Patent Publication Number: US-2023137665-A1

Title: Pathology review station

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is being filed on Mar. 26, 2021, as a PCT International Patent Application and claims the benefit of U.S. Provisional Application No. 63/001,038, filed Mar. 27, 2020, the complete disclosure of which is hereby incorporated herein by reference in its entirety. 
    
    
     INTRODUCTION 
     Lumpectomy techniques are used for removing cancerous or other abnormal tissue from a breast. A lumpectomy is a breast-conserving surgery that only removes a portion of the breast. The excised tissue is sent to a pathologist to evaluate if the tissue is benign or malignant. The pathologist may also determine if there is an acceptable margin between any cancerous or abnormal tissue and the exterior surface of the excised tissue. 
     Procedures used during pathology to slice the excised tissue and/or take samples from the excised tissue are vitally important to determine if all cancerous or abnormal tissue has been removed from the breast. If any amount of cancerous or abnormal tissue remains in the breast, then those cells could grow and otherwise spread throughout the body. Thus, it is important for the pathologist to be accurate when sampling or analyzing the excised tissue. 
     Additionally, pathologists may need to remove a surgical marker from the excised tissue. Markers are often used during surgery to direct a surgeon to remove a specific portion of the tissue identified by a radiologist. After excising the tissue identified by the surgical marker, the surgical marker is encased inside the excised tissue. In some instances, the marker may need to be tracked and/or isolated (for example, if the marker emits radiation). Quick and accurate removal of the marker from the excised tissue by the pathologist may be required. 
     It is with respect to these and other general considerations that the aspects disclosed herein have been made. Also, although relatively specific problems may be discussed, it should be understood that the examples should not be limited to solving the specific problems identified in the background or elsewhere in this disclosure. 
     SUMMARY 
     Examples of the present disclosure describe systems and methods relating to a pathology review station. In an aspect, the technology relates to a method for projecting an image onto a specimen at the pathology review station. The method includes receiving an image from an imager of at least a portion of a specimen and receiving a tray and the specimen in a receiver. The method further includes projecting a projected image onto the specimen, wherein the projected image is based at least in part on the image. 
     In an example, the projected image comprises the image. In another example, the method further includes identifying the specimen in the receiver based on at least one of the following: a user input, a characteristic of the specimen, and a characteristic of the tray. In a further example, the characteristic of the specimen is at least one of: a contour of the specimen and a map of the specimen. In yet another example, the characteristic of the tray is at least one of: a grid on the tray and a marker on the tray. In still a further example, the method further includes aligning the projected image relative to the specimen based at least in part on the operation of identifying the specimen. In another example, the specimen is a plurality of specimen slices. In a further example, the projected image further comprises a recommended incision line. 
     In another aspect, the technology relates to a computer-implemented method of projecting an image onto a specimen. The method includes identifying a specimen received in a projection area and identifying an image associated with the specimen. The method further includes projecting a projected image onto the specimen in the projection area, wherein the projected image is based at least in part on the image. 
     In an example, the operation of identifying the specimen is based on at least one or more of the following: a user input, a characteristic of the specimen, and a characteristic of a tray. In another example, the method further includes aligning the projected image relative to the specimen based at least in part on the operation of identifying the specimen. In a further example, the method further includes determining that the specimen is within the projection area, and based on the determination that the specimen is within the projection area, automatically projecting the projected image onto the specimen. In yet another example, the projected image includes the image. In still a further example, the projected image includes a recommended incision line. In another example, the specimen is a plurality of specimen slices. 
     In another aspect, a pathology review station is disclosed. The pathology review station includes a specimen receiver configured to receive a specimen, a processor, and memory storing computer executable instructions that, when executed by the processor, cause the pathology review station to perform a set of operations. The set of operations includes receiving an x-ray image of a specimen from an x-ray imager, and generating a projected image based at least in part on the x-ray image. The pathology review station further includes a projector configured to project the projected image onto the specimen. 
     In an example, the specimen receiver is further configured to receive a tray supporting the specimen. In another example, the set of operations further includes identifying the specimen based on one or more of: a user input, a characteristic of the specimen, and a characteristic of the tray; and based on identifying the specimen, aligning the projected image with the specimen. In a further example, the pathology review station and the x-ray imager are housed in a single unit. In yet another example, the pathology review station further includes a support stand, the support stand configured to position the projector above the specimen receiver. 
