| 1. |
- Bilsland, Elizabeth, 1973, et al.
(författare)
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Rck1 and Rck2 MAPKAP kinases and the HOG pathway are required for oxidative stress resistance
- 2004
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Ingår i: Molecular Microbiology. - : Wiley. - 0950-382X .- 1365-2958. ; 53:6, s. 1743-56
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Tidskriftsartikel (refereegranskat)abstract
- We demonstrate a role in oxidative and metal stress resistance for the MAPK-activated protein kinases Rck1 and Rck2 in Saccharomyces cerevisiae. We show that Hog1 is robustly phosphorylated in a Pbs2-dependent way during oxidative stress, and that Rck2 also is phosphorylated under these circumstances. Hog1 concentrates in the nucleus in oxidative stress. Hog1 localization is partially dependent on Rck2, as rck2 cells have more nuclear Hog1 than wild-type cells. We find several proteins with a role in oxidative stress resistance using Rck1 or Rck2 as baits in a two-hybrid screen. We identify the transcription factor Yap2 as a putative target for Rck1, and the Zn2+ transporter Zrc1 as a target for Rck2. Yap2 is normally cytoplasmic, but rapidly migrates to the nucleus upon exposure to oxidative stress agents. In a fraction of untreated pbs2 cells, Yap2 is nuclear. Zrc1 co-immunoprecipitates with Rck2, and ZRC1 is genetically downstream of RCK2. These data connect activation of the Hog1 MAPK cascade with effectors having a role in oxidative stress resistance.
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| 2. |
- Bodén, Anna, et al.
(författare)
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The human-in-the-loop : an evaluation of pathologists interaction with artificial intelligence in clinical practice
- 2021
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Ingår i: Histopathology. - : Wiley-Blackwell. - 0309-0167 .- 1365-2559. ; 79:2, s. 210-218
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Tidskriftsartikel (refereegranskat)abstract
- Aims: One of the major drivers of the adoption of digital pathology in clinical practice is the possibility of introducing digital image analysis (DIA) to assist with diagnostic tasks. This offers potential increases in accuracy, reproducibility, and efficiency. Whereas stand-alone DIA has great potential benefit for research, little is known about the effect of DIA assistance in clinical use. The aim of this study was to investigate the clinical use characteristics of a DIA application for Ki67 proliferation assessment. Specifically, the human-in-the-loop interplay between DIA and pathologists was studied. Methods and results: We retrospectively investigated breast cancer Ki67 areas assessed with human-in-the-loop DIA and compared them with visual and automatic approaches. The results, expressed as standard deviation of the error in the Ki67 index, showed that visual estimation (eyeballing) (14.9 percentage points) performed significantly worse (P < 0.05) than DIA alone (7.2 percentage points) and DIA with human-in-the-loop corrections (6.9 percentage points). At the overall level, no improvement resulting from the addition of human-in-the-loop corrections to the automatic DIA results could be seen. For individual cases, however, human-in-the-loop corrections could address major DIA errors in terms of poor thresholding of faint staining and incorrect tumour-stroma separation. Conclusion: The findings indicate that the primary value of human-in-the-loop corrections is to address major weaknesses of a DIA application, rather than fine-tuning the DIA quantifications.
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| 3. |
- Cervin, Ida, et al.
(författare)
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Improving the creation and reporting of structured findings during digital pathology review
- 2016
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Ingår i: Journal of Pathology Informatics. - : Medknow Publications. - 2229-5089 .- 2153-3539. ; 7:1, s. 32-32
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Tidskriftsartikel (refereegranskat)abstract
- Background: Today, pathology reporting consists of many separate tasks, carried out by multiple people. Common tasks include dictation during case review, transcription, verification of the transcription, report distribution, and report the key findings to follow-up registries. Introduction of digital workstations makes it possible to remove some of these tasks and simplify others. This study describes the work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Methods: We explored the possibility to have a digital tool that simplifies image review by assisting note-taking, and with minimal extra effort, populates a structured report. Thus, our prototype sees reporting as an activity interleaved with image review rather than a separate final step. We created an interface to collect, sort, and display findings for the most common reporting needs, such as tumor size, grading, and scoring. Results: The interface was designed to reduce the need to retain partial findings in the head or on paper, while at the same time be structured enough to support automatic extraction of key findings for follow-up registry reporting. The final prototype was evaluated with two pathologists, diagnosing complicated partial mastectomy cases. The pathologists experienced that the prototype aided them during the review and that it created a better overall workflow. Conclusions: These results show that it is feasible to simplify the reporting tasks in a way that is not distracting, while at the same time being able to automatically extract the key findings. This simplification is possible due to the realization that the structured format needed for automatic extraction of data can be used to offload the pathologists' working memory during the diagnostic review.
