2025-06-09 - Anatomic Pathology sCRG Meeting

1

Updates

@Scott Campbell 

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Immunohistochemistry for digital path - RECAP

@Scott Campbell 

Scope work and work plan

• Use p16 as a starting point.

• What is the overarching use case:

• Clinical documentation?

• Digital path to build clinical documentation?

• Research?

• Example paper for background:

https://www.bgcs.org.uk/wp-content/uploads/2019/05/BAGP-UKNEQAS-cIQC-project-p16-interpretation-guide-2018.pdf

Sample answer set for digital path use case:

Answer set: positive, negative, null (absent), wild type, equivocal with modifiers of: nuclear, cytoplasmic, membranous, diffuse, patchy, focal, strong, weak, moderate

Use cases:

1. DIgital path workflows require SCT concepts to identify what stains are being viewed at any given time.  High volume IHC stains do not have SCT concepts....
   
   A slide being scanned would communicate to the scanner/LIS/Digpath software what is being viewed by the pathologist.  (Is this DICOM use?)
   
   
   

2. DICOM (slide label/metadata) → WSI annotation:  Substance → observable
   
   
   

3. Antigen vs antibody?  Antigen targeting the antibody (detection methods/system not modeled here)...so, create antibody substances.
   
   
   

4. Consolidate list of antibody candidates from Leica, Duke, Nictiz for next meeting.  Ultimately, antigens WILL need to be authored, as well. This will be important in disorder content/modeling

Lists of candidate concepts

@Scott Campbell 

1. Duke - Immunostain volumes.xlsx
   
   
   
   

2. Palga - 20250327 Proteinen in PPM voor SCT Int all_rubrics.xlsx
   
   Immunopanel PMC.xlsx
   
   
   Property - Presence 
   Presence of what? - p16 antibody
   
   Workflow: 

   1. Antibody applied to tissue

   2. Antibody binds to antigen (protein) on structure of interest

   3. Antibodys have "subtypes"/monoclonal antibodies that a specific to sections of the protein (target)

   4. So, the antigen is the target.  The clone(s) is important in specificity/sensitivity (interpretation precision (@Scott Campbell words))

   5. Chromagen indicates the color of the antibody/antigen reaction.

OK.  Goal...model the antibodies and relevant closes.  The observable entity is the observation of the epitope of interest.  Information model carries the details of the clones.