     This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter. Additional aspects, features, and/or advantages of examples will be set forth in part in the description which follows and, in part, will be apparent from the description, or may be learned by practice of the disclosure. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying figures illustrate one or more aspects of the disclosed methods and systems for a pathology review station. In the appended figures, similar components and/or features may have the same reference label. Further, various components of the same type may be distinguished by following the reference label with a second label that distinguishes among the similar components. If only the first reference label is used in the specification, the description is applicable to any one of the similar components having the same first reference label irrespective of the second reference label. Non-limiting and non-exhaustive examples are described with reference to the following figures: 
         FIG.  1    depicts a pathology work area with a pathologist analyzing a specimen at a pathology review station. 
         FIG.  2    depicts a pathology review station of a pathology work area. 
         FIG.  3    depicts a specimen setup in a pathology work area. 
         FIG.  4    depicts a display of an image of specimen slices in a pathology work area. 
         FIG.  5    depicts a pathology review station of a pathology work area projecting a projected image onto the specimen. 
         FIG.  6    depicts specimen slices of a grossed specimen, setup in a pathology work area. 
         FIG.  7    depicts a display of an image of specimen slices in a pathology work area. 
         FIG.  8    depicts a pathology review station of a pathology work area projecting a projected image onto the specimen slices. 
         FIG.  9    illustrates a method for projecting an image onto a specimen. 
         FIG.  10    illustrates a method for identifying an image and projecting an image onto a specimen. 
         FIG.  11    illustrates an example suitable operating environment for a pathology review station. 
     
    
    
     While examples of the disclosure are amenable to various modifications and alternate forms, specific examples have been shown by way of example in the drawings and are described in detail below. The intention is not to limit the scope of the disclosure to the particular examples described. On the contrary, the disclosure is intended to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure and the appended claims. 
     DETAILED DESCRIPTION 
     Various aspects of the disclosure are described more fully below, with reference to the accompanying drawings, which show specific example aspects. However, different aspects of the disclosure may be implemented in many different forms and should not be construed as limited to the aspects described herein; rather, these aspects are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the aspects to those skilled in the art. Aspects may be practiced as methods, systems, or devices. The following detailed description is, therefore, not to be interpreted in a limiting sense. 
     One method of removing cancerous or abnormal cells is a breast-conserving procedure called a lumpectomy. After tissue is excised by a surgeon, the tissue specimen may be analyzed by a pathologist to determine if the tissue is cancerous and if there is a sufficient margin between cancerous or abnormal tissue and the exterior surface of the specimen. Sufficient margins may be dictated by best practices, hospital requirements, or other considerations. The process may then be repeated. 
     Once a specimen is received by pathology, an image is taken of the whole specimen, as received. In certain embodiments, the image may be an x-ray image. It is also contemplated that the image may be an optical image, CT image, contrast enhanced image and/or other images taken using known imaging modalities. After imaging the specimen, the image is viewed by a pathologist to determine where to slice the specimen to remove any embedded surgical markers. After removing surgical markers, the specimen is sliced (or “grossed”) into several pieces using a slicing instrument  130 , and imaged again. The x-ray image of the grossed specimen (or specimen slices) is viewed by the pathologist to determine where to take samples from the specimen for further analysis. 
     Accuracy and speed is desirable for this process. For example, if a pathologist does not accurately slice a specimen to remove a surgical marker, then the surgical marker may not be retrieved, or the specimen may be sliced in a way that interferes with later analysis. Moreover, if the pathologist does not accurately determine where to take samples from the specimen, then improper analysis may be performed, which could lead to misdiagnosis or inability to identify cancerous or abnormal tissue. Speed is also a desirable factor in the pathology process. For example, retrieval of surgical markers needs to be done quickly to ensure that a medical facility keeps track of any markers that emit radiation. Additionally, fast turnarounds of tissue analysis and lumpectomy results is preferable to determine if further surgery is required or desired, and provide a status update to the patient. If another example, the analysis could be performed during surgery. This “live” analysis could prevent rescheduling of additional surgeries by informing the surgeon that additional tissue should be taken before concluding surgery, and may also allow specimen orientation relative to the patient to be more easily maintained for additional excising. 
     The current pathology setup, however, does not promote accuracy or efficiency. Pathologists currently compare x-ray images side-by-side with the specimen being examined to determine where to slice and/or sample the specimen. This approximation procedure, performed simply by sight, is often not accurate to determine where to cut the specimen and sample from the specimen, as it is an approximation based on an image positioned away from the actual specimen. Additionally, the visual comparison between the image and the specimen to determine where to slice/sample the specimen is slow and inefficient. 
     Accordingly, the present disclosure provides systems and methods for a pathology review station that, in part, promotes accuracy and efficiency for pathology analysis of a specimen. In an example, the present disclosure provides methods and systems for projecting an image onto a specimen. As a further example, a projected image, which may be all or a portion of an image or based on an image or features of an image, may be projected onto a specimen obtained from a lumpectomy to assist a pathologist in slicing the specimen (e.g., to retrieve a marker used during surgery or gross a specimen into smaller specimen pieces) and/or sampling the specimen for further analysis. By projecting an image onto the specimen, a pathologist may more accurately and more quickly determine where to slice and/or sample the specimen. 
