University of Medicine and Dentistry of New Jersey (UMDNJ)
Piscataway, New Jersey
Lauri A. Goodell, Dorin Comaniciu, Peter Meer, David J. Foran

For additional information, see URL: http://pleiad.umdnj.edu/igds/

The subtle visible differences exhibited by some malignant lymphomas and chronic lymphocytic leukemia give rise to a significant number of false negatives during routine screening by medical technologists. Mantle cell lymphoma is a recently described entity which is often misdiagnosed as lymphocytic leukemia (CLL)/small lymphocytic lymphoma(SLL), or small cleaved cell lymphoma (SCCL). A prototypical image guided decision support (IGDS) system has been developed with the goal of aiding the medical technologist, pathology resident or pathologist in the detection and differentiation of abnormal lymphoid cell populations.

While traditional database systems utilize text-based information to search through databases, the image-guided decision support (IGDS) approach systematically searches through databases of consensus-graded medical cases based upon the visual content of constituent pathology image records. During preliminary, feasibility studies, the image-guided decision support prototype automatically delineated salient biological structures from digitized microscopic specimens and characterized the underlying pathology using a set of non-traditional spatial and spectral signatures. A weighted mixture of these measurements served as search criteria in a series of systematic queries which retrieved diagnoses, correlated clinical data, and image records of consensus-graded cases which exhibited spatial and spectral profiles which were consistent with those of the undiagnosed case. Utilizing a unique mulitmodal fusion agent, the system is voice activated and provides audio and graphical feedback. The prototype provided the correct classification, based on majority logic among retrieved cases, in approximately 86% of the trials. Studies comparing these classification rates with those of medical technologists and pathology residents are ongoing to determine the systems value as an educational tool.