For the first time ever, Rochester was the host city for the fall meeting of the Society for Pediatric Pathology (SPP), held at URMC Oct. 7-9. The event, co-sponsored by our department and the SPP, featured three days of academic presentations as well as extracurricular outings including a boat cruise on the Erie Canal and banquet at the historic George Eastman Museum.
URMC's Pedipath faculty Phil Katzman, M.D., and Leon Metlay, M.D., were co-chairs for the event, which they joked is sort of like hosting the Olympics without the corporate sponsorships. Each year the SPP holds two large meetings—one in the fall and another in the spring that coincides with USCAP. The fall meeting is traditionally hosted by a children’s hospital, and while Golisano Children’s Hospital is one of the largest in Upstate New York, it’s much smaller than most places who have hosted the SPP meeting in the past. For that reason, the event was an opportunity to showcase our city and institution and network with experts and trainees from across the country.
In total, 110 people attended the hybrid conference in person, with another 70 who joined virtually. Poster presentations were held in Flaum Atrium and platform sessions in the Class of ’62 Auditorium. The meeting also included talks by clinicians and investigators from URMC Pediatrics and Maternal-Fetal Medicine, who collaborated with pathology.
Being back in person meant a return to public speaking behind a podium, which pathologists rarely have the chance do in their daily work.
“I was uncharacteristically pushed in the forefront most of the meeting so I did a lot of the introductions which I’m not used to, but it was good,” said Katzman.
The sun shone brightly for the group outing on the Colonial Belle, giving guests time to chat and get fresh air before heading to dinner at the Eastman Museum. The museum, home of Kodak film pioneer George Eastman, appealed to guests. “Pathologists are visual people, so the Eastman House was a perfect fit,” Katzman said.
The meeting itself featured a variety of engaging presentations, made all the more appealing by the ability to have in-person discussion with other attendees.
“I had a blast and a half,” Metlay said. “After a few years without in-person meetings, to be able to stand and talk to somebody was just cool.”
Metlay even used the opportunity to bring a colleague to his office to look at slides from an interesting autopsy case. From a recruitment standpoint, our faculty also had the chance to promote the now-open pedipath fellowship—as did colleagues from other institutions with openings. “I spent a lot of time talking to residents and fellows; whether that bears fruit we’ll see,” Metlay said.
Pictured above: From left, Michael Arnold, M.D., Ph.D., far left, of Colorado Children’s Hospital, Cristina Pacheco, MD, of University of Washington, Jonathan Hecht of Beth Israel Deaconess, Lisa Teot of Boston Children’s, and URMC’s event co-chair Philip Katzman, M.D., at poster presentations on day 1.
Top photo: Richard Miller, Ph.D., of OBGYN, Pathology, Pediatrics and Environmental Medicine, presenting at the day 3 symposium on birth defects due to teratogenic vs. genetic effects in perinatal pathology.
Read about our pediatric pathology team in the latest issue of Golisano Children's Hospital publication Strong Kids: "Meet the Detectives Behind the Diagnosis"
Siba El Hussein, M.D. has been named to the American Society for Clinical Pathology’s 40 Under Forty List for 2022, which recognizes future leaders in the field.
El Hussein joined URMC in July 2021 and is board-certified in hemepath, cytopathology, anatomic and clinical pathology. In her first year, she received the department’s Excellence in Teaching Award, as voted for by residents in Pathology & Laboratory Medicine.
She is interested in integrating artificial intelligence into the pathology workflow that has inspired several AI-based models to aid in diagnosing challenging lymphomas.
“Pathology is witnessing a true renaissance thanks to the rapid rate of technologic development affecting every single aspect of this specialty," she said. "Embracing this change and capitalizing on it will help us unlock many biologic questions and bridge cutting edge knowledge to the bedside.”
She joins other winners from URMC including Jennifer Findeis-Hosey, M.D. who was honored in 2016. This year’s recipients also include Bonnie Choy, M.D., who graduated from the Rochester School of Medicine & Dentistry.
Follow Dr. El Hussein on Twitter: @SibaElHussein.
Faculty and trainees from Pathology & Laboratory Medicine at URMC celebrated the end of the academic year with research and teaching awards. View a photo gallery from the event.
Eric A. Schenk Award for Excellence in Teaching
Siba El Hussein, M.D.