     Although aspects of the present disclosure are described with respect to pathology analysis of excised breast tissue, it should be appreciated that the present disclosure may also be useful in variety of other applications where an image is projected (e.g., x-ray image, camera image, infrared image, CT scan, MRI, ultrasound, PET, or any other imaging) onto a specimen, tissue, bone, living organism, body part, or any other object, living or dead. 
     As an example,  FIG.  1    depicts a pathology work area  100  with a pathologist  102  analyzing a tissue specimen  106  at a pathology review station  120 . As described herein, a pathologist  102  may receive a specimen  106  to be analyzed in the pathology work area  100 . In this example, for clarity, the specimen includes excised tissue that may be analyzed using an imager  110 . As an example,  FIG.  1    illustrates a work area  100  that may include a work table  104 , imager  110 , display  118 , and pathology review station  120 . The imager  110  may be any variety of imaging equipment, as described herein, such as an x-ray imager, camera, infrared imager, CT scanner, MRI, ultrasound, PET, or any other imager capable of imaging a specimen. The imager  110  may have an imager interface with controls to allow the pathologist  102  to select preferences associated with imaging by the imager  110 , and an imager door  114  that may allow the specimen  106  to be placed inside of the structure of the imager  110 . The imager  110  may also include a display  118  and/or a pathology review station  120 . The imager  110 , display  118 , and pathology review station  120  may, in any combination, be housed in a single unit. Alternatively, the imager  110 , display  118 , and pathology review station  120  may be separate units. 
     The display  118  may show all or part of an image obtained by the imager  110  upon imaging the specimen  106 . As required or desired, the image obtained by the imager  110  may be manipulated by a pathologist. For example, the pathologist may select the entire image or only a portion of the image sent to the display  118  and/or provided to the pathology review station  120 . As another example, the pathologist may zoom in or out of the image. Additionally or alternatively, the pathologist may manipulate other aspects of the image, or a part of the image. For example, the pathologist may add one or more features to the image that may be sent to the display  118  and/or the pathology review station  120 , such as text, shapes, pointers, etc. As another example, the pathologist may delete or erase one or more portions of the image, which may then be sent to the display  118  and/or pathology review station  120 . The image may be provided via any type of connection, such as a wired connection, a network, a wireless connection (e.g., Bluetooth), stored on a USB, or any other portable storage medium to communicate the image from the imager  110  to the display  118 . In addition, or as an alternative, to showing all or part of the image of the specimen  106  on the display  118 , all or part of the image of the specimen  106  may be sent to the pathology review station  120 . 
     The pathology review station  120  may be configured to project the image onto all or part of the specimen  106  using a projector  122 . The projector  122  may be a digital light processing (DLP) projector, a liquid crystal display (LCD) projector, cathode ray tube (CRT) projector, laser, augmented reality (AR) or virtual reality (VR) virtual overlay, etc., to overlay all or part of the image of the specimen  106  onto the specimen  106 . The projector  122  may be positioned in any orientation about the specimen  106 . For example, the projector  122  may be placed above, below, or at any angle in relation to the specimen  106  to project all or part of the image. The projector  122  may be secured into place by a structure or support (not shown), such as a hanger, suspension device, support legs, frame, etc., to stabilize the projector  122  or hold the projector  122  in place. Additionally or alternatively, the projector  122  may be movable and/or repositionable in relation to the specimen  106 , display  118 , and/or imager  110 . 
     The projector  122  may be configured to overlay a projected image  124  onto the specimen  106 . The projected image  124  may include the entire image obtained by the imager  110 , a portion of the image, a feature  126  of the image (e.g., a calcification, abnormal cells, a surgical marker, an interest area, a projected image marker  128 A) or any other feature identifiable in the image that may or may not be visible on the specimen  106 , a recommended incision line, a recommended sample area, a margin from the exterior, or any other feature that may be helpful to a pathologist. 
     Although aspects discussed herein describe one image being projected onto a specimen  106 , it should be appreciated that the projected image  124  may include multiple images, multiple portions of images, or multiple features of images, and in any combination obtained by one or more imagers  110  of one or more types, as described herein. 
