Cambridge Healthtech Institute’s Fourth Annual

Digital Pathology

Transforming Medicine in a Digital World

March 7 – 9, 2016 | Moscone North Convention Center | San Francisco, CA
Part of the 23rd International Molecular Medicine Tri-Conference


In Partnership with

 API DPA

The Fourth Annual Digital Pathology conference will cover the full spectrum of topics currently making an impact on the digital pathology practice. Whole slide imaging has the potential to improve efficiency and cost-effectiveness, while providing access to high quality care in areas that are currently under-served. Many nations are leading the way with the use of whole slide images for primary diagnosis, while the United States is trailing behind. This year we will evaluate progress being made and the advantages of taking strides to digitize information to share images and data across institutions as well as encourage adoption by medical institutions and thereby lending expertise across geographic areas. Technical prowess in new technology, data analysis, machine learning and IT infrastructure in addition to standardization of practice will be highlighted. This conference will bring together leaders in the field that are truly committed to shape the future of medicine.

Scientific Advisory Board

Kenneth J. Bloom, M.D., CMO, Clarient, Inc.

Eric F. Glassy, M.D., FCAP, Medical Director, Affiliated Pathologists Medical Group

Liron Pantanowitz, M.D., Associate Professor, Pathology, University of Pittsburgh Medical Center

David L. Rimm, M.D., Ph.D., Professor, Pathology, Yale University


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Monday, March 7

10:30 am Conference Program Registration Open


HOT TOPICS

11:50 Chairperson’s Opening Remarks

12:00 pm KEYNOTE PRESENTATION: Implementation of Full Digital Workflow

Paul J. (Paulus Joannes) van Diest, M.D., Ph.D., Professor & Head, Pathology, University Medical Center Utrecht

This presentation will give an impression on how the Department of Pathology at the University Medical Center Utrecht is in the process of implementation of full digital workflow.

12:30 International Telepathology Makes a Difference

Liron Pantanowitz, M.D., Associate Professor, Pathology & Biomedical Informatics; Director, Pathology Informatics and UPMC Shadyside Cytology Divisions; Director, the Pathology Informatics Fellowship Program, University of Pittsburgh Medical Center

This talk about telepathology will focus more on clinical practice than technology, and demonstrate how international teleconsultation can significantly improve patient care by facilitating access to pathology expertise. Several years’ worth of experience will be shared involving international teleconsultation between the University of Pittsburgh Medical Center and KingMed Diagnostics in China. This talk will highlight key factors that may hinder or support a successful, sustainable and growing international telepathology partnership.

1:00 Session Break

Glencoe Software1:15 Luncheon Presentation I: Manage, Visualize, Analyze, Annotate, Share: The New Digital Pathology Paradigm

Rebecca M. Walker, Vice President, Global Sales & Marketing, Glencoe Software

1:45 Luncheon Presentation II (Sponsorship Opportunity Available)

2:15 Session Break


IN VIVO MICROSCOPY

2:30 Chairperson’s Remarks

Eric F. Glassy, M.D., FCAP, Medical Director, Affiliated Pathologists Medical Group

2:40 Potential Roles for ex vivo Optical Imaging for Tissue Evaluation in Surgical Pathology Practice

Savitri Krishnamurthy, M.D., Professor, Pathology, The University of Texas MD Anderson Cancer Center

Our work with Confocal microscopy platform using surgically excised tissues and needle core biopsies demonstrate the feasibility of using this technique for rapid evaluation of tissues with a high level of sensitivity and specificity. The role of this technique for tissue evaluation in routine Surgical Pathology practice needs to be evaluated in prospective clinical studies.

3:10 Multiphoton Microscopy: A Valuable Tool to Rapidly Evaluate and Triage ex vivo Tissues from a Genito-Urinary Prospective

Manu Jain, M.D., Assistant Attendee Optical Imaging Specialist, Dermatology, Memorial Sloan Kettering Cancer Center (MSKCC)

Multiphoton microscopy (MPM) generates histology-quality images rapidly from fresh tissue, without tissue processing. Fresh tissue from bladder, kidney, testis and prostate were imaged with MPM. Based on the architectural and cellular details, MPM could characterize normal components of the tissue and differentiate neoplastic from non-neoplastic. We envision MPM as a real-time diagnostic tool for bedside rapid evaluation of tissue and as an adjunct to frozen sectio for intra-operative margin assessment.

