Innovations: Brave new worlds.

Abstract

The field of cytopathology, from fine-needle aspiration to computer-assisted screening, has always attracted innovators and creative thinkers. Technology touches every aspect of our world and our cytopathology practice. Opportunities and challenges both are in abundant supply. In this new “Innovations” section, we will highlight the latest developments in technology, social media, and informatics to keep readers up to date. Social media has added new layers of interaction and networking capabilities to our field. The pathology and cytopathology communities have harnessed the power of these technologies to build stronger professional networks, share and discuss the latest research findings, and even conduct multi-institutional research studies. Social media platforms make the world smaller, enabling education and collaborations across continents. Journal clubs now can involve participants from across the country. Twitter chats regarding topics such as the Milan System, ancillary testing in cytology, and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) flatten hierarchies and allow unprecedented real-time access to experts in the field (Fig. 1). Our recent #CytoChat on the topic of NIFTP featured a real-time discussion of practice patterns, the sharing of useful articles, and expert input from Drs. Faquin and Rossi. This chat drew greater than 60 participants from around the world, garnering greater than 1 million potential impressions. Not sure how to get started with social media? A previously published article provides an overview of what social media can do for you, and how to get started.1 To make sure you do not miss out, follow Cancer Cytopathology on Facebook (https://www.facebook.com/CancerCytopath) and Twitter (https://twitter.com/CancerCytopath). The complexity of workflows and the need to meet quality assurance mandates have precipitated the computerization of the cytology laboratory to improve effectiveness and efficiency. As an early adopter of pathology informatics and its data management principle, the cytology laboratory has in some ways defined how data are collected, accessed, and analyzed. Another area of informatics to which cytology has made early contributions is digital pathology. Ironically, although one of the first successful implementations of digital pathology was the automation of the Papanicolaou test, progress in this realm of informatics has been delayed due to the unique challenges present in cytologic specimens and the use of whole-slide imaging (WSI). Nevertheless, computational progress and improved imaging technology have allowed pathology informatics to enter a period of rapid growth and innovation. Using improved WSI technology and z-stacking modalities to overcome the challenges of digitizing 3-dimensional cytologic material, leading investigators in the field of cytopathology have begun to exploit the advantages offered by digital pathology over traditional microscopy. To that end, this new and exciting section of Cancer Cytopathology will focus on highlighting innovative applications of pathology informatics in the cytology laboratory, including the use of traditional statistical tools and advanced deep-learning approaches for data mining and visualization. In an effort to increase visibility, we also will showcase how digital pathology continues to revolutionize the clinical practice of cytology through the application of WSI in telecytology for rapid on-site evaluation, remote consultation, and digital image analysis for diagnostic testing. To kick off this issue of Cancer Cytopathology, we would like to congratulate Dr. Louis J. Vaickus from Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, for winning this year's Young Investigator Challenge (Fig. 2). His work explored the development of a hybrid deep-learning and morphometric algorithm for the analysis of urine cytology specimens.2 This breakthrough article presents the framework for a system that can automate the Paris System for Urine Cytopathology reliably, with the potential to increase the efficiency of digital screening for urine WSI. Xiaoyin “Sara” Jiang, MD, is an associate professor of pathology at Duke University in Durham, North Carolina, and the associate director of the Duke BioRepository and Precision Pathology Center. Her areas of research and expertise are cytopathology and surgical pathology of the head and neck and endocrine systems, with particular interest in thyroid nodules, ultrasound-guided fine-needle aspiration, and novel applications of social media for medical professionals. Emilio Madrigal, DO, is a Cuban-born anatomic and clinical pathologist specializing in cytopathology and clinical informatics at the Massachusetts General Hospital in Boston, Massachusetts. He has special interests in salivary gland cytology and machine intelligence–powered digital image analysis. Dr. Madrigal received his Doctor of Osteopathic Medicine from Rowan University in Glassboro, New Jersey and has been certified by the American Board of Pathology in anatomic and clinical pathology and cytopathology.