     The pathology review station  120  may additionally identify or detect a location, position, or presence of a specimen  106 . Identification or detection of the specimen  106  may use a characteristic of the specimen  106 , a characteristic of the tray  134 , or any other characteristic identifiable on the specimen  106 , tray  134 , surrounding area, or projection area  108 . Characteristics of the specimen  106  may include a contour of the specimen  106 , a shape or size of the specimen  106 , a map of multiple calcifications existing on the specimen  106 , a map of multiple pieces of specimen  106 , or any other features identifiable on the specimen  106 , in any combination. Characteristics of the tray  134  may include a tray marker  128 B, a grid on the tray  134 , labels on the tray  134 , or any other characteristics identifiable on the tray  134 , in any combination. Additionally or alternatively, a pathologist  102  may identify or confirm identification of the specimen  106  manually. 
     Additionally, the pathology review station  120  may identify an image obtained by an imager  110  using a feature of the image. Features of the image may include imaged contours of the specimen  106 , imaged shape(s) or size(s) of the specimen  106 , an imaged map of multiple calcifications existing on the specimen  106 , an imaged map of multiple pieces of specimen  106 , an imaged tray marker of the tray  134 , an imaged grid on the tray  134 , imaged labels on the tray  134 , or any other features identifiable in the image obtained by the imager  110 , in any combination. 
     The identification or detection of the specimen  106  may be used to match an image with the identified specimen  106 , align an image with the identified specimen  106 , automatically project a matched image onto the identified specimen  106  when the specimen  106  is in a projection area  108  of the projector  122 , reorient an image relative to a re-positioned specimen  106 , identify specimen orientation relative to a patient from which the tissue was excised, or any other use of specimen identification by the pathology review station  120 , in any combination. The pathology review station  120  may match an image obtained by the imager  110  with the identified specimen  106  by comparing a characteristic of the specimen  106  or a characteristic of the tray  134  with a feature of the image. The matching may use one or more characteristics of each the specimen, tray, and/or image. Matching of an image with a specimen  106  may also be performed manually by the pathologist  102 . 
     The pathology review station  120  may also align a matched image with the identified specimen  106 . A projected image  124  may be projected onto the specimen  106 , based on the matched image. As described above, the projected image may be the entire matched image obtained by the imager  110 , one or more portions of the image, one or more features of the image that are a part of the image or are overlaid onto the image, or any other object associated with the image, in any combination. Alignment of the projected image  124  with the specimen  106  may be determined using a variety of methods, such as manual input by a pathologist  102  (e.g., zooming, reorienting, rotating, or other actions to change the projected image to align with the specimen  106 ), or automatic adjustment of the projected image  124  to align one or more features of the image with one or more characteristics of the specimen  106  and/or tray  134 . For example, a contour of the specimen  106  may be aligned with an imaged contour of the specimen  106  identified in the image obtained by the imager  110 . As another example, a tray marker  128 B of the tray  134  may be aligned with a projected image tray marker  128 B of the image obtained by the imager  110 . It should be appreciated that any other matching of characteristics or features, in any combination, may be used to align the projected image  124  with the specimen  106 . As a further example, the alignment may also include information associated with specimen orientation relative to a patient from which the tissue was excised, for ease of additional excising. The information associated with specimen orientation relative to a patient may be determined from any of the alignment methods discussed herein. Additionally, the pathology review station  120  may be capable of adapting the projected image  124  to conform to flat specimens and three dimensional specimens, or a combination of flat and three dimensional or warped surfaces. For example, a specimen  106  may be three dimensional while the tray  134  is flat and the projector may adapt portions of the projected image to conform to overlay with both the flat and three dimensional shapes. 
     Additionally or alternatively, the pathology review station  120  may automatically project an image onto the identified specimen  106  when the specimen  106  is in a projection area  108  of the projector  122  and automatically stop projection when the specimen  106  exits the projection area  108 . Automatic projection may occur before or after matching an image with the specimen  106  and/or aligning the image with the specimen  106 . In one example, a specimen may be identified as being in the projection area  108  by detecting that a characteristic of the specimen  106  and/or characteristic of the tray  134  are within the projection area  108 . In another example, a pathologist  102  may manually turn the projector  122  on or off. If a specimen is detected to be within the projection area  108 , the pathology review station  120  may automatically turn on and project a projected image  124  onto the specimen. If the pathology review station  120  has matched an image to the identified specimen  106 , then the projected image  124  may be based on the matched image. If there is no image matched in the methods described herein, then the pathology review station  120  may automatically select an image  124  based on other criteria, such as an order in which the images have been obtained by the imager  110 , a number of times a specimen  106  has been identified, a selection by the pathologist  102 , or any other association that may be made between an image obtained by the imager  110  and the identified specimen  106 . 
