Lymph Node Evaluation

I had a melanoma removed. Now I am going back for surgery. What is going to happen?

Regular Process

The surgical excision of a malignant melanoma is the first line of treatment. However, doctors also need to determine whether the cancer has spread to the lymph nodes (these drain fluid from around the site of the cancer and cancer cells often remain trapped in them as they start to spread throughout the body). These are therefore also removed. These are sliced manually and multiple levels of each slice are then examined by a histopathologist under the microscope to rule out the presence of cancer within each slice. Immunohistochemistry, which highlights the presence of cancer cells, is also performed to aid the histopathologist in his/her visual assessment. A simple case with several lymph nodes therefore rapidly becomes a repetitive, labor-intensive and time-consuming exercise with significant associated immunohistochemistry costs. 

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    Slice tissue into multiple levels
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    Analyze each level manually
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    Further immunohistochemistry tests
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    Write the report manually

4D Path Process

4D Path’s solution can greatly expedite this process and significantly reduce cost: no immunohistochemistry is needed, and the algorithm will automatically screen all slides and highlight any areas where cancer is present for confirmation by the histopathologist who can then amend (if needed) and authorize an automatically generated report. 

Automated
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    Slice tissue into multiple levels
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    Automated scan of each level
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    Automated report
Histopathological staging of a range of malignancies relies on lymph node assessment for cancer metastasis. In some cases, lymph node evaluation can be particularly time-consuming, such as in sentinel lymph node assessment in the so-called ‘EORTC protocol’ for malignant melanoma. In this case, individual lymph nodes are sliced and multiple levels of each slice are then examined to rule out the presence of metastatic deposits. This is performed in conjunction with immunohistochemistry to aid histopathologists in their visual assessment of the presence of cancer. A simple case with several lymph nodes therefore rapidly becomes a repetitive, labor-intensive and time consuming exercise with significant associated immunohistochemistry costs. 4D Path is developing a method to greatly expedite this process and significantly reduce cost by automating nodal assessment in the absence of immunohistochemistry. Our algorithm will automatically screen all slides and highlight metastatic foci for confirmation by the histopathologist who can then amend (if needed) and authorize an automatically generated report. The same strategy can be applied to metastatic deposits for other malignancies.