3:40 Spectral Biopsy: A Noninvasive Assessment of Tissue Pathology

James W. Tunnell, Ph.D., Associate Professor, Biomedical Engineering, University of Texas, Austin

Optical spectroscopic techniques allow one to noninvasively assess tissue pathology. This so-called “spectral biopsy” requires device and algorithm development to translate these traditional bench-top methods to clinically usable devices. We will highlight our recent work combining several techniques in a multi-modality approach (combined Raman, diffuse optical and laser induced fluoresce), including recent results of its clinical use.

4:10 Demonstrating Clinical Impact: Getting Paid for
Next-Generation Sequencing in 2016 and Beyond

Kyle Fetter, Vice President, Advanced Diagnostics, XIFIN, Inc.

This session will highlight any updates on PAMA, Medicare and commercial payor trends in coverage and pricing, and what labs should be looking out for this year, and beyond.

Definiens4:25 Integrated Phenomics and Big Data for Biomarker Discovery and Test Development

Ralf Huss, M.D., CMO, Definiens

Histological phenotypes play an essential role in cancer diagnostics. Since the treatment decisions are becoming increasingly complex through the availability of innovative drugs, Tissue Phenomics represents a novel technique to discover meaningful patterns that predict drug response. This method is based on digital pathology, image analysis and data mining including a comprehensive big data approach.

4:40 Refreshment Break and Transition to Plenary Session

5:00 Plenary Keynote Session

6:00 Grand Opening Reception in the Exhibit Hall with Poster Viewing

7:30 Close of Day


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Tuesday, March 8

7:00 am Registration Open and Morning Coffee

8:00 Plenary Keynote Session

9:00 Refreshment Break in the Exhibit Hall with Poster Viewing


DIGITAL PATHOLOGY AND IMMUNE CHECKPOINT THERAPY

10:05 Chairperson’s Remarks

David L. Rimm, M.D., Ph.D., Professor, Pathology, Yale University

10:15 Tissue-Based Assessment of PD-L1 and Other Tumor Microenvironmental Factors in Melanoma Specimens

Janis M. Taube, M.D., MSc, Director, Dermatopathology; Assistant Professor, Dermatology and Pathology, Johns Hopkins

Immunohistochemical detection of PD-L1 and other checkpoint molecules may serve as biomarkers for selecting immunotherapeutic regimens for patients with advanced melanoma. The evaluation of the utility of PD-L1 as a biomarker has been hampered by the different antibodies and assays used. We will discuss the current issues associated with immune checkpoint companion diagnostics and potential future applications for use of these assays in patients with melanoma.

10:45 Tissue-Based Analyses to Guide Immunotherapy for Lymphoma

Scott Rodig, M.D., Ph.D., Hematopathologist, Pathology, Brigham and Women’s Hospital

Targeted immunotherapy has achieved long-lasting clinical responses in a subset of patients with a variety of aggressive malignancies. I will discuss the cellular and molecular characteristics of classical Hodgkin lymphoma that render this tumor-type uniquely susceptible to PD-1 blockade and correlations between tissue-based biomarker analysis and clinical outcome with either conventional chemotherapy or immunotherapy, and extensions of these observations to additional lymphoma subtypes.

11:15 Immune Profiling of Lung Cancer Tissue Specimens

Ignacio I. Wistuba, M.D., Department Chair, Translational Molecular Pathology, Division of Pathology/Lab Medicine; Anderson Clinical Faculty Chair, Cancer Treatment and Research, The University of Texas MD Anderson Cancer Center

The anti-tumor benefit of blocking immune checkpoints in lung cancer, particularly PD-1 and PD-L1, has revolutionized the therapy of this disease. Because of variable responses to immunotherapy (IMT), there is an urgent need for predictive biomarkers to guide personalization of lung cancer treatment. A comprehensive approach to identify and validate IMT-related biomarkers in lung cancer tissue specimens, including digital pathology and genomic methodologies, will be described.