Janet Sparks Teaching Award
Kate Ackerman, M.D., MBA
Chair’s Recognition Award
Dwight J. Hardy, Ph.D.
Graduate Program Awards
Outstanding Scientific Contribution
Jiatong Liu, MS
Robert Mooney Award for Outstanding Doctoral Dissertation
Olivia Marola, Ph.D.
Congratulations, Graduating Residents and Fellows! Where They're Headed:
- Tatsiana Pukhalskaya, M.D. – Dermatopathology Fellowship, University of California San Francisco
- Anthony Cardillo, M.D.—Clinical Informatics Fellowship/Assistant Professor, New York University
- Caroline Miller, M.D.—Blood Bank/Transfusion Medicine Fellowship, URMC
- Chauncey Syposs, D.O.—Hematopathology Fellowship, URMC
- Numbereye Numbere, M.B.B.S.—Faculty, Gastrointestinal Pathology, URMC
- Michael Greas, M.D.—Dermatopathologist, Loma Linda University (California)
- Ilyas Yambayev, M.D.—Faculty, Boston Medical Center
This year, three of our full-time faculty were promoted to associate professor, which is the first big step in their advancement in the world of academia. It’s a milestone marking their early accomplishments, signaling that they have found their academic groove.
As many know, finding your stride can take years of trial and error. In pathology especially, it’s a demanding balancing act for faculty who wear clinical and academic hats, no matter their level of seniority.
What do they all have in common? Curiosity and an appetite for new discovery. Answering the big questions by going back to basics through research that makes way for better patient care. It’s a high calling, but just how do you find time to make new discoveries when there are only 24 hours in a day? Here, they share what makes them tick, in their own words.
Helene McMurray, Ph.D.
Background: She is a UR School of Medicine & Dentistry alumna, earning her Ph.D. in microbiology and immunology and completing a postdoctoral fellowship in biomedical genetics there. She joined the Pathology faculty in 2017 and recently completed national and state board certification to serve as assistant director of the Tissue Typing/Histocompatibility Lab at Strong Memorial. She is also director of the pathology graduate program. Read her CV.
Current research: Active research collaborations with colleagues at Wilmot Cancer Institute and the departments of Biomedical Genetics, and Biostatistics and Computational Biology, applying approaches in genomics, bioinformatics, biostatistics, and cell and molecular biology.
How would you describe the process of climbing the academic ladder?
It’s like gardening. You start off with a couple of pea plants and, if you’re lucky, by the end of your career you’ll end up with a whole garden—a body of work that’s your area of expertise.
You have a background in different specialties. What do you like about this department, specifically?
I really appreciate the opportunities that I have found in pathology. It is a different world from the basic science departments I’ve been in. The demands on your time and brain are constantly shifting but I’ve found it really engaging to go back and forth between different ways of thinking—sometimes with very urgent problems for our patients and sometimes abstract concepts related to gene regulation or cancer biology. It’s been really enjoyable and I’m proud that I’ve been able to be successful in all those places.
What is challenging about balancing your research and clinical work?
We have a treasure trove of clinical samples in my lab but using them for research is separate from our main clinical workflows. As scientists, we all have a lot of ideas that could be impactful but, at the end of the day, our patients need their testing done. I think simply finding time to work on all the interesting questions you identify is a challenge for people trying to work both clinically and scientifically.
What inspires you to press on?
If you like scientific exploration and discovery, there’s nothing else that’s really like that in the world. It’s a little bit like the people who quit their jobs and travel the world instead. I’m not a world traveler at heart but I like digging into the minutia of biology and trying to understand things that nobody has understood before. The "Star Trek" mentality of “boldly going where no one has gone before” is the mindset I have existed in since I was 16 years old and started working in my first scientific lab.
One way or another, I will always want to ask questions about things no one understands and then try to figure out the answers. That leads to a lot of frustration some of the time, but if you’ve gone this far, you figure out how to overcome that and keep going.
Zhenqiang Yao, B.Med., Ph.D.
Background: He was a postdoctoral researcher recruited to the department by Dr. Brendan Boyce in 2003. Yao has established and grown his own research program at URMC since 2015 when he got his first R01 research project from the NIH, with a second R01 to be announced soon. Yao has also received research funding from the Department of Defense and New York State Department of Health. Read his CV.
