Utility of Effusion Cytology and Image Analysis in the Diagnosis of Mesothelioma

描述(申请人提供)：间皮瘤是一种罕见但往往致命的疾病，通常与暴露在石棉中有关。恶性间皮瘤和良性间皮细胞增生的鉴别通常是通过活检标本的组织学检查来评估组织侵袭性。胸腔积液(肺和胸壁之间的液体)细胞学检查通常是一种侵入性较小的程序，可以在大多数医院获得。鉴于无法评估组织的侵袭性，从细胞学标本中诊断这种恶性肿瘤通常是不可能的。我们的提案详细说明了将与宾夕法尼亚州西部卫生系统病理和实验室医学系统主席(Jan F.Silverman，M.D.)以及克利夫兰诊所解剖病理医学主任(Tarik M.Elsheikh，M.D.)合作进行的一个试点项目。为了测试Rohde博士在卡内基梅隆大学(CMU)的实验室最近开发的一种图像分析方法，该方法可以直接从胸腔积液细胞学检测癌症。将Rohde博士的方法应用于Silverman博士提供的数据(在申请中详细说明)的初步结果表明，该方法可能对恶性间皮瘤的诊断有用。这项初步研究的目的将是测试Rohde博士的实验室开发的方法的准确性，该方法直接从渗出细胞学中区分恶性间皮瘤和良性间皮细胞增生，从两个更大的队列患者 机构(WPAHS和CC)。如果成功，该项目的完成可能会对降低总体成本和避免与侵入性手术相关的健康风险产生重大影响。该项目的成功完成还可能为在几个类似的细胞病理学、诊断和预后挑战中应用类似的技术铺平道路。

DESCRIPTION (provided by applicant): Mesothelioma is a rare though often fatal disease, often associated with exposure to asbestos. The differentiation of malignant mesothelioma from benign mesothelial proliferation is often achieved by assessing tissue invasiveness from histological examination of biopsy specimens. Pleural effusion (fluid between lung and the chest wall) cytology is often a less invasive procedure that can be made available in most hospitals. Diagnosis of this malignancy from cytology specimens is often not possible, given that tissue invasiveness cannot be assessed. Our proposal details a pilot project to be conducted in collaboration with the System Chair of Pathology and Laboratory Medicine of Western Pennsylvania Health System (Jan F. Silverman, M.D.), as well as the Anatomic Pathology Medical Director of the Cleveland Clinic (Tarik M. Elsheikh, M.D.) to test an image analysis approach most recently developed by Dr. Rohde's laboratory at Carnegie Mellon University (CMU) for cancer detection directly from pleural effusion cytology. Preliminary results resulting from the application of Dr. Rohde's methods to data provided by Dr. Silverman (detailed in the application) indicates the method can potentially be useful for diagnosis of malignant mesothelioma. The objective of the pilot study would be to test the accuracy of the method developed by Dr. Rohde's laboratory in differentiating malignant mesothelioma from benign mesothelial proliferation directly from effusion cytology with a larger cohort of patients from two institutions (WPAHS and CC). If successful, the completion of the project could have a significant impact in reducing overall costs and avoiding health risks associated with invasive procedures. The successful completion of this project could also pave the way for the application of similar techniques on several similar cytopathology diagnostic and prognostic challenges.