Development of a semi-automated method for tumor budding assessment in colorectal cancer and comparison with manual methods

Tumor budding is an established prognostic feature in multiple cancers but routine assessment has not yet been incorporated into clinical pathology practice. Recent efforts to standardize and automate assessment have shifted away from haematoxylin and eosin (H&E)-stained images towards cytokeratin (CK) immunohistochemistry. In this study, we compare established manual H&E and cytokeratin budding assessment methods with a new, semi-automated approach built within the QuPath open-source software. We applied our method to tissue cores from the advancing tumor edge in a cohort of stage II/III colon cancers (n=186). The total number of buds detected by each method, over the 186 TMA cores, were as follows; manual H&E (n=503), manual CK (n=2290) and semi-automated (n=5138). More than four times the number of buds were detected using CK compared to H&E. A total of 1734 individual buds were identified both using manual assessment and semi-automated detection on CK images, representing 75.7% of the total buds identified manually (n=2290) and 33.7% of the total buds detected using our proposed semi-automated method (n=5138). Higher bud scores by the semi-automated method were due to any discrete area of CK immunopositivity within an accepted area range being identified as a bud, regardless of shape or crispness of definition, and to inclusion of tumor cell clusters within glandular lumina ('luminal pseudobuds'). Although absolute numbers differed, semi-automated and manual bud counts were strongly correlated across cores (ρ=0.81, p<0.0001). Despite the random, rather than 'hotspot', nature of tumor core sampling, all methods of budding assessment demonstrated poorer survival associated with higher budding scores. In conclusion, we present a new QuPath-based approach to tumor budding assessment, which compares favorably to current established methods and offers a freely-available, rapid and transparent tool that is also applicable to whole slide images.

Vulnerability management using a formalized description

The article considers the main stages of vulnerability management and the problems arising in risk assessment and decision making during vulnerability management in the information and telecommunications system. It is assumed that modern techniques are not sufficient for effective vulnerability management. There is a need for creating a risk assessment system to improve decision-making procedures. The comparison of the formalized and informal description of the information and telecommunication system is described. The conclusion from the comparison results is that the formalized description has a number of advantages, so it is necessary that it should be built based on a formalized description of the information and telecommunication system. When adding qualitative vulnerability assessments (such as Common Vulnerability Scoring System vulnerabilities), this system will be unambiguous, clear, flexible, and easy to use. An additional advantage of such a system is the ability to automate assessment and decision-making processes, which will eliminate human influence and minimize the subjective factor in the management of vulnerabilities in the information and telecommunications system. Such a system will not exclude the influence of the security administrator, but will help him in decision-making, risk assessment, reduce the likelihood of errors, will help new staff in choosing decisions.