SILVER SPRING, Md. –
The Joint Pathology Center possesses the nation’s oldest pathology tissue repository and one of the largest in the world with over 55 million glass slides and 30 million tissue blocks. For more than a century, its specialists have collected diseased tissue samples, preserving them for medical researchers of the future.
That future has arrived, and the Defense Logistics Agency is helping JPC scientists embrace it.
Col. Joel T. Moncur, director of the JPC, said his command was mandated by Congress through the National Defense Authorization Act of 2008 to maintain and modernize the repository to support its mission of consultation, education, and research.
“We take that very seriously,” Moncur said. “In the age of artificial intelligence and machine learning algorithms, modernizing the repository means digitizing it.”
For digitization, Moncur’s team turned to Defense Logistics Agency Disposition Services-Document Services, a leading provider of federal document management solutions.
“Government partnerships between agencies offer the flexibility our customers need,” said Joe Fagan, a DLA customer audit and engagement specialist. “[Our agency] manages everything from project requirements analysis to formal solicitations and technical evaluations to contract implementation and funds management in an ‘as-a-service’ model.”
Fagan pointed to DOD Instruction 5330.03 that articulates DLA Document Services as the single manager to the Defense Department for printing, office print devices, and digital conversion projects.
“It’s our mission and the support we provide frees up our warfighter customers to focus on their critical missions,” Fagan said.
This particular mission he said, involves the digitization of 12 million glass slides to help unlock valuable insights that could pave the way for the development of new and enhanced therapies.
The physical slides are just like most people remember from high school biology class – just two glass plates with a thin tissue sample sandwiched between them. No matter how well maintained a slide repository is, slides still deteriorate over time.
Dr. Francisco Rentas directs JPC’s tissue repository and said the scanning of slides has been going on for a few years. Our current goal is to scan all cases from a number of years and create digitized disease-specific collections for use in education and research. Since we are a secondary pathology consultation entity, a large portion of our cases are difficult to diagnose and could be unique.
“So, when you get cases that you only see maybe once in your lifetime, you want to digitize those cases immediately,” Rentas said.
He said that the partnership between JPC, DLA and the contractor has resulted in more than two million slides scanned in the past two and a half years.
Rentas continued, they’ve requested additional scanners and personnel for the project to reach a target of more than 1.5 million slides scanned each year. Also, their primary goal of having all these slides scanned is to help train AI algorithms on how to look for and recognize diseased tissue.
“If you expose a computer to a thousand cases with the same diagnoses and you train the algorithm to learn ‘this is breast cancer, this is fat, this is not malignant tissue,’ at some point the computer is going to learn that,” Rentas said. “The more cases you can provide a computer with, the better the algorithm is going to get.”
He likened AI learning to a young child who is taught the difference between a dog and cat by their parents. It takes repetition, but eventually the child can tell the difference between dogs and cats even though there is a lot of variation between the breeds of each.
“So, if we are looking for a specific disease, let’s say prostate cancer,” Rentas stated, “right now, we have thousands of cases that we can use to train computers to diagnose prostate cancer.”
Rentas doubts computers will replace pathologists. He believes AI will be used to screen cases, freeing up the pathologist to concentrate on those that are flagged with abnormalities.
JPC has a research project currently underway with the National Cancer Institute, to which it has provided more than 20,000 whole slide images so far.
“They have been able to correlate some of the AI findings with clinical outcomes, which is exactly what you want,” Rentas said.
Because the JPC is part of the Defense Department, it must be careful when collaborating with other entities; and everything, they do must have a legal, regulatory, and ethical review, including robust safeguards on Personal Identifying Information. No protected health or identifying information is provided for any case. To further support these measures, the JPC has been working on the development of a data governance policy with the assistance from Defense Health Agency officials.
“Good and timely communication has been key in this project,” Rentas added.
Every couple of weeks, he meets face to face with representatives from DLA and the contracting team. They discuss the project, what has been achieved since their last meeting, and what they plan to achieve before they meet again.
“The JPC project is unique, but most of the jobs we are digitizing have a common theme of historical preservation on aging materials,” Fagan said. “Digitizing legacy information from paper and film and placing the content in a centralized repository offers our customers newfound real-time access and authorized information sharing.”
Fagan said that while some documents may be considered historical, they are often still relevant. For instance, the U.S. Army Corps of Engineers had DLA digitize historical information on dams, rivers, reservoirs, and facilities that manage waterways throughout the country. Now, the information is more easily accessed in times of natural disasters when quick response is crucial.
Through the partnership between DLA Document Services and JPC, the world is witnessing a convergence of technology, research, and medical expertise that is likely to transform the landscape of medical treatment. As researchers delve deeper into the digitized archives, the hope is that their discoveries will translate into tangible advancements, bringing new hope to countless individuals affected by cancer and other diseases.
“The team has built a very sophisticated pipeline to digitize slides, and already, those slides are being used to create capabilities we don’t have otherwise, like predicting prognoses for some of the most prevalent cancers in the military among active-duty service members,” Moncur said. “We have received support in many different ways for this project: technical support, logistics support, the expertise of our own staff. It takes all that, all together, to make a complex project like this move forward and we are really grateful to everybody who is involved. We wouldn’t have been able to do this project if it wasn’t for DLA’s support.”