11:45 Beyond PD-L1: Other Potential Companion Diagnostic Tests for Immune Checkpoint Therapy

David L. Rimm, M.D., Ph.D., Professor, Pathology, Yale University

The current companion diagnostic tests and nearly all publications related to immune checkpoint therapies are based on assessment of PD-L1. Some assess PD-L1 in the epithelial component while others emphasize stromal expression. However, there may be other methods for assessment of response to these therapies based on the presence of subsets of T-cells or assessment of the activation of these T-cells. It is also possible that assessment of other co-stimulators or competitive receptors may influence prediction of response to therapy. These non-Pd-L1 methods will be reviewed in this lecture.

12:15 pm Session Break

illumina NEW12:25 Luncheon Presentation I: Shared Accountability: How Genomics & Informatics Will Engage Consumers, Providers and Payers toward true Personalized Medicine

Satnam Alag, Ph.D., Vice President, Software Development, Enterprise Informatics

Genomics data is a big deal when context and meaning is attached to it. Smart data - the right data at the right time to the right person - can help Consumers, Providers and Payers enhance and inform care decisions. That's the prize but how do you get your hands on it? We will focus on Genomics & Informatics and how companies like Illumina are working to provide solutions.

Philips12:55 Luncheon Presentation II: Integrated Oncology Diagnostics enabled by Digital Pathology

Reinhold Wimberger-Friedl, Ph.D.,Principal Scientist, Philips Research, Europe Philips

At Philips we develop an integrated approach of staining-based and molecular characterization of the tumor and its micro-environment. Digital pathology with WSI analytics enables a comprehensive quantification of cellular composition of the tumor. A proprietary model determines the tumor-driving signaling pathways from mRNA expression profiles.

1:25 Refreshment Break in the Exhibit Hall with Poster Viewing


HOT TOPICS II

2:00 Chairperson’s Remarks

Liron Pantanowitz, M.D., Associate Professor, Pathology & Biomedical Informatics; Director, Pathology Informatics and UPMC Shadyside Cytology Divisions; Director, the Pathology Informatics Fellowship Program, University of Pittsburgh Medical Center

2:10 Digital Microbiology – The New Frontier

Susan Novak-Weekley, Ph.D., D(ABMM), Director, Microbiology, Molecular Infectious Disease & Serology Testing, Southern California Permanente Medical Group

Manual workup of bacterial cultures is a process that all clinical microbiologists are familiar with. Newer incubators on the market contain digital cameras that can take an image of growth on a petri dish. These images can then be presented to the technologist for analysis. Digital microbiology allows for culture work up by observing the plates via a computer screen. This lecture will cover the application of Digital Microbiology and important considerations with implementation.

2:40 Comparison of Two PD-L1 Antibodies Using Fluorescence and Brightfield IHC

Michelle Dean, BSc., Functional Tissue Imaging Unit, Translational Labs, Tom Baker Cancer Centre

3:10 WSI – Reduction to Clinical Utility

Stephen M. Hewitt, M.D., Ph.D., Clinical Investigator; Head, Experimental Pathology and Lab of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, FDA

Whole Slide Imaging has matured greatly over the last decade, however implementation for clinical application is occurring at a much slower pace. Although many challenges have been overcome, the current challenges are the “nuts and bolts” of delivering quality-defined images rapidly to users. This talk will address the challenges of developing and deploying a robust whole slide imaging solution that drives pathologist productivity.

Indica3:40 Mining Complex Biomarker Expression Patterns in Tissues Using an Integrated Image Analysis and Informatics Platform

Kate Lillard Tunstall, Ph.D., CSO, Indica Labs

Vlado Ovtcharov, Senior Algorithm Engineer, Indica Labs

Combining multispectral and serial section analysis capabilities with new spatial analysis tools, Indica Labs' HALO analysis platform allows scientists to investigate increasingly complex biomarker expression patterns across whole slide tumour sections. As the number of analysis end points expand, the need shifts from data collection to data management and mining. Indica Labs introduces STRATA, a new platform for visualizing, managing and mining biomarker analysis data to identify end points associated with patient outcomes.