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| 4. |
- Hoefener, Henning, et al.
(författare)
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Deep learning nuclei detection: A simple approach can deliver state-of-the-art results
- 2018
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Ingår i: Computerized Medical Imaging and Graphics. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0895-6111 .- 1879-0771. ; 70, s. 43-52
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Tidskriftsartikel (refereegranskat)abstract
- Background: Deep convolutional neural networks have become a widespread tool for the detection of nuclei in histopathology images. Many implementations share a basic approach that includes generation of an intermediate map indicating the presence of a nucleus center, which we refer to as PMap. Nevertheless, these implementations often still differ in several parameters, resulting in different detection qualities. Methods: We identified several essential parameters and configured the basic PMap approach using combinations of them. We thoroughly evaluated and compared various configurations on multiple datasets with respect to detection quality, efficiency and training effort. Results: Post-processing of the PMap was found to have the largest impact on detection quality. Also, two different network architectures were identified that improve either detection quality or runtime performance. The best-performing configuration yields f1-measures of 0.816 on Hamp;E stained images of colorectal adenocarcinomas and 0.819 on Ki-67 stained images of breast tumor tissue. On average, it was fully trained in less than 15,000 iterations and processed 4.15 megapixels per second at prediction time. Conclusions: The basic PMap approach is greatly affected by certain parameters. Our evaluation provides guidance on their impact and best settings. When configured properly, this simple and efficient approach can yield equal detection quality as more complex and time-consuming state-of-the-art approaches. (C) 2018 The Authors. Published by Elsevier Ltd.
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| 5. |
- Kost, Henning, et al.
(författare)
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Training nuclei detection algorithms with simple annotations
- 2017
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Ingår i: Journal of Pathology Informatics. - : Elsevier BV. - 2229-5089 .- 2153-3539. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Generating good training datasets is essential for machine learning-based nuclei detection methods. However, creating exhaustive nuclei contour annotations, to derive optimal training data from, is often infeasible. Methods: We compared different approaches for training nuclei detection methods solely based on nucleus center markers. Such markers contain less accurate information, especially with regard to nuclear boundaries, but can be produced much easier and in greater quantities. The approaches use different automated sample extraction methods to derive image positions and class labels from nucleus center markers. In addition, the approaches use different automated sample selection methods to improve the detection quality of the classification algorithm and reduce the run time of the training process. We evaluated the approaches based on a previously published generic nuclei detection algorithm and a set of Ki-67-stained breast cancer images. Results: A Voronoi tessellation-based sample extraction method produced the best performing training sets. However, subsampling of the extracted training samples was crucial. Even simple class balancing improved the detection quality considerably. The incorporation of active learning led to a further increase in detection quality. Conclusions: With appropriate sample extraction and selection methods, nuclei detection algorithms trained on the basis of simple center marker annotations can produce comparable quality to algorithms trained on conventionally created training sets.
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| 6. |
- Källén, Hanna, et al.
(författare)
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Towards Grading Gleason Score using Generically Trained Deep convolutional Neural Networks
- 2016
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Ingår i: 2016 IEEE 13th International Symposium on Biomedical Imaging (ISBI). - : Institute of Electrical and Electronics Engineers (IEEE). - 9781479923496 - 9781479923502 ; 2016-June, s. 1163-1167
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Konferensbidrag (refereegranskat)abstract
- We developed an automatic algorithm with the purpose to assist pathologists to report Gleason score on malignant prostatic adenocarcinoma specimen. In order to detect and classify the cancerous tissue, a deep convolutional neural network that had been pre-trained on a large set of photographic images was used. A specific aim was to support intuitive interaction with the result, to let pathologists adjust and correct the output. Therefore, we have designed an algorithm that makes a spatial classification of the whole slide into the same growth patterns as pathologists do. The 22-layer network was cut at an earlier layer and the output from that layer was used to train both a random forest classifier and a support vector machines classifier. At a specific layer a small patch of the image was used to calculate a feature vector and an image is represented by a number of those vectors. We have classified both the individual patches and the entire images. The classification results were compared for different scales of the images and feature vectors from two different layers from the network. Testing was made on a dataset consisting of 213 images, all containing a single class, benign tissue or Gleason score 3-5. Using 10-fold cross validation the accuracy per patch was 81 %. For whole images, the accuracy was increased to 89 %.
