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In this episode, I’m joined by Dr. Giovanni Lujan, Nick Best, and Dr. Alae Kawam to explore a topic that hits close to home for many of us in digital pathology: why do so few pathologists attend digital pathology conferences? We delve into the barriers, opportunities, and actionable solutions that can help bridge this gap and drive the adoption of digital pathology across the profession.

What You’ll Hear in This Episode:

• Startling Observations (00:02:00): Only 10% of attendees at some digital pathology conferences are pathologists. Why is this the case, and what does it mean for the future of the field?
• Barriers to Adoption (00:04:00): From time constraints to a lack of institutional support, we unpack the key challenges stopping pathologists from going digital.
• Mentorship and Collaboration (00:09:00): How mentorship programs can connect seasoned professionals with early-career pathologists to share knowledge and drive adoption.
• The Role of the Next Generation (00:15:00): Insights into how young pathologists can lead the way with their enthusiasm and fresh perspectives.
• Engaging the Skeptics (00:07:00): Strategies to introduce hesitant or resistant pathologists to the transformative power of digital tools.
• Global Comparisons (00:10:00): What can the U.S. learn from Europe and Asia about accelerating digital pathology adoption?
• Leveraging Leadership and Advocacy (00:19:00): How young pathologists can work with leadership to introduce digital pathology as a standard practice in their organizations.
• The Impact of Digital Pathology on Work-Life Balance (00:20:00): Exploring how remote sign-outs and shorter turnaround times can enhance both patient care and pathologists’ quality of life.
• Making Digital Pathology the Norm (00:24:00): Ideas for shifting digital pathology from a secondary option to the standard of care, addressing common fears and misconceptions.
• Future Plans and Next Steps (00:28:00): A look at actionable steps for advancing digital pathology through podcasts, mentorship, and departmental advocacy.

Key Takeaways:
This conversation isn’t just about identifying challenges—it’s about solutions. We discuss how collaboration, leadership, and individual responsibility can drive meaningful change in digital pathology. Whether you’re a seasoned pathologist or just starting your career, this episode offers inspiration and actionable ideas to make digital pathology a core part of the profession.

Connect With Us:
Share your thoughts on why more pathologists aren’t attending these conferences. What’s holding them back, and what changes would you like to see in your department? Let’s keep this important conversation going!

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Leveraging AI for Deep Insights into Tertiary Lymphoid Structures in Colorectal Cancer

In this episode of the Digital Pathology Podcast, I introduce 'Aleks + AI,' a new experimental series leveraging Google's Notebook LM to delve deeper into scientific literature.

Today's focus is on tertiary lymphoid structures (TLS) and their potential to predict colorectal cancer prognosis. We discuss a study published in the October 2024 issue of Precision Clinical Medicine, exploring different methods of quantifying TLS using digital pathology and AI. 

The paper title is: "Comparative analysis of tertiary lymphoid structures for predicting survival of colorectal cancer: a whole-slide images-based study"

The findings highlight TLS density as a reliable predictor of survival and its correlation with immune responses and microsatellite instability. We also touch upon the potential for AI to streamline TLS analysis in clinical settings and the broader implications for personalized medicine. Join us as we dive into the intersection of digital pathology and computer science, featuring insights and commentary from my AI co-hosts, Hema and Toxy.

00:00 Welcome and Introduction
00:45 Introducing the New AI Tool: Notebook LM by Google
01:11 Experimental Series: "Aleks + AI"
02:06 Deep Dive into Tertiary Lymphoid Structures (TLS)
03:18 Understanding TLS and Their Role in Colorectal Cancer
04:20 Quantification Methods and Key Findings
05:02 Implications for Personalized Medicine
09:02 AI in TLS Analysis and Future Prospects
11:00 CMS Classification and TLS Density
12:08 Study Limitations and Future Directions
15:40 Final Thoughts and Wrap-Up
16:28 Feedback and Future Plans

THIS EPISODE'S RESOURCES

• 116: DigiPath Digest #18 | Federated Learning in Pathology. Developing AI Models While Preserving Privacy

PUBLICATION DISCUSSED TODAY

📝 Comparative analysis of tertiary lymphoid structures for predicting survival of colorectal cancer: a whole-slide images-based study
🔗https://academic.oup.com/pcm/article/7/4/pbae030/7826772

📱 Send us a text

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In today's DigiPath Digest, we delve into federated learning, a decentralized approach to AI training that preserves data privacy.

