Digital Pathology Blog

The ICC Profile: What Is It and Why Is It Important When Considering Digital Pathology Technologies?

Consistency and reliability of image quality is more important than ever as the adoption of digital pathology increases across clinical, education and research workflows.

The International Color Consortium (ICC) has developed a set of standards to be applied in the management of color for digital images. In color management, the ICC profile is a set of data that characterizes a color input or output device or a color space according to standards promulgated by the Consortium.

The public health events of the past few years changed our society as most of us knew it. Downtown commercial office space in our cities remains widely available. Even the sprawling suburban campuses around those large cities designed to entice workers to work closer to home for work-life balance are now being sold at a fraction of what those properties were valued at just several years ago. As a railfan, I know that ridership on commuter trains remains significantly below pre-March 2020 levels.

From baby boomers to millennials, folks are working remotely. This is not entirely new to some verticals, but for many industries and markets, it is. A 4-day office work week with a remote Friday or Monday was well-established in the past. After 9/11, many large companies with operations in large urban areas established virtual private networks should the need for them arise in our future. Insurance, retail, sales and marketing, financial houses, consultants and the like had many of the necessary components in place in March 2020 for this transition.

This line, of course, was made popular in a scene from The Phantom Menace: Episode 1. A deadly fish is chasing Qui-Gon and others underwater, and that fish gets taken down by a bigger fish. As fishermen, we often use this line after catching a good sized fish, but not a huge fish. You get your bait, jig, crankbait or other contraption you have come up with back in the water to catch a bigger fish.

Over the past three decades, this has been a constant theme in healthcare and laboratory medicine. Mergers and acquisitions are commonplace, and while the big fish have swallowed up the little fish decades ago, there is always a bigger fish.

Anatomic Pathology has been experiencing a major paradigm shift over the past several years as digital technology provides new ways of performing the daily work. Changes in workflow are affecting all aspects of pathology, whether clinical, research or education.

The early years of whole-slide-scanning offered academic institutions a way to provide teaching sets, resident collections and publication images without requiring technical staff to perform additional recuts, staining procedures and handling of blocks and slides. While there was indeed clinical utilization of telepathology techniques as far back as 1968¹, widespread use was limited. Over time, however, the use of telepathology became a way to perform intra-operative consultations, share cases, collaborate and seek clinical opinions from colleagues and outside experts.

As a first-year pathology resident, one of both the most daunting and exhilarating experiences of your training was presenting at tumor boards. The preparation to do so as a junior resident, meticulously reviewing every slide and picking the best ones to show the pertinent findings, was in and of itself a laborious task. Reviewing them again with your attending to confirm the slide(s) you chose showed the pertinent features also took time. Thinking about what to read in the report during the course of the tumor board was another task, planning for when the moderator says, “Can we review the pathology?” and what your spiel was going to be.

My maternal grandfather was a glazier. He was orphaned at a young age and raised in an orphanage on the West side of Chicago with 2 brothers. One of those brothers died during adolescence. My grandfather and his oldest brother fought in World War II and became part of America’s Greatest Generation. He and his brother started Chicago Glass which became the largest glazier company in the city. For over 30 years, my grandfather hung glass on some of the tallest buildings in the world at the time. Sears Tower, John Hancock, Lake Point Tower, Standard Oil, you name it, he worked on it. Buildings downtown had to be “glassed in” by November 15 if the electricians, plumbers, elevator, drywall and carpet guys were to have a chance to work through the winter for spring occupancy on a residential or commercial high rise. In the winters, my grandfather drove a cab between “indoor” jobs such as hanging mirrors, repairing windows or building storm windows. He would drive me around in his large Checker cab and point out what buildings he worked on and what he did, what worked and what didn’t, if he got injured, or one of his men did, and when they “glassed” it in.

We were privileged to present at the Digital Pathology and AI forum hosted by The Pathologist. In our portion of the forum, Dr. Wilbur focused on how the use cases and workflow solutions of digital pathology compare to those in the clinical environment. Dr. Wilbur focuses on how the use cases and workflow solutions of digital pathology compare to those in the clinical environment. While both of these are well established in the clinical setting, image management systems need some additional features to satisfy the requirements for research. Use cases and workflows are similar in how the user interacts with the digital environment but can be quite different in how they relate to the ultimate task and output.

A radiologist, an internist, a surgeon and a pathologist go duck hunting. The radiologist is up first and a flock of ducks fly overhead. He raises his shotgun but does not shoot. The surgeon asked him why he didn’t shoot to which the radiologist replied, “They had the outline of ducks, their contrast looked like ducks, but I wasn’t sure they were ducks.” The internist is up next. When the next flock flies overhead, he raises his shotgun in the air but does not shoot. The surgeon, getting irate at what is happening, asked the internist why he did not shoot to which the internist replied, “They looked like ducks and quacked like ducks, but I wasn’t sure they were ducks.”

The strains of the last two plus years have forced us to make many changes to our daily routines, both on a personal and a professional level. Remote interactions have become the norm, with families “zooming” for the holidays and family events, elbow bumps instead of hand-shakes, and remote work conferences and meetings in all walks of life. We are all looking forward to the return to many of our previous lifestyles, but the old adage remains true, out of adversity comes opportunity.

There is a joke among surgeons and oncologists -- the pathologist at a tumor board is like the guy whose funeral that you are attending; you can't do it without him, but you don't want him saying too much. 

Nearly 2 years ago, our tumor boards went "virtual". Like billions around the world, we scrambled to get Zoom, GoToMeeting, WebEx and other applications up and running to hear each other’s voices and share screens to show radiology and pathology images. We anticipated that by the Summer or Fall we would be back to "normal".