Current research: Yao’s lab investigates projects related to musculoskeletal disease (osteoporosis) and breast cancer. Yao’s team is investigating how immune cells, particularly T lymphocytes, interact with bone cells to cause bone loss with aging. They are also developing a new agent to treat osteoporosis, and recently developed a novel macrophage-based targeted therapy to prevent and eliminate breast cancer metastases, in hopes that it can be expanded to treat other cancers including lung, pancreatic and prostate.
Why did you choose to step away from practicing medicine?
Research is what pushes the boundaries of clinical practice. As a doctor you see many patients affected by osteoporosis and cancer. I realized that you could work your whole life and see the same problems without finding ways to make patient care better. I want to do work that will benefit patients, today and into the future.
Was there a moment that you are proud of, or made you sure that you were in the right profession?
Yes, there have been a few. When I was working in Dr. Boyce’s lab, I discovered a new osteoclast forming pathway limited by non-canonical NF-kB signaling. These findings helped earn my first NIH R01 in 2015. More recently, I proposed a new NIH project to investigate age-related osteoporosis and to test our newly patented agent to treat osteoporosis, which was top-ranked during the review process.
Getting funding for cancer research is extremely competitive. I’m proud that my method to treat breast cancer was recently awarded by the Department of Defense, which funded just six percent of 500 applications.
What keeps you going?
Research can be difficult. You spend a lot of time writing grant applications in a way that should be easily understood by your peers. You also spend more time working to get funding and get published than you do at the bench. I have been doing research, not only as a scientist but also a clinical practitioner, to explain diseases using data I gather every day.
I hope that my discoveries can be translated to the bedside to improve patient care, and that’s what keeps me going.
Bin Zhang, Ph.D.
Background: Zhang came to URMC in 2015 after finishing his Ph.D. in molecular genetics and genomics, a genomics fellowship at Cold Spring Harbor Laboratory, and a clinical cytogenetics fellowship at Washington University in St. Louis. He became Director of the Cytogenetics Laboratory in 2017, marking the beginning of a new chapter in his career. Up until then, Zhang had focused more on translational research. Read his CV.
Current research: Zhang splits his time between his research lab at Strong Memorial and overseeing the Cytogenetics Lab at Bailey Road. His research primarily focuses on the formation, plasticity, and epigenetic inheritance of centromere. He will also be collaborating with Archibald Perkins, M.D., Ph.D., on a new grant from the Department of Defense to study evolution of Monosomy 7 Myelodysplastic Syndrome.
How has your clinical work changed the way you approach research?
Now, as a cytogeneticist, I frequently solve clinical cases by integrating both medical evidence and biological mechanisms together. As a scientist with a clinical position, I am consistently exposed to the imminent challenges of the field as I investigate various unique cases. Compared to before I became a clinical cytogeneticist, this increased exposure definitely helps me form more basic research questions/hypotheses oriented towards potential medical applications.
Research also keeps the clinical work more dynamic, as a solid understanding of underlying mechanisms helps interpret clinical data in a systematic way and classify related clinical phenomena. For me, clinical work and basic science research are mutually beneficial. I often enjoy coming in on weekends to take care of bench work.
It’s been six years since you took over a clinical lab. Was there ever an “aha” moment for you?
I probably spent my first three years here searching for a relevant and interesting research topic. I had many discussions on ideas with colleagues and pursued some pilot experiments. Three years ago, I finally found a project/scientific question I realized I wanted to pursue for the rest of my research career. I had never had that feeling before and it was a great moment for me and my research aspirations, even though it was just the beginning.
Tell us more about your research area.
The subject is centromere biology and its potential medical applications. I’m a cytogeneticist and we read chromosomes every day. The centromere is an important machinery for chromosome segregation, so it’s very relevant to our daily clinical work as well as human diseases like cancer and certain constitutional disorders. My background matches this field well. I have the skills to ask questions and I am very fortunate to have support from the department.
What keeps you going?
It’s not easy having a clinical responsibility while pursuing basic science research. However, I keep going because it is immensely fulfilling when I can solve genetic puzzles, link them to important biological questions or hypotheses, and even test them. I have passion for science because we can exercise what we know to make new discoveries. And eventually, these new discoveries will come back to help patient management. This, I consider very rewarding.
This story was published in the Spring 2022 Issue of the Pathways to Excellence Newsletter. Read the full issue here.