     If specimen  106  and the projector  122  move relative to each other, then identification, matching, aligning, and/or projection may need to be re-performed by the pathology review station  120 . For example, if the specimen  106  and projector  122  are moved relative to each other, the characteristics used to identify the specimen  106  may need to be adjusted to enable matching of the characteristics with image features, and/or the projection may need to be adjusted or reoriented to accurately overlay the projected image  124  onto the specimen  106 , after movement or reorientation. 
       FIG.  2    depicts an example of a pathology review station  120 . As described above with respect to  FIG.  1   , the projector  122  may be any type of projector with any form of support structure  132 . As an example,  FIG.  2    shows the projector  122  supported by a structure  132 . The structure  132  may include a base (or specimen receiver)  133 B to receive a specimen  106  and/or a tray  134  supporting the specimen  106 . The may be configured to hold, secure, move, or otherwise position a free-standing specimen  106  base  133 B and/or a tray  134 . One or more support arms  133 A may be used, and may extend from a base  133 B of the structure  132 , or from any other direction (e.g., a support arm  133 A may be positioned above or beside the projector  122  to suspend the projector  122 ). The support arms  133 A of the structure  132  may hold, secure, move, or otherwise position the projector  122  relative to a projection area  108  of the projected image  124 . For example, if the structure  132  includes both a base  133 B and support arms  133 A, then the projector may be positioned relative to the specimen  106  and/or tray  134  received at the base  133 B of the structure  132 . 
     As described above, the projected image  124 , projected onto the specimen  106  and/or tray  134 , may include a projected image marker  128 A aligned with a tray marker  128 B of the tray  134  and/or a feature  126  of the image aligned with the specimen  106  using a characteristic of the specimen  106  and/or tray  134  and a feature of the image. This alignment analysis may be performed in an operating environment of the pathology review station  120 . Additionally, the operating environment may be configured to receive an image of the specimen  106  obtained by the imager  110 . As an example, the pathology review station  120  may also have a specimen receiver of the structure  132  configured to receive the tray  134  and/or specimen  106 , and a projector  122  configured to project the projected image  124  onto the specimen  106 . 
       FIGS.  3 - 5    depict aspects of the pathology review station with a single, whole, intact specimen. The pathology review station  220  may be used with a whole, intact specimen  206  when a pathologist is locating and removing a surgical marker encased in the specimen  206 . Additionally, outside of pathology, a specimen  206  may be desired to be maintained as a whole, intact piece during analysis, such as in the case of a live specimen or live tissue. 
       FIG.  3    depicts a specimen  206  setup in a pathology work area  200 . As described herein, the specimen  206  may be free-standing in the pathology review station (e.g., pathology review station  220  shown in  FIG.  5   ), or supported by a tray  234 . The specimen  206  and the tray  134  may each include a variety of characteristics, as described herein. As an example,  FIG.  3    shows a single specimen  206  supported by a tray  234  with the tray including a tray marker  228 B. 
       FIG.  4    depicts a display  218  of an image  236  of a specimen  206 . As described herein, the specimen  206  (e.g., specimen  206  in  FIGS.  3  and  5   ) may be imaged by an imager (e.g., similar to imager  110  as described with respect to  FIG.  1   ). A display  218  may show an image  236  obtained by the imager. The display may show the entire image  236  obtained by the imager or portions or features of the image  236  to be projected. The image may have features  226 ,  228 A, as described herein. The image  236  may be the same or different from the projected image (e.g., an x-ray image obtained by the imager may be different than a projection corresponding with an interest area of the specimen). As an example,  FIG.  4    shows a display  218  with an x-ray image  236  of the specimen  206  displayed with the features  226 ,  228 A associated with the specimen  206  (e.g., an interest area  226 ) and the tray (e.g., an imaged tray marker  228 A). 
       FIG.  5    depicts a pathology review station  220  projecting a projected image  224  onto the specimen  206 . In an example, a projector  222  of the pathology review station  220  may project a projected image  224  onto a specimen  226 . The size, orientation, or other visual aspects of the projected image  224  may be adjusted depending on an orientation and location of the specimen  206 , which may depend on the orientation and location of the specimen  206  relative to the projector  222 . For example, for clarity, a representation of a cross section  238  of the projected image  224  is depicted away from the projection area  208 . It should be appreciated that the cross section  238  is to clarify components of the projected image  224  that may be projected onto the specimen  206 . In the example shown in  FIG.  5   , the projected image  224  may include all features  226 ,  228 A of the image obtained by the imager shown in  FIG.  4   . In this example, the projected image  224  includes features such as a contour  237  of the specimen  206 , an interest area  226  of the specimen, and a projected image marker  228 A. It should be appreciated, however, that any number or combination of features may be included in the projected image  224 . 
