FIGURE 3.

Pixel pathways for diagnostic whole slide imaging (WSI) and multiplex immunofluorescence (mIF) systems. In the current FDA WSI system paradigm (top row), image pixels are traced sequentially through a three-component system that includes brightfield scanner, viewing software, and computer monitor to be interpreted by the Pathologist. In a proposed cell-phenotype centric mIF system (bottom row), the pixel pathway originates with scanning of mIF and then H&E stains on the same slide, a capability of Ultivue’s ISP technology. In model A (top), mIF and H&E images are separately analyzed using the indicated tools, and then images are merged after analysis. In model B (bottom), merged mIF and H&E images are subject to a novel data pipeline such as cell-based annotation of H&E sections for analysis by deep learning, allowing earlier definition of each cell’s phenotype in the system’s pixel pathway. Both models converge so the Pathologist can visualize the merged image with analyses, followed by judgment of the diagnostic (Dx), prognostic (Px), and predictive (Rx) explanations and interpretations when issuing the patient’s diagnostic report.