I discuss recent papers from PubMed and share my experiences experimenting with AI tools like Perplexity and Gemini for research efficiency.

You will also get updates on upcoming plans, including leveraging AI to share more podcasts with you.

Did I mention that this is the last livestream of the year as I head to Poland for Christmas? No More DigiPath Digests. We got to number 18 (I overestimated it a bit in the podcast), and you have been instrumental in continuing this series!

Big THANK YOU to all the digital Pathology #TRLBLZRS showing up every Friday morning for this!

Join me as we tackle the nuances of federated learning and its impact on healthcare and pathology.

00:00 Introduction and Greetings
00:18 Today's Topic: Federated Learning
00:57 AI Tools and Updates
04:39 Federated Learning in Detail
08:03 Challenges and Benefits of Federated Learning
11:21 Exploring More Papers and Future Plans
22:53 Wrapping Up and Final Thoughts

Links and Resources:

• Subscribe to Digital Pathology Podcast on YouTube
• Free E-book "Pathology 101"
• YouTube (unedited) version of this episode
• Try Perplexity with my referral link
• My new page built with Perplexity

Publications Discussed Today:

📝 Privacy-preserving federated data access and federated learning: Improved data sharing and AI model development in transfusion medicine
🔗https://pubmed.ncbi.nlm.nih.gov/39610333/

📝 A review on federated learning in computational pathology
🔗https://pubmed.ncbi.nlm.nih.gov/39582895/


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This episode features a conversation with Dr. Richard Doughty, Senior Medical Advisor at Aiforia Technologies, whose dual training in veterinary and medical pathology offers a unique perspective on the intersections of these fields. Together, we explore the challenges, opportunities, and innovations shaping digital pathology today.

What You’ll Learn in This Episode:

• [00:00:00] Challenges in Pathology Today
  Discussing the pathologist shortage, delayed diagnoses, and how AI can address these issues.
• [00:03:00] A Pathologist’s Dual Perspective
  Dr. Doughty shares his journey of becoming both a veterinary and medical pathologist, and what this means for pathology innovation.
• [00:08:00] AI’s Role in Pathology
  Insights into how clinician-centric AI tools like Aiforia are designed to improve diagnostic workflows and outcomes.
• [00:14:00] Addressing Challenges in AI Integration
  Strategies for overcoming hurdles like algorithm aversion, skill retention, and fostering trust in AI systems.
• [00:22:00] Preparing Future Pathologists
  The importance of incorporating AI training into residency programs and creating a digitally savvy workforce.
• [00:44:00] How to Implement AI Effectively
  Practical advice on selecting tools, collaborating with providers, and setting realistic goals for AI adoption in practice.

Resources and Links Mentioned:

• Learn More About Aiforia: https://www.aiforia.com/
• Download Digital Pathology 101
• Contact Dr. Richard Doughty: [email protected]
• Watch more videos created together with Aiforia: VIDEO PLAYLIST

This episode is supported by Aiforia Technologies, leaders in AI-powered solutions for digital pathology.

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In this episode, I sit down with Dr. Nina Kottler, Associate Chief Medical Officer of Clinical AI at Radiology Partners, to dive into the evolving role of AI in radiology and how it can shape the future of digital pathology. Dr. Kottler shares her unique journey, expertise, and practical frameworks for implementing AI that enhance patient care and streamline diagnostic workflows.

