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Image analysis: A primer for pathologists
BOOK REVIEWS
BOOK REVIEWS Image Analysis: A Primer for Pathologists. Alberto M. Marchevshy and Peter H. Bartels (10 Contributors). New York, Raven Press, 1994, $98.00.
Tietz Textbook of Clinical Chemistry, ed. 2. C. A. Burtis and E. R. Ashwood. Philadelphia, Saunders, 1994, 2,368 pages, $125.00.
This collected work by pathologists and computer scientists aims to use accessible language requiring minimal computer experience. The editors introduce pathologists to the basics of image analysis and its applications to histopathology and cytopathology. Their stated goal is to stimulate others to apply these methods to the study of problems in pathology. Despite an initial warning that some chapters may include mathematical detail that is too complex, this reviewer found few such episodes. Their brevity and content, as well as the associated text, rendered their impact on the book's message harmless. The book is organized logically in four sections. Chapters one through three discuss the history of quantitation in pathology. Chapters four through six are devoted to surveys of the main quantitative methods; these include stereology, morphometry, and microphotometry. Data analysis is considered in chapter seven. Sections devoted to quantitative immunocytochemistry, ploidy analysis, and automated cervical cytology comprise the last three chapters. A helpful glossary of terms used in image analysis precedes a very complete index. The editors have given the contributors a free hand, noting that in this new field, the individual writings are based on the author's experience. The reader will find some duplication of issues considered in certain chapters. This reviewer found this to be an asset, in that complex subjects are considered from two points of view. Chapter one provides a good introduction and history, and concludes by discussing unresolved problems including standards in preparation and staining, instrumentation, and data storage. Chapter two is devoted to the video photometer that is responsible for our ability to move from the slide to the computer. Individual parts of the discussion focus on the microscope, relay optics, the video camera, and the digitized image. Issues in microscope components and adjustments are highlighted. Overall, I would expect this chapter to provide conceptual underpinning for those trying to understand manufacturers' instrument settings and recommendations. Chapter three discusses algorithms for scene segmentation. This section is very useful, because it is at this point that most pathologist-operators initially apply their diagnostic skills to define, control, and limit what is actually analyzed by the instrument. Chapter eight discusses quantitative immunocytochemistry, and considers techniques and controls useful in evaluating cell proliferation, h o r m o n e receptors, and tumor markers. Technical considerations and the clinical use of image-based ploidy analysis are discussed in chapter nine. Most pathologists seeking to use image analysis wish to provide ploidy analysis, or quantitative immunocytochemistry; most use commercially available instruments and widely accepted preparatory methods. This book is not a "how to" manual, but it will be valuable to those seeking a greater understanding of these methods. To quote Dr. Barrels and coworkers (chapter 7): "there is something basically unsatisfactory about scientific results obtained by means of a black box." The authors and editors of this book succeed in illuminating some of the box's interior for those who would put specimens in the top and take reports out the bottom of the box.--MJCHAEL STANLEY,MD, Department of Pathology, Univer-
Advances and discoveries in medical science and the increasing regulatory and economic pressures constantly alter the practice of clinical laboratory medicine. The second edition of this comprehensive textbook was designed to meet the ever-changing environment of present day clinical laboratories. Although this massive book has been updated to reflect recent advances in modern diagnostic medicine, numerous chapters are present that remain unchanged from the first edition. The book has been reorganized into six major sections entitled Laboratory Principles, Analytical Techniques and Instrumentation, Chemometrics, Laboratory Management, Analytes, and Pathophysiology. Each section is further divided into several chapters, with a total of 41 chapters contributed by 61 authors. Navigation through chapters is now easier with the addition of larger subheadings and a slightly larger font size. These modifications, along with the high quality of the tables and illustrations make this an easy to read book. Two new chapters have been added that make this edition of the book more complete. Chapter 18, entitled "Nucleic Acid Biochemistry and Diagnostic Applications," provides an excellent review of nucleic acid biochemistry for the novice in molecular biology. This is followed by a description of molecular diagnostic techniques and their applications in diagnosing infectious agents, malignancies, and genetic diseases. The chapter on tumor markers (chapter 21) is wellorganized and describes the biochemistry, physiological properties, methods of measurement, and clinical applications of many of the more common tumor markers currently available. These new chapters are a welcome addition to the book, and like the other chapters, are of high quality. Approximately half of the book has been revised to reflect modern advances in clinical chemistry. Reference lists have been greatly expanded, and major revisions have occurred in descriptions of state-of-the-art technology such as fiber optics, lasers, flow cytometry and capillary electrophoresis, and the application of these techniques to diagnostic medicine. The chapter on automation has been updated to include new immunoassay configurations, instrumentation, and biosensors. The impact of new federal regulations on laboratory safety has prompted the addition of chemical hygiene and exposure control plans, as well as revisions in standards for accreditation (cholesterol standardization). The chapter entitled "Quality Management" now stresses the importance of improved performance with diminished costs and includes a discussion of analytical quality control as well as total quality management. Other chapters have been greatly expanded such as the chapter on endocrinology which is subdivided into seven parts and the chapter on mineral and bone metabolism. In summary, the second edition of Tietz is one of the most comprehensive textbooks for clinical chemistry. Although the book has not been completely revised, the modifications that were made greatly improve its quality. Although the overall dimensions of the book have not changed, the text has been expanded to more than 2,300 pages that are noticeably thinner. The book is still a bargain at $125.00. As the field of clinical chemistry continually expands to incorporate recent advances in laboratory testing, one cannot help but wonder just how enormous this textbook will become? One suggestion
sity of Arkansas for Medical Sciences, Little Rock, AR.