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| 7. |
- Molin, Claes, 1977, et al.
(författare)
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mRNA stability changes precede changes in steady-state mRNA amounts during hyperosmotic stress
- 2009
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Ingår i: RNA. - : Cold Spring Harbor Laboratory. - 1355-8382 .- 1469-9001. ; 15:4, s. 600-614
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Tidskriftsartikel (refereegranskat)abstract
- Under stress, cells need to optimize the activity of a wide range of gene products during the response phases: shock, adaptation, and recovery. This requires coordination of several levels of regulation, including turnover and translation efficiencies ofmRNAs. Mitogen-activated protein (MAP) kinase pathways are implicated in many aspects of the environmental stress response,including initiation of transcription, translation efficiency, and mRNA turnover. In this study, we analyze mRNA turnover ratesand mRNA steady-state levels at different time points following mild hyperosmotic shock in Saccharomyces cerevisiae cells. Theregulation of mRNA stability is transient and affects most genes for which there is a change in transcript level. These changesprecede and prepare for the changes in steady-state levels, both regarding the initial increase and the later decline of stressinducedmRNAs. The inverse is true for stress-repressed genes, which become stabilized during hyperosmotic stress inpreparation of an increase as the cells recover. The MAP kinase Hog1 affects both steady-state levels and stability of stressresponsivetranscripts, whereas Rck2 influences steady-state levels without a major effect on stability. Regulation of mRNAstability is a wide-spread, but not universal, effect on stress-responsive transcripts during transient hyperosmotic stress. Bydestabilizing stress-induced mRNAs when their steady-state levels have reached a maximum, the cell prepares for thesubsequent recovery phase when these transcripts are to return to normal levels. Conversely, stabilization of stress-repressedmRNAs permits their rapid accumulation in the recovery phase. Our results show that mRNA turnover is coordinated withtranscriptional induction.
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| 8. |
- Molin, Claes, 1977
(författare)
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The oxidative and osmotic stress responses of S. cerevisiae
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The yeast Hog1 is a stress responsive mitogen activated protein kinase (MAPK) similar to mammalian p38 and JNK. Rck2 is a protein kinase downstream of Hog1. The Hog1 pathway was previously implicated exclusively in the response to osmotic stress. This thesis investigates the role of the Hog1 MAPK signaling pathway in global post-transcriptional regulation and survival during environmental stress. We have shown that mutations in Hog1 pathway components make cells sensitive to oxidative and heavy metal stress and that Hog1 and Rck2 are activated during these stress conditions. Putative downstream components involved in oxidative stress resistance are identified. Rck2 has a profound effect on the translational apparatus. During stress, Rck2 prevents polysome levels from falling too low. A kinase-dead allele of Rck2 confers stress sensitivity, and causes inactive polysomes to persist bound to mRNA during stress. Transcripts encoding translational components are deregulated in rck2 mutants. In response to osmotic stress, the Hog1 pathway affects mRNA levels of several hundred genes. This is accomplished to a large extent by regulation of mRNA stability, which is fast, widespread, and specific for several large groups of genes. Regulation of mRNA stability is dynamic throughout the response and precedes accumulation as well as decline of transcript levels. Unexpectedly, Rck2 has a larger effect on total transcript levels than on stability, indicating a role in transcription. A comparison between two large scale studies reveals a positive global correlation between changes in polysomal association and mRNA stability in the adaptation phase. No global correlation was found in the early response. Among genes annotated as stress responsive, two groups were found which differed in their regulation at the polysomal level early in the response, and these were used to discover new genes with a characteristic post-transcriptional behavior after stress. Transcripts encoding components of the cytoplasmic translational apparatus were divided into three separate groups with a characteristic behavior. A group of genes shown to be translationally upregulated was shown to also be stabilized in response to stress.
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| 9. |
- Molin, Jesper, 1987, et al.
(författare)
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A comparative study of input devices for digital slide navigation
- 2015
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Ingår i: Journal of Pathology Informatics. - : Elsevier BV. - 2229-5089 .- 2153-3539. ; 6:7
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Tidskriftsartikel (refereegranskat)abstract
- Quick and seamless integration between input devices and the navigation of digital slides remains a key barrier for many pathologists to "go digital." To better understand this integration, three different input device implementations were compared in terms of time to diagnose, perceived workload and users' preferences. Six pathologists reviewed in total nine cases with a computer mouse, a 6 degrees-of-freedom (6DOF) navigator and a touchpad. The participants perceived significantly less workload (P
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| 10. |
- Molin, Jesper, 1987, et al.