In an increasingly digital world, will glass slides and microscopes grow obsolete? The short answer is probably—but we’re not there yet. With the emergence of digital pathology, whole slide imaging (WSI) and assistive technologies that help pathologists work more efficiently, we are inching closer to going fully digital in everyday practice. Vektra Casler, M.D., director of our new Informatics division, is leading the effort to gradually incorporate WSI into certain subspecialties at URMC.
Whole slide imaging is a method in which glass slides are placed under a camera microscope that captures images that can then be viewed on a computer screen. From there, the images can be easily saved and shared virtually for diagnosis, and virtual consultation, as well as teaching purposes. This not only alleviates the burden of transporting slides back and forth between institutions (or even across the hall) but has potential to change how pathologists do their jobs. The end goal of becoming all-digital is still years away, she explains.
“The goal of diagnostic medicine overall is to have all the puzzle pieces at your fingertips so you can render a diagnosis quickly and as best and efficiently as you can,” said Casler. “We want to digitize as many aspects as possible so the pathologist and the slides don’t have to be in the same room.”
The benefits of WSI are two-fold. In addition to providing greater portability, going digital allows the user to apply artificial intelligence (AI) to the scanned image. While computers aren’t going to make them obsolete, this kind of AI can help set the stage for the pathologist to make a final diagnosis.
“AI is never going to be completely in the driver seat,” said Casler, who compares the pathologist to a pilot flying a plane with help from a GPS and radar. “You have a very real responsibility and if you misdiagnose a case, somebody could die or have their life change forever.”
Because a computer is very fast at doing mundane things, AI can identify visual hotspots and immediately pinpoint potential areas of concern on the scanned image so the pathologist can zero in on those areas. The result is a nice pairing of detection software, which is highly sensitive, with an expert pathologist, who is highly specific. Both can help the latter work more efficiently by saving time and tedium that comes with traditional microscope-based practice.
We as an institution are just getting into the game when it comes to WSI, and becoming fully digital will take time. One challenge is available equipment. URMC currently has some microscope scanners that can scan a few dozen slides at a time. The next step will be purchasing a scanner that can scan 10 times the number of slides.
Perhaps the greatest challenge, however, is the sheer size of the data. For example, one scanned slide is 1.5 gigabytes – which is as large as a full movie, Casler explained. Like other outside institutions that have hundreds of terabytes of storage, we hope to follow suit by getting a central server to host the files so they are not only easily accessible from anywhere but stored securely for years to come. Digital pathology will not only strengthen and streamline patient care, but teaching opportunities as well.
“This foray into WSI and getting our feet wet into digitizing is going to open a door to teaching sets and research so we can do our job better in the future,” said Casler.
John Plavnicky, chief supervisor of Cytology, recently gave a quick tutorial on a new digital scanning instrument called the Hologic Genius. The instrument performs whole slide imaging on gynecologic specimens, and though it’s currently being used in Europe, it’s still awaiting FDA approval in the U.S. Plavnicky’s team is working in conjunction with the vendor to use it for research in the meantime, making URMC one of the first institutions in the country to experiment with the Genius.
To start, they are running about 500 previously-tested samples on the Genius and re-screening slides to compare results to microscope-based diagnoses – very much like a “double blind” study. In future studies, they will likely simplify the process and compare the instrument’s findings to the known diagnoses.
The Genius works after samples are loaded into the machine, which then captures a scanned image of each slide and saves it to a server. The image is then viewable on a separate computer monitor from virtually anywhere. The software program then applies rapid detection to certain fields of view on the image, highlighting areas that could contain cells of interest.
“If it works, it’ll increase the flexibility in when and where screening is done,” said Plavnicky. Right now, the process of slide examination is laborious. Each slide has to be physically moved from a prep area to a cytotech, then to a pathologist and finally placed in a storage area. Going digital removes some of these (literal) moving parts.
“Now we’re limited to where we can sign these out because the scope has to be connected to the imager,” he said. “That would go away with this system because it’s linked to a server accessible anywhere.”
As a longtime cytotech who spends many hours at the scope, he said the prospect of going digital is a big shift. But it’s not as big of a leap as you’d think.
“It feels strange in field that revolves around microscopy. Not that it’s going away,” he said, pointing directly at the microscope within the machine itself. “The technology is not necessarily removing it. It’s removing the way it’s utilized.”