Episode Highlights and Key Moments:

• [00:00:45] Introduction to Dr. Nina Kottler
  Dr. Kottler discusses her background in applied mathematics, her journey into medicine, and her work at Radiology Partners, where she combines clinical practice with AI innovation.
• [00:04:30] Breaking Down Complex Problems in AI
  Nina explains her approach to tackling large clinical challenges by breaking them down into manageable parts, a method that’s essential for developing and optimizing AI solutions.
• [00:08:15] The Role of Data Orchestration
  We dig into “data orchestration” and how ensuring data is aligned with the right AI model is key to producing accurate and reliable clinical outcomes.
• [00:11:45] Life Cycle of an Exam in Radiology
  Nina takes us through each step in the radiology workflow—from the initial patient consultation to reporting—and highlights how AI can streamline and enhance each phase.
• [00:17:00] Evolution of AI Models in Healthcare
  We explore how AI has evolved, from early CAD systems to today’s multimodal and transformer models, and the exciting possibilities they bring to both radiology and pathology.
• [00:23:20] Addressing the Lag in AI Adoption in Healthcare
  We discuss the challenge of keeping up with AI advancements while balancing patient safety, regulatory standards, and the need for reliability in clinical settings.
• [00:27:50] Frameworks for Reducing Variability and Improving Accuracy
  Nina shares actionable frameworks that Radiology Partners uses to reduce variability and improve diagnostic precision—strategies that pathology can learn from.
• [00:32:40] AI in Workflow Optimization: Where It Has Real Impact
  We discuss specific use cases in clinical workflows that show where AI can bring the greatest value, especially in enhancing patient care through optimized processes.
• [00:36:50] The Power of Multimodal AI and Vision-Language Models
  Combining large language models with computer vision is moving diagnostics closer to comprehensive, AI-driven care—a promising development we explore in depth.
• [00:42:15] The Future of Agents in AI
  We dive into the concept of “agents” in AI and how these systems may soon coordinate multiple models for more complex and precise clinical analyses.
• [00:48:10] Where to Learn More about Dr. Nina Kottler’s Work
  Nina shares where you can catch her upcoming talks and presentations, plus resources for staying updated on the latest in AI for radiology and digital pathology.

If you're a pathologist, radiologist, or healthcare professional curious about AI’s impact on diagnostics, this episode is packed with practical guidance on integrating AI into clinical workflows. Join us as we explore how AI is shaping the future of radiology and pathology!

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Welcome back to the DigiPath Digest, fresh from PathVision! 

In this episode we will dive into the latest updates from the PathVision conference, covering trends in AI-driven diagnostics, the expansion of digital pathology into primary care, and the exciting new frontier of glassless pathology.

Join me as I recap the highlights of PathVision and the latest updates from the digital pathology literature, including discussions on:

• AI Integration in Pathology: Learn how AI is advancing breast cancer diagnostics with tools like Ki-67 scoring models and multi-label AI for mammography, aimed at reducing unnecessary biopsies.

• Global Health & Digital Microscopy: Hear about innovative projects from Sweden and Finland focused on AI-supported digital microscopy in primary healthcare labs, bringing accessible diagnostics to underserved areas.

• Glassless Pathology with MUSE: Discover how glassless pathology is changing tissue imaging with MUSE (Microscopy with UV Surface Excitation), enabling diagnostics without the need for traditional glass slides. Dr. Zuraw breaks down what this means for future pathology workflows.

Plus, a shout-out to the vendors and partners making these advancements possible, and insights from Dr. Zuraw’s conversations with digital pathology trailblazers from around the globe, including new developments from Asia in digital pathology education and technology.

Timestamps:

• [0:00] PathVision Highlights & Global Attendees
• [5:15] AI in Diagnostic Workflows: Dr. Anil Parwani’s “Pathology Train Ride”
• [12:30] Moving Beyond Narrow AI: Multimodal and Foundational Models
• [18:45] Glassless Pathology: A New Frontier with MUSE Microscopy
• [25:10] Integrating Digital Microscopy in Global Health Labs
• [32:00] Breast Cancer Month: New Advances in AI for Diagnostics
• [42:00] One Health & AI for Disease Detection in Primary Care
• [48:30] Special Interviews: Jun Fukuoka and Asian Society of Digital Pathology

Links and Resources:

• Subscribe to Digital Pathology Podcast on YouTube
• Pathology News 
• Signify Research Monthly Recap
• YouTube version of this episode

Publications Discussed Today:

📝 AI-Supported Digital Microscopy Diagnostics in Primary Health Care Laboratories: Protocol for a Scoping Review
🔗https://pubmed.ncbi.nlm.nih.gov/39486020/

📝 Ki-67 evaluation using deep-learning model-assisted digital image analysis in breast cancer
🔗https://pubmed.ncbi.nlm.nih.gov/39478421/

📝A Multi-label Artificial Intelligence Approach for Improving Breast Cancer Detection With Mammographic Image Analysis
🔗https://pubmed.ncbi.nlm.nih.gov/39477432/

📝 A comprehensive evaluation of an artificial intelligence based digital pathology to monitor large-scale deworming programs against soil-transmitted helminths: A study protocol
🔗 https://pubmed.ncbi.nlm.nih.gov/39466830/


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In this episode, I meet with Adam Cole, MD, and Jason Camilletti about how digital pathology transforms the field. Adam, the CEO of TruCore Pathology, and Jason, the CEO of PathNet Labs, share their unique journeys from the military to becoming digital pathology leaders. We explore their experiences, challenges, and innovations in integrating AI and digital tools into their practices.

Key Topics Discussed:

• [00:00:00] Introduction to AI in Pathology
• [00:01:00] Adam and Jason’s Military Backgrounds
• [00:05:00] Adam’s Story of Becoming a Mobile Pathologist
• [00:10:00] The Move to Fully Digital Pathology
• [00:14:30] AI’s Role in Pathology
• [00:20:00] Challenges in Implementing Digital Pathology
• [00:25:00] Improving Patient Outcomes with Digital Tools
• [00:29:00] Digital Pathology’s Impact on Patient Care
• [00:38:00] Using AI for Quantifying Tumor Volume
• [00:40:00] The Role of AI in Enhancing Diagnostics

Adam and Jason emphasize the immense potential of AI in pathology, but also the need for thoughtful integration. The future of pathology lies in using digital tools to provide faster, more accurate diagnoses while maintaining the critical human element. Tune in to learn how AI is reshaping the field and what it means for both pathologists and patients.

THIS EPISODE'S RESOURCES:

• TruCore website
• PathNet Website

OTHER EPISODES YOU MIGHT LIKE:

• The Evolution of Digital Pathology – from Improved Histology Quality to Fair Use of Pathology Data w/ Matthew O. Leavitt, DDx Foundation
• Achieving work-life balance in medicine as a pathologist with digital pathology w/ Todd Randolph, MD 

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Become a Digital Pathology Trailblazer get the "Digital Pathology 101" FREE E-book and join us!

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In this episode of the Digital Pathology Podcast, I had an insightful discussion with Matthew Nunez, CEO of MUSE Microscopy, as we explored the revolutionary potential of MUSE, the first direct-to-digital pathology imager. Matthew introduced us to how this device is poised to transform traditional pathology workflows, eliminate physical slides, and bring diagnostic precision and speed to a new level.

Key Topics Discussed:

• [00:00:00] Introduction to Digital Pathology Workflow
• [00:01:00] Meet MUSE: A Direct-to-Digital Pathology Solution
• [00:02:00] Technical Details and Imaging Capabilities
• [00:04:00] UV Light Surface Excitation Technology in MUSE
• [00:06:00] Advantages of MUSE for Pathology Practice
• [00:08:00] Stereology and Deeper Imaging with MUSE
• [00:12:00] MUSE in Clinical and Veterinary Pathology
• [00:16:00] Impact of MUSE on Turnaround Time and Accuracy
• [00:20:00] Use of MUSE in Remote and Mobile Pathology Clinics
• [00:24:00] Second Opinions and the Portable Design of MUSE
• [00:26:00] Patient-Centered Pathology and In-Office Diagnoses
• [00:28:00] Reimbursement and Coding for Direct-to-Digital Pathology
• [00:29:00] The Future of Pathology with MUSE Technology

Matthew and I wrapped up with a look at how MUSE is bridging the gap between pathology and patient care. By eliminating physical slides and enabling in-office diagnoses, MUSE makes digital pathology more accessible and efficient, transforming the way pathologists work. Whether you’re in a clinical setting, a veterinary lab, or working remotely, MUSE’s real-time, direct-to-digital capabilities offer a promising future for faster, more accurate diagnostics.