(författare)
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Feature-enhancing zoom to facilitate Ki-67 hot spot detection
- 2014
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. - 9780819498342 ; 9041
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Konferensbidrag (refereegranskat)abstract
- Image processing algorithms in pathology commonly include automated decision points such as classifications. While this enables efficient automation, there is also a risk that errors are induced. A different paradigm is to use image processing for enhancements without introducing explicit classifications. Such enhancements can help pathologists to increase efficiency without sacrificing accuracy. In our work, this paradigm has been applied to Ki-67 hot spot detection. Ki-67 scoring is a routine analysis to quantify the proliferation rate of tumor cells. Cell counting in the hot spot, the region of highest concentration of positive tumor cells, is a method increasingly used in clinical routine. An obstacle for this method is that while hot spot selection is a task suitable for low magnification, high magnification is needed to discern positive nuclei, thus the pathologist must perform many zooming operations. We propose to address this issue by an image processing method that increases the visibility of the positive nuclei at low magnification levels. This tool displays the modified version at low magnification, while gradually blending into the original image at high magnification. The tool was evaluated in a feasibility study with four pathologists targeting routine clinical use. In a task to compare hot spot concentrations, the average accuracy was 75±4.1% using the tool and 69±4.6% without it (n=4). Feedback on the system, gathered from an observer study, indicate that the pathologists found the tool useful and fitting in their existing diagnostic process. The pathologists judged the tool to be feasible for implementation in clinical routine.
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| 11. |
- Molin, Jesper, 1987, et al.
(författare)
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Scale Stain: Multi-Resolution Feature Enhancement in Pathology Visualization
- 2016
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Digital whole-slide images of pathological tissue samples have recently become feasible for use within routine diagnostic practice. These gigapixel sized images enable pathologists to perform reviews using computer workstations instead of microscopes. Existing workstations visualize scanned images by providing a zoomable image space that reproduces the capabilities of the microscope. This paper presents a novel visualization approach that enables filtering of the scale-space according to color preference. The visualization method reveals diagnostically important patterns that are otherwise not visible. The paper demonstrates how thisapproach has been implemented into a fully functional prototype that lets the user navigate the visualization parameter space in real time. The prototype was evaluated for two common clinical tasks with eight pathologists in a within-subjects study. The data reveal thattask efficiency increased by 15% using the prototype, with maintained accuracy. By analyzing behavioral strategies, it was possible to conclude that efficiency gain was caused by a reduction of the panning needed to perform systematic search of the images. The prototype system was well received by the pathologists who did not detect any risks that would hinder use in clinical routine.
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| 12. |
- Molin, Jesper, 1987, et al.
(författare)
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Slide navigation patterns among pathologists with long experience of digital review
- 2015
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Ingår i: Histopathology. - : Wiley. - 0309-0167 .- 1365-2559. ; 67:2, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In order to develop efficient digital pathologyworkstations, we studied the navigation patterns ofpathologists diagnosing whole-slide images. To gain abetter understanding of these patterns, we built aconceptual model based on observations. We alsodetermined whether or not new navigation patternshave emerged among pathologists with extensive digitalexperience.Methods and results: Five pathologists were asked todiagnose a set of four cases while thinking out loud.The navigation within the digital slides was recordedand divided into re-occurring navigation actions. Thepathologists reused the same type of actions, but theiroccurrence differed. The most common action was aslow panning that followed an edge structure orcovered an area systematically, which accounted for30.2% of all actions and had a median duration of7.2 s. Of all the actions, 49% were carried out withinthe navigation overview and 38% of the actionscould not have been performed with a conventionalmicroscope.Conclusions: The new navigation possibilities in thedigital workstation were used to a large extent. Thedivision of actions into different concepts can be usedto find and prioritize between existing user interfacedesigns as well as to understand the different navigationstyles used by different pathologists.
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| 13. |
- Molin, Jesper, 1987, et al.
