into normal or cancerous tissue and a three-class classification into normal, low grade cancer, and high grade cancer. The task of detecting gland boundaries, which is a prerequisite of shape-based analysis, was carried out using a deep convolutional neural network designed for segmentation of glandular structures. A support vector machine (SVM) classifier was trained using shape features derived from BAM. Through cross-validation, we achieved an accuracy of 97% for the two-class and 91% for three-class classification.
UHCW Research: Snead, David
Monday, 13 November 2017
Sickle cell and thalassaemia screening: handbook for laboratories
These documents from Public Health England set out policy and standards for laboratories working with the sickle cell and thalassaemia (SCT) screening programme.
Tuesday, 7 November 2017
Direct quantitative measurement of the kinetics of HLA-specific antibody interactions with isolated HLA proteins
Human Immunology, ISSN 0198-8859, http://dx.doi.org/10.1016/j.humimm.2017.10.012
HLA specific antibodies vary in their pathogenicity and this is likely to be the net effect of constant chain usage, quantity, specificity, and affinity. Here we have measured the affinity of human monoclonal antibodies for a range of HLA proteins. Purified antibodies and ligands allowed dynamic interactions to be measured directly by surface plasmon resonance. Physiochemical differences between pairs of ligands were quantified using electrostatic mismatch and hydrophobic mismatch scores.
All antibodies were characterized by fast on-rates and slow off rates but with a wide range of association rates (k on, 3.63–24.25 × 10 5 per mol per second) and dissociation rates (k off , 0.99–10.93 × 10 −3 per second). Dissociation constants (K D ) ranged from 5.9 × 10 −10 M to 3.0 × 10 −8 M. SN320G6 has approximately a twenty-fold greater affinity for HLA A2 compared with SN607D8, but has a similar affinity for HLA-A2 and B57. In contrast, SN607D8 has greater than a twofold greater affinity for HLA-A2 compared with A68. Similarly, WK1D12 has about a threefold greater affinity for HLA-B27 compared with B7. The higher affinity interactions correlate with the specificity of stimulating antigen. This is the first study to directly measure the binding kinetics and affinity constants for human alloantibodies against HLA.
UHCW Research: Sunil Daga, Robert Higgins and Daniel Zehnder
HLA specific antibodies vary in their pathogenicity and this is likely to be the net effect of constant chain usage, quantity, specificity, and affinity. Here we have measured the affinity of human monoclonal antibodies for a range of HLA proteins. Purified antibodies and ligands allowed dynamic interactions to be measured directly by surface plasmon resonance. Physiochemical differences between pairs of ligands were quantified using electrostatic mismatch and hydrophobic mismatch scores.
All antibodies were characterized by fast on-rates and slow off rates but with a wide range of association rates (k on, 3.63–24.25 × 10 5 per mol per second) and dissociation rates (k off , 0.99–10.93 × 10 −3 per second). Dissociation constants (K D ) ranged from 5.9 × 10 −10 M to 3.0 × 10 −8 M. SN320G6 has approximately a twenty-fold greater affinity for HLA A2 compared with SN607D8, but has a similar affinity for HLA-A2 and B57. In contrast, SN607D8 has greater than a twofold greater affinity for HLA-A2 compared with A68. Similarly, WK1D12 has about a threefold greater affinity for HLA-B27 compared with B7. The higher affinity interactions correlate with the specificity of stimulating antigen. This is the first study to directly measure the binding kinetics and affinity constants for human alloantibodies against HLA.
UHCW Research: Sunil Daga, Robert Higgins and Daniel Zehnder
Monday, 16 October 2017
Tissue pathway for histopathological examination of the placenta
This tissue pathway from the Royal College of Pathologists aims to provide guidance on the range of indications for referral of aplacenta for histopathological examination and minimum standards for pathologists
undertaking placental examinations. Variations to the standard pathway for singleton
placentas, relating to pregnancies from multiple gestations, are also included. Please note
that products of conception (1st trimester) have been included in the tissue pathways for
gynaecological pathology.
Sickle cell and thalassaemia screening: care pathway
This document from Public Health England describes the sickle cell and thalassamia (SCT) screening pathways.
See also Sickle cell and thalassaemia screening: handbook for laboratories
See also Sickle cell and thalassaemia screening: handbook for laboratories
Thursday, 28 September 2017
Pathology networks
NHS Improvement has identified 29 potential pathology networks, allowing for the transformation of pathology services into a series of networks across the country.
They have been working with providers since the end of last year, to validate pathology data. These data collections have enabled the NHS to construct its most comprehensive picture of pathology services across the country, through which it is able to compare overall, regional and local performance year-on-year. By bringing together clinical expertise, pathology services will become more efficient, in order to deliver better value, high quality care for patients.
Tuesday, 19 September 2017
A Novel Measure for Nuclear Pleomorphism in Lung Adenocarcinoma
Bioinformatics meets digital patholgy
Nuclear morphology is used as a significant cue in different histology grading systems such as grading of breast cancer [1]. At the early stages of cancer, tumour nuclei have similar shape, size and texture. At the advanced stages, tumour nuclei deform into non-uniform shapes and unequal sizes. In lung cancer, several studies have shown that nuclear pleomorphism is a potential prognostic indicator and could be correlated with patient survival [2, 3]. Pathologists normally score nuclear pleomorphism by comparing them with the normal cells. They typically observe nuclei size, shape and the visibility of nucleoli [1]. This scoring mechanism is hugely affected by the subjectivity of human perception, as enormous variations in nuclear morphology make it very difficult for human observer to describe it in a precise way. Therefore, the reproducibility and reliability of these scoring systems are uncertain [4, 5].
In this study, we provide an automatic and objective method to measure the variability of nuclei shapes in tumour regions to overcome the limitations of the current clinical routine in nuclei scoring.
UHCW Research: D. Snead
Nuclear morphology is used as a significant cue in different histology grading systems such as grading of breast cancer [1]. At the early stages of cancer, tumour nuclei have similar shape, size and texture. At the advanced stages, tumour nuclei deform into non-uniform shapes and unequal sizes. In lung cancer, several studies have shown that nuclear pleomorphism is a potential prognostic indicator and could be correlated with patient survival [2, 3]. Pathologists normally score nuclear pleomorphism by comparing them with the normal cells. They typically observe nuclei size, shape and the visibility of nucleoli [1]. This scoring mechanism is hugely affected by the subjectivity of human perception, as enormous variations in nuclear morphology make it very difficult for human observer to describe it in a precise way. Therefore, the reproducibility and reliability of these scoring systems are uncertain [4, 5].
In this study, we provide an automatic and objective method to measure the variability of nuclei shapes in tumour regions to overcome the limitations of the current clinical routine in nuclei scoring.
UHCW Research: D. Snead
Monday, 18 September 2017
NIHR Signal Blood test and ECG may safely rule out heart attack
A high sensitivity troponin test accurately ruled out a heart attack amongst a third of patients presenting to the emergency department with chest pain. A patient with no detectable troponin and normal electrocardiogram was almost certain not to have had a heart attack.
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