Molecular digital pathology: progress and potential of exchanging molecular data

ABSTRACT Many of the demands to perform next generation sequencing (NGS) in the clinical laboratory can be resolved using the principles of telepathology. Molecular telepathology can allow facilities to outsource all or a portion of their NGS operation such as cloud computing, bioinformatics pipelines, variant data management, and knowledge curation. Clinical pathology laboratories can electronically share diverse types of molecular data with reference laboratories, technology service providers, and/or regulatory agencies. Exchange of electronic molecular data allows laboratories to perform validation of rare diseases using foreign data, check the accuracy of their test results against benchmarks, and leverage in silico proficiency testing. This review covers the emerging subject of molecular telepathology, describes clinical use cases for the appropriate exchange of molecular data, and highlights key issues such as data integrity, interoperable formats for massive genomic datasets, security, malpractice and emerging regulations involved with this novel practice.

[1]  Alexis B. Carter,et al.  Next-Generation Sequencing Informatics: Challenges and Strategies for Implementation in a Clinical Environment. , 2016, Archives of pathology & laboratory medicine.

[2]  Medicare, Medicaid, and CLIA programs; laboratory requirements relating to quality systems and certain personnel qualifications. Final rule. , 2003, Federal register.

[3]  P. Lin Criminal judgments to medical malpractice in Taiwan. , 2009, Legal medicine.

[4]  H. Alper,et al.  Using the Cre/lox system for targeted integration into the human genome: loxFAS-loxP pairing and delayed introduction of Cre DNA improve gene swapping efficiency. , 2012, Biotechnology journal.

[5]  John D Pfeifer,et al.  Detection of FLT3 internal tandem duplication in targeted, short-read-length, next-generation sequencing data. , 2013, The Journal of molecular diagnostics : JMD.

[6]  Eric D Green,et al.  The Complexities of Genomic Identifiability , 2013, Science.

[7]  E. Rebar,et al.  Genome editing with engineered zinc finger nucleases , 2010, Nature Reviews Genetics.

[8]  Marc Salit,et al.  Synthetic Spike-in Standards Improve Run-Specific Systematic Error Analysis for DNA and RNA Sequencing , 2012, PloS one.

[9]  P. A. Futreal,et al.  Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. , 2012, The New England journal of medicine.

[10]  Navid Farahani,et al.  Overview of Telepathology. , 2016, Clinics in laboratory medicine.

[11]  Somak Roy Molecular Pathology Informatics. , 2015, Surgical pathology clinics.

[12]  Somak Roy,et al.  SeqReporter: automating next-generation sequencing result interpretation and reporting workflow in a clinical laboratory. , 2014, The Journal of molecular diagnostics : JMD.

[13]  Shashikant Kulkarni,et al.  Assuring the quality of next-generation sequencing in clinical laboratory practice , 2012, Nature Biotechnology.

[14]  Michael J Ackerman,et al.  Association of Arrhythmia-Related Genetic Variants With Phenotypes Documented in Electronic Medical Records. , 2016, JAMA.

[15]  Paolo Rocco,et al.  Good laboratory practice for clinical next-generation sequencing informatics pipelines , 2015 .

[16]  Rakesh Nagarajan,et al.  Clinical genomicist workstation. , 2013, AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science.

[17]  Barbara Zehnbauer,et al.  Current landscape and new paradigms of proficiency testing and external quality assessment for molecular genetics. , 2013, Archives of pathology & laboratory medicine.

[18]  Savita Shrivastava,et al.  Validation of a next-generation sequencing assay for clinical molecular oncology. , 2014, The Journal of molecular diagnostics : JMD.

[19]  R. Houlston,et al.  Generation of Artificial FASTQ Files to Evaluate the Performance of Next-Generation Sequencing Pipelines , 2012, PloS one.

[20]  Birgit Funke,et al.  College of American Pathologists' laboratory standards for next-generation sequencing clinical tests. , 2015, Archives of pathology & laboratory medicine.

[21]  M. DePristo,et al.  A framework for variation discovery and genotyping using next-generation DNA sequencing data , 2011, Nature Genetics.

[22]  Ella L. Kim,et al.  Intratumoral Heterogeneity, Its Contribution to Therapy Resistance and Methodological Caveats to Assessment , 2014, Front. Oncol..

[23]  Yuya Kobayashi,et al.  A Systematic Comparison of Traditional and Multigene Panel Testing for Hereditary Breast and 77 78 79 80 81 82 Ovarian Cancer Genes in More Than 1000 Patients , 2015 .

[24]  Renato Martins,et al.  Validation and implementation of targeted capture and sequencing for the detection of actionable mutation, copy number variation, and gene rearrangement in clinical cancer specimens. , 2014, The Journal of molecular diagnostics : JMD.

[25]  Francesco Vallania,et al.  Performance of common analysis methods for detecting low-frequency single nucleotide variants in targeted next-generation sequence data. , 2014, The Journal of molecular diagnostics : JMD.

[26]  John D Pfeifer,et al.  Comparison of clinical targeted next-generation sequence data from formalin-fixed and fresh-frozen tissue specimens. , 2013, The Journal of molecular diagnostics : JMD.

[27]  K. El Emam,et al.  Methods for the de-identification of electronic health records for genomic research , 2011, Genome Medicine.

[28]  Carolyn Sue Richards,et al.  Methods-based proficiency testing in molecular genetic pathology. , 2014, The Journal of molecular diagnostics : JMD.

[29]  Joshua L. Deignan,et al.  ACMG clinical laboratory standards for next-generation sequencing , 2013, Genetics in Medicine.

[30]  Elizabeth A. Krupinski,et al.  2014 American Telemedicine Association clinical guidelines for telepathology: Another important step in support of increased adoption of telepathology for patient care , 2015, Journal of pathology informatics.

[31]  Ulrich Broeckel,et al.  Characterization of 137 Genomic DNA Reference Materials for 28 Pharmacogenetic Genes: A GeT-RM Collaborative Project. , 2016, The Journal of molecular diagnostics : JMD.

[32]  J. Doudna,et al.  The new frontier of genome engineering with CRISPR-Cas9 , 2014, Science.