(författare)
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Understanding Design for Automated Image Analysis in Digital Pathology
- 2016
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Ingår i: 9th Nordic Conference on Human-Computer Interaction, NordiCHI 2016, Gothenburg, Sweden, 23-27 October 2016. - New York, NY, USA : ACM. - 9781450347631 ; 23-27-October-2016:58
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Konferensbidrag (refereegranskat)abstract
- Digital pathology is an emerging healthcare field taking advantage of technology that allows digitization of microscopy images. Such digitization enables the use of automated digital image analysis techniques, which could be beneficial for the diagnostic review and prognosis of a variety of conditions. As yet, human-computer interaction (HCI) issues in this field, which is mostly based on visual analysis, have not been systematically explored. Based on reflecting on the process of designing and deploying systems for digital pathology, we propose a new understanding to design automated tools for such environments. We used meeting minutes, design briefs, interviews, personal notes and other artifacts to conduct a thematic analysis. This enabled us to establish four design considerations for introducing digital image analysis to routine pathology that concern level of detail, verification, communication and transparency.
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| 14. |
- Molin, M., et al.
(författare)
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Case management at an outpatient unit for severe and enduring eating disorder patients at Stockholm Centre for Eating Disorders : a study protocol
- 2016
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Ingår i: International Journal of Eating Disorders. - London, United Kingdom : BioMed Central. - 0276-3478 .- 1098-108X .- 2050-2974. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with severe and enduring eating disorders (SEED) are seriously ill and have a low quality of life. Case management (CM), originally developed for adult patients with severe mental disabilities, has been shown to enhance social functioning and improve quality of life, while reducing the number and length of hospitalizations. In 2014, a special unit based on CM, for patients with SEED (the Eira unit) was started at Stockholm Centre for Eating Disorders, Sweden.Method/Design: This study aims to investigate if CM can improve SEED patients' quality of life, and reduce their eating disorder symptoms as well as their health care consumption. Methods for data collection are a semi-structured diagnostic interview, self-report questionnaires, and a qualitative interview. The diagnostic interview and the self-report assessments will be done at start of treatment and at follow-ups after 1, 2, and 3years. The qualitative interview will be conducted 1 year after start of treatment. The study is approved by the ethical review board in Stockholm in compliance with the Helsinki Declaration.Discussion: CM is a possible new contribution to the treatment methods for SEED. It does not aim at remission, but rather to accept life as it is, and to enhance quality of life in the presence of the ED. This study will investigate the potential benefits of this novel intervention in a special unit for SEED patients.Trail Registration: Clinicaltrials.gov Id: NCT02897622.
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| 15. |
- Ståhlbom, Emilia, et al.
(författare)
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Should I make it round? Suitability of circular and linear layouts for comparative tasks with matrix and connective data
- 2024
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Ingår i: Computer graphics forum (Print). - : WILEY. - 0167-7055 .- 1467-8659.
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Tidskriftsartikel (refereegranskat)abstract
- Visual representations based on circular shapes are frequently used in visualization applications. One example are circos plots within bioinformatics, which bend graphs into a wheel of information with connective lines running through the center like spokes. The results are aesthetically appealing and impressive visualizations that fit long data sequences into a small quadratic space. However, the authors' experiences are that when asked, a visualization researcher would generally advise against making visualizations with radial layouts. Upon reviewing the literature we found that there is evidence that circular layouts are preferable in some cases, but we found no clear evidence for what layout is preferable for matrices and connective data in particular, which both are common data types in circos plots. In this work, we thus performed a user study to compare circular and linear layouts. The tasks are inspired by genomics data, but our results generalize to many other application areas, involving comparison and connective data. To build the prototype we utilized Gosling, a grammar for visualizing genomics data. We contribute empirical evidence on the suitedness of linear versus circular layouts, adding to the specific and general knowledge concerning perception of circular graphs. In addition, we contribute a case study evaluation of the grammar Gosling as a rapid prototyping language, confirming its utility and providing guidance on suitable areas for future development.
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| 16. |
- Ståhlbom, Emilia, et al.
(författare)
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The thorny complexities of visualization research for clinical settings: A case study from genomics
- 2023
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Ingår i: FRONTIERS IN BIOINFORMATICS. - : FRONTIERS MEDIA SA. - 2673-7647. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- In this perspective article we discuss a certain type of research on visualization for bioinformatics data, namely, methods targeting clinical use. We argue that in this subarea additional complex challenges come into play, particularly so in genomics. We here describe four such challenge areas, elicited from a domain characterization effort in clinical genomics. We also list opportunities for visualization research to address clinical challenges in genomics that were uncovered in the case study. The findings are shown to have parallels with experiences from the diagnostic imaging domain.
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| 17. |
- Swaminathan, Swarna, 1975, et al.
