1. www.cost.esf.org European Cooperation in the field of Scientific and Technical Research COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract EURO-TELEPATH. Telepathology Network in Europe COST Action IC0604 Start date: 05/11/2007 End date: 05/11/2011 Year: 2 Marcial García Rojo, MD, PhD Chair Hospital General de Ciudad Real / Spain

2. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 2 Action Parties Grant Holder: Foundation for Health Research in Castilla-La Mancha, FISCAM. GH Representative: Marcial García Rojo Spain

3. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 3 Action participants (including WG experts)

4. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 4 Use of COST instruments YR 1YR 2YR 3YR 4 No. of MC / WG meetings 53(+3 next) No. of STSMs13(+3) No. of workshops / conferences 32(+2) No. of joint publications 510 No. of training schools 01 GASG (activities) Posters, website

5. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 5 Scientific context and objectives (1/2) Background / Problem statement: Adequate technological framework for the management of multimedia electronic healthcare records –Informatics applied to Anatomic Pathology –Research on standards to represent, interpret, browse, retrieve digital medical images –World wide search engine –Collaborate with Standardisation bodies with previous research conclusions. Main challenges are educational, technological, and complexity of health information systems. Brief reminder of MoU objectives: Evaluate and validate the common technological framework and communication standards required to access, transmit and manage digital medical records by pathologists and other medical specialties in a networked environment.

6. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 6 Scientific context and objectives (2/2) Research directions: 1.Automation procedures in Pathology. Best technology available and under research. 2.Scanning solutions for Pathology microscopic slides. 3.Technological solutions for compression and storage problems with large image files. 4.Virtual slide standard viewer specifications which allow efficient reviewing of pathology images. 5.International standards (DICOM, HL7, SNOMED, CEN) and IHE initiative. 6.Model for pathology and other hospital information systems 7.An European-scope telepathology network 8.Collection of interesting and typical samples, and clinico- pathological sessions

7. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 7 Working groups 4 Working Groups Coordinators WG1. Pathology Business Modelling e.g. Consensus study of existing workflows in pathology departments Thomas Schrader (Germany) and Luis Gonçalves (Portugal) WG2 – Informatics Standards in Pathology e.g. Participation in covered standards bodies and initiatives. Christel Le Bozec (France) and Bernd Blobel (Germany) WG3 – Images: Analysis, Processing, Retrieval and Management e.g. study on the image analysis models (methods, systems, tools, fields of pathology). Janina Slodkowska (Poland) and EPFL (Switzerland) WG4 – Technology and Automation in Pathology e.g. analysis of microscope brands. Marcial García Rojo (Spain) and Bernd Blobel (Germany)

8. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 8 2008: IHE workflow proposals can help increasing productivity and automation procedures Analysis of Scanning solutions has become essential Pathology DICOM object model has been published JPEG is aware of compression and storage in Pathology 2009: Process modelling and hospital information systems White paper on Anatomic Pathology Reporting to Public Health Repositories Image analysis of immunohistochemical quantification has been evaluated Nanotechnology and multispectral imaging can play a role Results vs. Objectives

9. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 9 Significant highlights (1/2) 9 th European Congress on Telepathology and 3 rd International Congress on Virtual Microscopy 200 experts (35 countries) and all microscope brands 5 COST related joint research papers were presented. A total of 16 keynote lectures, 76 papers, 15 posters, 2 satellite symposia, and 2 short training courses (IHE and virtual slides) Proceedings published in BioMed Central (PubMed) A STSM was arranged during this congress EURO-TELEPATH is already know by international standardization bodies (DICOM, IHE pathology groups). A joint meeting DICOM-IHE- EURO-TELEPATH has been arranged.

10. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 10 Significant highlights (2/2) Workshop on “Quantitative immunohistochemistry in digital pathology” I.T. engineers, bioinformaticians, biologists, oncologists, pathologists Consensus as obtained on standardization of immuno- histochemistry to improve quality and the current status of quantitative image analysis in immunohistochemistry. The collaborative study on breast carcinoma HER2/neu and hormonal receptors is a main output of this meeting. The draft of an EC RTD Framework project proposal was presented

11. COST is supported by the EU RTD Framework Programme ESF provides the COST Office through an EC contract 11 Most STSM planned during first year could not be performed since research groups found other alternatives (company funding) or a candidate could not be selected. As an alternative, to foster young scientists participation, a training school was arranged on image analysis using open source software. Next critical phases should include: –Complete business modeling of pathology processes using most suitable notation –Terminology: SNOMED CT for Anatomic Pathology –Interfacing whole slide imaging platforms and image automatic analysis –Postprocessing integration of radiology technical framework (DICOM) Challenges