4:10 St. Patrick’s Day Celebration in the Exhibit Hall with Poster Viewing

5:00 Breakout Discussions in the Exhibit Hall

These interactive discussion groups are open to all attendees, speakers, sponsors, & exhibitors. Participants choose a specific breakout discussion group to join. Each group has a moderator to ensure focused discussions around key issues within the topic. This format allows participants to meet potential collaborators, share examples from their work, vet ideas with peers, and be part of a group problem-solving endeavor. The discussions provide an informal exchange of ideas and are not meant to be a corporate or specific product discussion.

Return on Investment for Digital Pathology

Liron Pantanowitz, M.D., Associate Professor, Pathology & Biomedical Informatics; Director, Pathology Informatics and UPMC Shadyside Cytology Divisions; Director, the Pathology Informatics Fellowship Program, University of Pittsburgh Medical Center

  • Are there proven business cases for implementing digital pathology?
  • Can digital pathology for primary diagnosis be financially justified?
  • What are the direct and indirect costs when adopting digital pathology?

Clinical Informatics Fellowships: Transforming Medicine and Medical Education

Bruce Levy, M.D., CPE, Associate Professor, Pathology, University of Illinois, Chicago; Associate Chief Health Information Officer, University of Illinois at Chicago Hospital and Health Sciences System

  • How to establish an ACGME-accredited fellowship in Clinical Informatics
  • Discussing the experiences of the inaugural group of fellows and faculty
  • Why a fellowship program open to all physicians will change the practice of medicine
  • How the training model is different from the traditional ACGME approach and lessons that can be applied to other residencies and fellowships

What Laboratories are Considering Total Laboratory Automation (TLA) which includes Digital Microbiology, and Why?

Susan Novak-Weekley, Ph.D., D(ABMM), Director or Microbiology, Molecular Infectious Disease & Serology Testing, Southern California Permanente Medical Group

  • Challenges and considerations for institutions and laboratories
  • Digital Microbiology systems and potential features
  • Future perspectives from clinical microbiologists

6:00 Close of Day


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Wednesday, March 9

7:00 am Registration Open

7:00 Breakfast Presentation (Sponsorship Opportunity Available) or Morning Coffee

8:00 Plenary Keynote Session Panel

10:00 Refreshment Break and Poster Competition Winner Announced in the Exhibit Hall


HOW TO MAXIMIZE VALUE OF DIGITAL IMAGING:
Improving Quality of Care through Machine Learning Approaches

10:50 Chairperson’s Remarks

Kenneth J. Bloom, M.D., CMO, Human Longevity, Inc.

11:00 Slide-Free Histology via MUSE: UV Surface Excitation Microscopy for Imaging Unsectioned Tissue

Richard Levenson, M.D., Professor and Vice Chair, Strategic Technologies, Pathology & Laboratory Medicine, University of California, Davis Medical Center

Slide-free methods for rapid tissue histological analysis can cut hours off usual pathology slide preparation procedures. One approach to accomplish this is MUSE (Microscopy with UV Surface Excitation), which exploits the shallow penetration of UV light to excite fluorescent signals from only the most superficial tissue elements. The method is non-destructive, and eliminates the need for conventional histology processing, formalin fixation, paraffin embedding, or thin sectioning.

11:30 The Impact of Machine Learning on the Practice of Pathology

Kenneth J. Bloom, M.D., CMO, Human Longevity, Inc.

12:00 pm Late Breaking Presentation

12:30 Session Break

12:40 Luncheon Presentation (Sponsorship Opportunity Available)
or Enjoy Lunch on Your Own

1:10 Refreshment Break in the Exhibit Hall and Last Chance for Poster Viewing


DIGITIZED CYTOLOGY

1:50 Chairperson’s Remarks

David C. Wilbur, M.D., Professor, Pathology, Massachusetts General Hospital

2:00 Cytology Education in the Digital Era

Stanley J. Radio, M.D., Professor and Medical Director, Cytotechnology Program, University of Nebraska Medical Center

The rapidly contracting number of cytotechnology training programs in the U.S. and the advent of digital learning in all aspects of education has provided the impetus for us to establish satellite programs and develop novel methods to deliver instruction to all students. We utilize virtual cytology slides for virtual slide boxes, learning modules that include cytology/histology correlation, slide morphology tests and student presentations, both local and satellite as well as many other applications.