(författare)
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Rck2 is required for reprogramming of ribosomes during oxidative stress
- 2006
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Ingår i: Molecular Biology of the Cell. ; 17:3, s. 1472-1482
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Tidskriftsartikel (refereegranskat)abstract
- Rck2 is a mitogen-activated protein kinase-activated protein kinase in yeast implicated in translational regulation. rck2Delta mutants are mildly sensitive to oxidative stress, a condition that causes dissociation of actively translating ribosomes (polysomes). In rck2Delta cells, polysomes are lost to an even higher degree than in the wild-type upon stress. Cells overexpressing the catalytically inactive rck2-kd allele are highly sensitive to oxidative stress. In such cells, dissociation of polysomes upon stress was instead greatly delayed. The protein synthesis rate decreased to a similar degree as in wild-type cells, however, indicating that in rck2-kd cells, the polysome complexes were inactive. Array analyses of total and polysome-associated mRNAs revealed major deregulation of the translational machinery in rck2 mutant cells. This involves transcripts for cytosolic ribosomal proteins and for processing and assembly of ribosomes. In rck2Delta cells, weakly transcribed mRNAs associate more avidly with polysomes than in wild-type cells, whereas the opposite holds true for rck2-kd cells. This is consistent with perturbed regulation of translation elongation, which is predicted to alter the ratio between mRNAs with and without strong entry sites at ribosomes. We infer that imbalances in the translational apparatus are a major reason for the inability of these cells to respond to stress.
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| 18. |
- Thorstenson, Sten, et al.
(författare)
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Implementation of large‑scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013
- 2014
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Ingår i: Journal of Pathology Informatics. - : Elsevier BV. - 2229-5089 .- 2153-3539. ; 5:14
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Tidskriftsartikel (refereegranskat)abstract
- Recent technological advances have improved the whole slide imaging (WSI) scanner quality and reduced the cost of storage, thereby enabling the deployment of digital pathology for routine diagnostics. In this paper we present the experiences from two Swedish sites having deployed routine large-scale WSI for primary review. At Kalmar County Hospital, the digitization process started in 2006 to reduce the time spent at the microscope in order to improve the ergonomics. Since 2008, more than 500,000 glass slides have been scanned in the routine operations of Kalmar and the neighboring Linköping University Hospital. All glass slides are digitally scanned yet they are also physically delivered to the consulting pathologist who can choose to review the slides on screen, in the microscope, or both. The digital operations include regular remote case reporting by a few hospital pathologists, as well as around 150 cases per week where primary review is outsourced to a private clinic. To investigate how the pathologists choose to use the digital slides, a web-based questionnaire was designed and sent out to the pathologists in Kalmar and Linköping. The responses showed that almost all pathologists think that ergonomics have improved and that image quality was sufficient for most histopathologic diagnostic work. 38 ± 28% of the cases were diagnosed digitally, but the survey also revealed that the pathologists commonly switch back and forth between digital and conventional microscopy within the same case. The fact that two full-scale digital systems have been implemented and that a large portion of the primary reporting is voluntarily performed digitally shows that large-scale digitization is possible today.
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| 19. |
- Vannas, Christoffer, et al.
(författare)
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Treatment Monitoring of a Patient with Synchronous Metastatic Angiosarcoma and Breast Cancer Using ctDNA
- 2024
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Ingår i: International Journal of Molecular Sciences. - 1661-6596 .- 1422-0067. ; 25:7
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Tidskriftsartikel (refereegranskat)abstract
- Angiosarcoma is a rare and aggressive type of soft-tissue sarcoma with high propensity to metastasize. For patients with metastatic angiosarcoma, prognosis is dismal and treatment options are limited. To improve the outcomes, identifying patients with poor treatment response at an earlier stage is imperative, enabling alternative therapy. Consequently, there is a need for improved methods and biomarkers for treatment monitoring. Quantification of circulating tumor-DNA (ctDNA) is a promising approach for patient-specific monitoring of treatment response. In this case report, we demonstrate that quantification of ctDNA using SiMSen-Seq was successfully utilized to monitor a patient with metastatic angiosarcoma. By quantifying ctDNA levels using 25 patient-specific mutations in blood plasma throughout surgery and palliative chemotherapy, we predicted the outcome and monitored the clinical response to treatment. This was accomplished despite the additional complexity of the patient having a synchronous breast cancer. The levels of ctDNA showed a superior correlation to the clinical outcome compared with the radiological evaluations. Our data propose a promising approach for personalized biomarker analysis to monitor treatment in angiosarcomas, with potential applicability to other cancers and for patients with synchronous malignancies.
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