     The projected image  224  may be projected onto a projection area  208  that, in an example, may be the same size as a tray  234  that may support the specimen  206 . The tray  234  may be placed into a specimen receiver  235 , which may be sized to fit a particular tray  234  or sized to support a variety of tray sizes. Additionally, the specimen receiver  235  may be adjustable to accommodate for a variety of tray sizes. As an example, the specimen receiver  235  may be the same size as the tray  234  which may be the same size as the projected image  224  as a specified distance away from the projector. The projected image  224  may be matched with the specimen  206 , as described herein. As an example,  FIG.  5    shows a specimen  206  with an identified characteristic being a contour and/or calcification and a tray  234  having a characteristic of a tray marker  228 B. In this example, the projected image  224  is matched with, aligned with, and projected onto, the specimen  206  and the tray  234  such that the projected contour  237  of the specimen  206  aligns with a contour of the specimen  206 , the interest area  226  aligns with the interest area on the specimen  206 , the projected image marker  228 A aligns with the tray marker  228 B, and the projection area overlaps a surface of the tray  234 . Although  FIG.  5    shows specific features of the image being projected onto the specimen  206  via the projected image  224 , it should be appreciated that any combination of features of the image may be projected onto the specimen  206  via the projected image  224 . 
       FIGS.  6 - 8    depict aspects of the pathology review station  320  with a grossed specimen  306 . Aspects of  FIGS.  6 - 8    may be described in the context of  FIGS.  3 - 5    and may not necessarily be described further. The pathology review station  320  may be used with a grossed specimen  306  when a pathologist is sampling the specimen slices  306  for further analysis. 
       FIG.  6    depicts specimen slices  306  of a grossed specimen (e.g., specimen  106 ,  206 ). As described herein, the specimen slices  306  may be free-standing in the pathology review station (e.g., pathology review station  320  shown in  FIG.  8   ), or supported by a tray  334 . The specimen slices  306  and the tray(s)  234  may include a variety of characteristics, as described herein. Specimen slices  306  may include an additional characteristics over the characteristics that may be included for a single, whole, intact specimen (e.g., specimen  106 ,  206 ). One example of an additional characteristic may be mapping of each piece of the specimen slices  306  relative to each other. One or more trays  334  may be used to support the specimen slices  306 . As an example,  FIG.  3    shows nine specimen slices  306  supported by a single tray  334  with the tray including a tray marker  328 B. 
       FIG.  7    depicts a display  318  of an image  336  of specimen slices  306 . As described herein, the specimen slices  306  may be imaged by an imager (e.g., similar to imager  110  as described with respect to  FIG.  1   ). A display  318  may show an image  336 , as described herein at least in part with respect to  FIG.  4   . As an example,  FIG.  7    shows a display  318  with an x-ray image  336  displayed with a features  326 ,  328 A associated with the specimen slices  306  (e.g., an interest area  326 ) and the tray (e.g., an imaged tray marker  328 A). 
       FIG.  8    depicts a pathology review station  320  projecting a projected image  324  onto the specimen slices  306 , similar to the pathology review station of  FIG.  5   . In an example, a projector  322  of the pathology review station  320  may project a projected image  324  onto specimen slices  326 . The size, orientation, or other visual aspects of the projected image  324  may be adjusted depending on an orientation and location of the specimen slices  306 , which may depend on the orientation and location of the specimen slices  306  relative to the projector  322 . For example, for clarity, a representation of a cross section  338  of the projected image  324  is depicted away from the projection area  308 . It should be appreciated that the cross section  338  is to clarify components of the projected image  324  that may be projected onto the specimen  206 . In the example shown in  FIG.  8   , the projected image  324  may include all features  326 ,  328 A of the image obtained by the imager shown in  FIG.  7   . In this example, the projected image  324  includes features such as a map  337  of the specimen slices  306 , an interest area  326  of the specimen slices  306 , and a projected image marker  328 A. It should be appreciated, however, that any number or combination of features may be included in the projected image  324 . 
       FIGS.  9  and  10    illustrate methods that may be performed by the systems described herein. In  FIGS.  9  and  10   , operations encased in dotted lines may be optional.  FIG.  9    illustrates a method  900  for projecting an image onto a specimen (e.g., with the pathology review station systems described herein). Method  900  begins at operation  902  where the pathology review station receives an image obtained by an imager of at least a portion of a specimen, as described herein. The image may be received by an operating environment of the pathology review station. The specimen may be a single, whole, intact specimen, or a grossed specimen with a plurality of specimen slices. Method  900  then proceeds to operation  904  where the pathology review station receives a tray and the specimen in a receiver. The receiver may be a base of a structure or may represent a projection area of the pathology review station. The specimen may be supported by one or more tray(s) when placed into the specimen receiver, or alternatively, the specimen may be placed into the specimen receiver without a tray. 