Listen to this episode to learn how MUSE is redefining the standard workflow in pathology!

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What does the FDA jurisdiction for LDTs mean for the labs? Do they need to worry? How do they need to change the way they operate?

In this episode, I talk with Dr. Thomas Nifong, a clinical pathologist and VP of CDX operations at Acrovan Therapeutics, about the recent FDA ruling on laboratory-developed tests (LDTs) issued on May 6th, 2024. We discuss the implications of considering LDTs as medical devices, requiring regulation, and explore the authority of FDA versus CLIA. The conversation also covers historical contexts, practical implications of regulatory changes, and the roles of organizations like CAP, ACLA, and AMP in legal challenges against the FDA. We dive into the differences in requirements between CLIA and FDA, New York's alternative approval route, and potential impacts on lab operations and compliance. Join us for an insightful conversation filled with essential information for those in the field of molecular pathology.

00:00 Introduction and Special Guest Announcement
00:24 FDA's New Rule on Laboratory Developed Tests (LDTs)
01:58 Recording the Podcast: A Casual Lunch Conversation
03:47 Understanding FDA's Authority Over Medical Devices
08:07 Disputes and Legal Challenges
12:03 Practical Implications and Industry Reactions
12:47 Understanding FDA's Focus: Safety and Efficacy
14:11 The Role of CMS and Medical Necessity
14:48 Congressional Involvement and Legal Authority
16:06 Impact on Labs and Future LDTs
18:33 Quality Systems and Compliance
20:16 Modifications and Software Updates
21:16 Conclusion and Next Steps

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In this episode, I had a fascinating conversation with Candice Chu, DVM, PhD, DACVP, about how artificial intelligence (AI) is reshaping veterinary diagnostics and education. Candice, a clinical pathologist and educator at Texas A&M, is using AI tools like ChatGPT to improve efficiency in clinical workflows and academic processes. We explored the practical applications of AI, ethical concerns, and its future impact on veterinary medicine.

Key Topics Discussed:

• [00:00:00] Introduction to AI in Veterinary Education and Diagnostics
  I ask Candice how AI is changing veterinary education and diagnostics, and she explains how AI is boosting efficiency in both areas.
• [00:01:00] Candice’s Journey in Veterinary Medicine
  Candice shares her journey from Taiwan to the U.S., her career in veterinary pathology, and becoming an educator at Texas A&M.
• [00:05:00] Custom GPT Model for Clinical Pathology
  Candice describes the development of her custom GPT model for clinical pathology and its role in improving diagnostic efficiency.
• [00:10:00] AI Tools for Academic and Clinical Efficiency
  We talk about how AI tools reduce repetitive tasks, giving professionals more time for critical thinking and decision-making.
• [00:14:30] Ethical Concerns When Using AI in Veterinary Medicine
  Candice emphasizes the ethical responsibility of using AI, highlighting the importance of human judgment in AI-assisted diagnostics.
• [00:20:00] How Veterinary Students Can Leverage AI
  Candice shares tips on how students can use AI to enhance learning, from simplifying research to generating case questions.
• [00:29:00] AI’s Role in Academic Writing and Veterinary Practice
  We discuss how AI tools streamline academic writing and research, and how AI will continue shaping veterinary practice in the future.
• [00:39:00] Critical Thinking and AI in Veterinary Medicine
  Candice and I conclude by discussing how critical thinking and professional responsibility are essential when using AI tools.

Candice highlighted the transformative role AI can play in both veterinary education and diagnostics, improving efficiency while requiring responsible use. While AI tools like ChatGPT offer many benefits, the human element—our critical thinking and judgment—remains crucial in ensuring accurate results and ethical practices.

This episode provides practical insights on how veterinary professionals, educators, and students can harness AI to streamline workflows and improve diagnostic accuracy. Be sure to listen to the full conversation for actionable tips on integrating AI into your practice!

EPISODE RESOURCES:

• About Dr. Candice Chu (Including her social media and achievements)
• Candice's Paper
• Undermind AI
• Youtube Episode of this Episode

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