Project Abstract: The LTR has implemented electronic pathology (e-path) reporting at all pathology laboratories (except those with small cancer cases), covering over 95% of microscopically confirmed Louisiana cancer cases. We have also promulgated the legislative rules authorizing LTR to obtain tumor tissues for biospecimen research. Through the NCI-funded SEER-Linked Virtual Tissue Repository (VTR) study and supporting other biospecimen research, we have enhanced our infrastructures and exercised the ability to serve as an honest broker for biospecimen research, such as obtaining the necessary regulatory approval, retrieving required tumor tissues, and annotating them with cancer data. We are eager to take on this new opportunity to improve and expand further our capacity to support the development of automated digital image analysis algorithms to aid histomorphologic assessment by pathologists and examine associations between extracted microscopic features and disease outcome and response to treatments.