     Upon receiving the specimen and the tray in the specimen receiver, the pathology review station may perform a number of optional actions, such as at operation  906  where the pathology review station identifies the specimen in the receiver. This may be performed by an operating environment of the pathology review station. As described herein, the specimen may be identified based on user input, a characteristic of the specimen, or a characteristic of the tray. As further described herein, the characteristic of the specimen may be a contour of the specimen, an interest area on the specimen, or a map of the specimen slices, and a characteristic of the tray may be a grid on the tray or a marker on the tray. Additionally or alternatively, at operation  908 , the pathology review station may match the image with the specimen. Matching of the image with the specimen may be performed automatically by the pathology review station, or manually, as described herein. Additionally or alternatively, at operation  910 , the pathology review station aligns the projected image relative to the specimen. The alignment may be based on the operation of identifying the specimen (operation  906 ). 
     Method  900  ends at operation  912  where the pathology review station projects a projected image onto the specimen, wherein the projected image is based at least in part on the image, as further described herein. The projected image may include the image, or one or more features associated with the image, as described herein. 
       FIG.  10    illustrates a method  1000  for identifying an image and projecting an image onto a specimen (e.g., with the systems described herein). Method  1000  begins at operation  1002  where the pathology review station identifies a specimen received in a projection area. There may be a single, whole, intact specimen, or a plurality of specimen slices. A specimen or specimen slices may be identified by the pathology review station based on user input, characteristics of the specimen, or characteristics of the tray supporting the specimen, as described herein. 
     After operation  1002 , method  1000  continues to operation  1004  where the pathology review station identifies an image associated with the specimen. The image may be identified manually, using features of the image compared against characteristics of the specimen and/or tray, or other types of automatic selection by the pathology review station, as described herein. This may be similar to matching operation  908  described in  FIG.  9   . The method  1000  may then perform operation  1006 , where the pathology review station aligns the projected image relative to the specimen. The alignment may be based on the operation of identifying the specimen (operation  1004 ). At operation  1008 , the pathology review station may determine that the specimen is within the projection area. This determination may be based on a detection of characteristics of the specimen and/or tray and/or identified features of the image. 
     Method  1000  ends at operation  1010  where the pathology review station projects a projected image onto the specimen in the projection area, wherein the projected image is based at least in part on the image. If the pathology review station performs operation  1008 , then the projection at operation  1010  may be automatic upon a determination that the specimen is within the projection area. The projected image may include the image or one or more features associated with the image, as described herein. 
       FIG.  11    illustrates an example suitable operating environment for a pathology review station described herein. In its most basic configuration, operating environment  1100  typically includes at least one processing unit (or processor)  1102  and memory  1104 . Depending on the exact configuration and type of computing device, memory  1104  (storing, instructions to perform projection of an image onto a specimen) may be volatile (such as RAM), non-volatile (such as RAM, flash memory, etc.), or some combination of the two. This most basic configuration is illustrated in  FIG.  11    by dashed line  1106 . Further, environment  1100  may also include storage devices (removable,  1108 , and/or non-removable,  1110 ) including, but not limited to, magnetic or optical disks or tape. Similarly, environment  1100  may also have input device(s)  1114  such as keyboard, mouse, pen, voice input, etc. and/or output device(s)  1116  such as a display, speakers, printer, etc. Also included in the environment may be one or more communication connections  1112 , such as LAN, WAN, point to point, etc. In embodiments, the connections may be operable to facility point-to-point communications, connection-oriented communications, connectionless communications, etc. 
     Operating environment  1100  typically includes at least some form of computer readable media. Computer readable media can be any available media that can be accessed by processing unit (or processor)  1102  or other devices comprising the operating environment. By way of example, and not limitation, computer readable media may comprise computer storage media and communication media. Computer storage media includes volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD) or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, or any other non-transitory medium which can be used to store the desired information. Computer storage media does not include communication media. 
     Communication media embodies computer readable instructions, data structures, program modules, or other data in a modulated data signal such as a carrier wave or other transport mechanism and includes any information delivery media. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared, microwave, and other wireless media. Combinations of the any of the above should also be included within the scope of computer readable media. 
     The operating environment  1100  may be a single computer operating in a networked environment using logical connections to one or more remote computers. The remote computer may be a personal computer, a server, a router, a network PC, a peer device or other common network node, and typically includes many or all of the elements described above as well as others not so mentioned. As an example, the operating environment  1100  may be shared between an imager, such as imager  110 , and a pathology review station, such as pathology review station  120 . As another example, the imager and the pathology review station may each have a unique operating environment  1100 . As a further example, the operating environment  1100  may be shared between multiple imagers and/or multiple pathology review stations. The logical connections may include any method supported by available communications media. Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets and the Internet. 