1391
BOOK REVIEWS Image Analysis: A Primer for Pathologists. Alberto M. Marchevshy and Peter H. Bartels (10 Contributors). New York, Raven Press, 1994, $98.00.
Tietz Textbook of Clinical Chemistry, ed. 2. C. A. Burtis and E. R. Ashwood. Philadelphia, Saunders, 1994, 2,368 pages, $125.00.
This collected work by pathologists and computer scientists aims to use accessible language requiring minimal computer experience. The editors introduce pathologists to the basics of image analysis and its applications to histopathology and cytopathology. Their stated goal is to stimulate others to apply these methods to the study of problems in pathology. Despite an initial warning that some chapters may include mathematical detail that is too complex, this reviewer found few such episodes. Their brevity and content, as well as the associated text, rendered their impact on the book's message harmless. The book is organized logically in four sections. Chapters one through three discuss the history of quantitation in pathology. Chapters four through six are devoted to surveys of the main quantitative methods; these include stereology, morphometry, and microphotometry. Data analysis is considered in chapter seven. Sections devoted to quantitative immunocytochemistry, ploidy analysis, and automated cervical cytology comprise the last three chapters. A helpful glossary of terms used in image analysis precedes a very complete index. The editors have given the contributors a free hand, noting that in this new field, the individual writings are based on the author's experience. The reader will find some duplication of issues considered in certain chapters. This reviewer found this to be an asset, in that complex subjects are considered from two points of view. Chapter one provides a good introduction and history, and concludes by discussing unresolved problems including standards in preparation and staining, instrumentation, and data storage. Chapter two is devoted to the video photometer that is responsible for our ability to move from the slide to the computer. Individual parts of the discussion focus on the microscope, relay optics, the video camera, and the digitized image. Issues in microscope components and adjustments are highlighted. Overall, I would expect this chapter to provide conceptual underpinning for those trying to understand manufacturers' instrument settings and recommendations. Chapter three discusses algorithms for scene segmentation. This section is very useful, because it is at this point that most pathologist-operators initially apply their diagnostic skills to define, control, and limit what is actually analyzed by the instrument. Chapter eight discusses quantitative immunocytochemistry, and considers techniques and controls useful in evaluating cell proliferation, h o r m o n e receptors, and tumor markers. Technical considerations and the clinical use of image-based ploidy analysis are discussed in chapter nine. Most pathologists seeking to use image analysis wish to provide ploidy analysis, or quantitative immunocytochemistry; most use commercially available instruments and widely accepted preparatory methods. This book is not a "how to" manual, but it will be valuable to those seeking a greater understanding of these methods. To quote Dr. Barrels and coworkers (chapter 7): "there is something basically unsatisfactory about scientific results obtained by means of a black box." The authors and editors of this book succeed in illuminating some of the box's interior for those who would put specimens in the top and take reports out the bottom of the box.--MJCHAEL STANLEY,MD, Department of Pathology, Univer-
Advances and discoveries in medical science and the increasing regulatory and economic pressures constantly alter the practice of clinical laboratory medicine. The second edition of this comprehensive textbook was designed to meet the ever-changing environment of present day clinical laboratories. Although this massive book has been updated to reflect recent advances in modern diagnostic medicine, numerous chapters are present that remain unchanged from the first edition. The book has been reorganized into six major sections entitled Laboratory Principles, Analytical Techniques and Instrumentation, Chemometrics, Laboratory Management, Analytes, and Pathophysiology. Each section is further divided into several chapters, with a total of 41 chapters contributed by 61 authors. Navigation through chapters is now easier with the addition of larger subheadings and a slightly larger font size. These modifications, along with the high quality of the tables and illustrations make this an easy to read book. Two new chapters have been added that make this edition of the book more complete. Chapter 18, entitled "Nucleic Acid Biochemistry and Diagnostic Applications," provides an excellent review of nucleic acid biochemistry for the novice in molecular biology. This is followed by a description of molecular diagnostic techniques and their applications in diagnosing infectious agents, malignancies, and genetic diseases. The chapter on tumor markers (chapter 21) is wellorganized and describes the biochemistry, physiological properties, methods of measurement, and clinical applications of many of the more common tumor markers currently available. These new chapters are a welcome addition to the book, and like the other chapters, are of high quality. Approximately half of the book has been revised to reflect modern advances in clinical chemistry. Reference lists have been greatly expanded, and major revisions have occurred in descriptions of state-of-the-art technology such as fiber optics, lasers, flow cytometry and capillary electrophoresis, and the application of these techniques to diagnostic medicine. The chapter on automation has been updated to include new immunoassay configurations, instrumentation, and biosensors. The impact of new federal regulations on laboratory safety has prompted the addition of chemical hygiene and exposure control plans, as well as revisions in standards for accreditation (cholesterol standardization). The chapter entitled "Quality Management" now stresses the importance of improved performance with diminished costs and includes a discussion of analytical quality control as well as total quality management. Other chapters have been greatly expanded such as the chapter on endocrinology which is subdivided into seven parts and the chapter on mineral and bone metabolism. In summary, the second edition of Tietz is one of the most comprehensive textbooks for clinical chemistry. Although the book has not been completely revised, the modifications that were made greatly improve its quality. Although the overall dimensions of the book have not changed, the text has been expanded to more than 2,300 pages that are noticeably thinner. The book is still a bargain at $125.00. As the field of clinical chemistry continually expands to incorporate recent advances in laboratory testing, one cannot help but wonder just how enormous this textbook will become? One suggestion
sity of Arkansas for Medical Sciences, Little Rock, AR.
1391