17.15 – 18.05 Manuel Salto Tellez - Digital Pathology & Artificial Intelligence, the Third Revolution in Pathology

Histopathology became an established, global and accepted clinical discipline in the first half of the 20th Century. Since then 3 main developments have reshaped the way we practice it. Immunohistochemistry (IHC) [1] provided important information in both diagnostic and discovery, helping the delivery of a more accurate and sophisticated taxonomy of diseases (diagnostic value), and also the performance of key tests with a genetic, prognostic and predictive value [2]. The second revolution (“the molecular diagnostic revolution”) was different and, in many occasions, this analysis has been performed outside the routine pathological strategies, making pathologists facilitators rather thean leaders in this field [3, 4].

In our opinion, Digital Pathology (DP) and Artificial Intelligence (AI) represents an incipient “third revolution” that is strongly knocking at the door of pathology. From a practical point of view, DP/AI have the potential to make the complex and fragmented pathway of routine pathological tissue interrogation a more seamless endeavour at, at least, 3 levels, namely a) the analysis of H&E for diagnostic purposes; b) the scoring of tissue hybridization-based biomarkers for therapeutic decision-making; and c) the annotation of H&E samples ahead of nucleic acid extraction.

This lecture will discuss in detail our contributions to the application of DP in this areas and, in particular a) the application of QuPath, an open source digital pathology system widely used globally, developed in our laboratory, to the analysis of known biomarkers [5]; b) the analysis of markers of adaptive immunity and cancer immunotherapy [6]; and c) the development and utilization of TissueMark®, a product developed to annotate and characterize the H&E of samples ahead of genomic testing [6].

1. Soilleux E and Gatter KC. The Antibody Revolution: How 'Immuno' Changed Pathology. Chapter 15 in Understanding Disease: A Centenary Celebration of the Pathological Society, 2006, Hall P and Wright NA editors, John Wiley & Sons, Incorporated, ISBN-10 0470032200 & ISBN-13 9780470032206
2. McCourt CM, Boyle D, James J, Salto-Tellez M. Immunohistochemistry in the era of personalised medicine. J Clin Pathol. 2013 Jan;66(1):58-61
3. Morphomolecular pathology: setting the framework for a new generation of pathologists. Jones JL, Oien KA, Lee JL, Salto-Tellez M. Br J Cancer. 2017 Nov 21;117(11):1581-1582. doi: 10.1038/bjc.2017.340.
4. Time for change: a new training programme for morpho-molecular pathologists? Moore DA, Young CA, Morris HT, Oien KA, Lee JL, Jones JL, Salto-Tellez M. J Clin Pathol. 2018 Apr;71(4):285-290.
5. Integrated tumor identification and automated scoring minimizes pathologist involvement and provides new insights to key biomarkers in breast cancer. Bankhead P, Fernández JA, McArt DG, Boyle DP, Li G, Loughrey MB, Irwin GW, Harkin DP, James JA, McQuaid S, Salto-Tellez M, Hamilton PW. Lab Invest. 2018 Jan;98(1):15-26.
6. QuPath: Open source software for digital pathology image analysis. Bankhead P, Loughrey MB, Fernández JA, Dombrowski Y, McArt DG, Dunne PD, McQuaid S, Gray RT, Murray LJ, Coleman HG, James JA, Salto-Tellez M, Hamilton PW. Sci Rep. 2017 Dec 4;7(1):16878.

CV Professor Manuel Salto-Tellez (MD-LMS, FRCPath, FRCPI) is the Chair of Molecular Pathology at Queen’s University Belfast, and the Lead of the Queen’s Precision medicine centre of Excellence.

By July 2018, Prof Salto-Tellez was author or co-author of more than 260 internationally peer-reviewed articles in translational science, molecular pathology and diagnostics. He has published a similar number of abstracts in international conferences, and is editor or contributor to some of the key textbooks of pathology and oncology. He studied Medicine in Spain (Oviedo), Germany (Aachen) and The Netherlands (Leiden). He specialized in Histopathology in the UK (Edinburgh and London) and in Molecular Pathology in USA (Philadelphia). For more than 10 years he worked at the National University of Singapore and its National University Hospital, where he was associate professor, senior consultant, director of the Diagnostic Molecular Oncology Centre, Vice-dean for Research and senior scientist at the Cancer Research Institute.

Prof Salto-Tellez serves in committees associated with CRUK, NICE and REF, among others. He holds more than £15M in competitive grant funding, including the new Precision Medicine Centre of Excellence, a visionary development aiming to redefine the process of biomarker development and test adoption in the UK and globally.