     As discussed above, augmented reality (AR) systems may be utilized to display the images discussed herein. AR systems may detect or identify a projection area of the pathology review station using methods and systems described herein, including aligning an outline of an x-ray image with a detected outline of a specimen, detecting a characteristic of a specimen and/or a tray, etc. The AR system may operate separately from other components of the pathology review station or may share one or more components, such as components described in the system  100  of  FIG.  1    or components described in the example operating environment of  FIG.  11   . Some specific examples of AR systems for the pathology review station are described below. Although specific examples of AR systems are provided, other AR systems may also be used. 
     In an example, an AR system may include a wearable device or a device otherwise mountable on the head or body (otherwise referred to as a wearable AR system) of a pathologist using the pathology review station. A wearable AR system may include glasses, goggles, headgear, shoulder-mountable face shields, etc. In an example, processing capabilities of the wearable AR system may be self-contained or otherwise integrated into the wearable AR system. Additionally, the wearable AR system may include one or more cameras coupled with, or integrated into, the wearable AR system. The cameras may capture images or video of a specimen and provide that data to a processor of the wearable AR system. The images or video provided by the camera to the processor may be used to detect or identify a specimen and/or a projection area in the pathology review station, as further described herein. In an instance where the wearable AR system includes lenses, the lenses may be transparent, semi-transparent lenses, or non-transparent. For transparent or semi-transparent lenses, the wearable AR system may virtually project, rather than physically project, a projected image on the lens to overlay the detected specimen and/or projection area that is viewable through transparent or partially transparent lens by the pathologist. Alternatively, for non-transparent lenses, the wearable AR system may display an image or video captured by the cameras to represent the real world and overlay the projected image onto the image or video such that the projected image appears on an image or video of the specimen. 
     In another example, an AR system may include a display. The AR display may be the same as the display  118  described in  FIG.  1   . Alternatively, the AR display may be independent from the display  118 . For example, an AR display may include a tablet, phone, or any other portable or non-portable display. Similar to the wearable AR system described above, the AR display may be controlled by one or more processors that may be integrated into the AR display or may be communicatively coupled to the AR display. The processing capabilities may be shared between the AR display and the display  118  or may be independent. In addition to the AR display, the AR system includes one or more cameras to capture images or video to send to the processor(s). The cameras may be integrated into the AR display or may be coupled to the AR display and/or the processor(s) via a wired or wireless connection. As further described herein, a specimen and/or a projection area in the pathology review station may be identified or detected, based on the images or video. In an instance where the cameras are not integrated into a portable AR display, the cameras may be positioned near or inside the pathology review station such as to include the specimen and/or projection area inside of a view of the cameras. The cameras may be fixed or movable in a position relative to components of the pathology review station. For example, the cameras may be positioned overhead to capture a top-down view of the pathology review station, mountable to a table, display, or imager, mountable to a pathologist, or otherwise positionable or mountable near the pathology review station. The AR system may display an image or video captured by the cameras on the AR display and overlay the projected image onto the image or video feed on the AR display such that the projected image appears on an image or video of the specimen. 
     As should be appreciated, while the above methods have been described in a particular order, no such order is inherently necessary for each operation identified in the methods. For instance, the operations identified in the methods may be performed concurrently with other operations or in different orders. In addition, the methods described above may be performed by the systems described herein. For example, a system may have at least one processor and memory storing instructions that, when executed by the at least one processor, cause the system to perform the methods described herein. 
     The embodiments described herein may be employed using software, hardware, or a combination of software and hardware to implement and perform the systems and methods disclosed herein. Although specific devices have been recited throughout the disclosure as performing specific functions, one of skill in the art will appreciate that these devices are provided for illustrative purposes, and other devices may be employed to perform the functionality disclosed herein without departing from the scope of the disclosure. 
     This disclosure describes some embodiments of the present technology with reference to the accompanying drawings, in which only some of the possible embodiments were shown. Other aspects may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments were provided so that this disclosure was thorough and complete and fully conveyed the scope of the possible embodiments to those skilled in the art. Further, as used herein and in the claims, the phrase “at least one of element A, element B, or element C” is intended to convey any of: element A, element B, element C, elements A and B, elements A and C, elements B and C, and elements A, B, and C. 
     Although specific embodiments are described herein, the scope of the technology is not limited to those specific embodiments. One skilled in the art will recognize other embodiments or improvements that are within the scope and spirit of the present technology. Therefore, the specific structure, acts, or media are disclosed only as illustrative embodiments. The scope of the technology is defined by the following claims and any equivalents therein.