2:30 Digital Pathology Applications in Cytologic Specimens: Unique Aspects and Solutions for Optimization

David C. Wilbur, M.D., Director, Clinical Imaging in Pathology, Massachusetts General Hospital; Professor of Pathology, Harvard Medical School

A number of maneuvers can be accomplished to solve the 3-dimensional problems with cytology specimens, including real time image streaming, multiplane scanning, intercalation of multiple scanned planes, and embedding of focused video clips and high resolution scan areas. Use of these technologies can afford similar accuracy in the interpretation of cytology digital images as is now found to be the case in histologic digital images.

3:00 Cytology Digital Consultation

Liron Pantanowitz, M.D., Associate Professor, Pathology & Biomedical Informatics; Director, Pathology Informatics and UPMC Shadyside Cytology Divisions; Director, the Pathology Informatics Fellowship Program, University of Pittsburgh Medical Center

Experience with the practice of telecytology has greatly increased. Cytology digital teleconsultation has been employed for rapid evaluation of specimens, remote interpretation of Pap tests, and for rendering second opinions on challenging non-gynecologic cases. The aim of this talk is to review the topic of telecytology and highlight the benefits and shortcomings of this digital imaging application.

3:30 PANEL DISCUSSION

4:00 Session Break


REIMAGINING PATHOLOGY IMAGING

4:10 Chairperson’s Remarks

Bruce Levy, M.D., CPE, Associate Professor, Pathology, University of Illinois, Chicago; Associate Chief Health Information Officer, University of Illinois at Chicago Hospital and Health Sciences System

4:15 Utilizing High-Resolution Tiled Displays to Enhance Collaboration for Patient Care, Medical Research and Education

Bruce Levy, M.D., CPE, Associate Professor, Pathology, University of Illinois, Chicago; Associate Chief Health Information Officer, University of Illinois at Chicago Hospital and Health Sciences System

Whole-slide images (WSI) can produce disruptive change throughout medicine. We “re-imagined” the microscope in the era of cloud computing by combining WSI with the rich collaborative environment of the Scalable Adaptive Graphics Environment (SAGE). SAGE is well suited to display, manipulate and collaborate using WSI simultaneously with other images and data. We have successfully used SAGE for patient care, multidisciplinary conferences, medical research, and undergraduate and graduate level medical education.

4:45 Digital Imaging Tools for Hematopathology

Mohamed Salama, M.D., Professor, Pathology, University of Utah; Director, Hematopathology Fellowship Program; Director, Immunohistochemistry and Digital Imaging, ARUP Reference Lab

Hematologists and hematopathologists are increasingly using digital imaging tools for a wide spectrum of practice settings. However, digital imaging applications for effective learning and diagnosis rendering are not yet routinely incorporated in practice. We will share our experience in utilizing digital tools for hematopathology. We will demonstrate methods and applications for effectively using digital imaging tools. We will cover the essential elements as well as the pitfalls, advantages and challenges in utilization of digital tools in practice.

5:15 The Need for an Ontology Framework in Computational Histopathology

John E. Tomaszewski, M.D., MASCP, Professor and Chair, Pathology and Anatomical Sciences, School of Medicine and Biomedical Sciences, State University of New York, Buffalo

Quantitative HistoCAD data is of a size which is on par with other modes of big data. HistoCAD data will require highly structured representations in order to support the computational analysis of these data. A quantitative histological image ontology (QHIO) is needed to allow for the structured representation of HistoCAD data. Analogous to the great success of the Gene Ontology (GO), QHIO is anticipated to promote enhanced interoperability of HistoCAD data sets between and amongst investigators in human pathobiology.

5:45 Close of Conference Program


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