Vol. 25 • Issue 1 • Page 31
Pathology
What do Star Wars: The Force Awakens and Digital Pathology have in common? The answer is very close to director J.J. Abrams’ synopsis: “Each tells a story that has its own self-contained beginning, middle and end but at the same time, implies a history that preceded it and also hints at a future to follow.”
Digital pathology has actually been around for several decades. It essentially started as photo microscopy the first time pathologists attached cameras to their microscopes and took static pictures that could be used for publications or to produce Kodachrome slides used for educational purposes.1 With the ability to utilize monitors and telecommunication services, telepathology was introduced in 1986, which then opened the door to practice pathology over long distances using digital images.2
There has been a reawakening and the battle is just beginning. Today, the global digital pathology market is expected to be driven by the growing prevalence of various types of cancer around the world. The application of digital pathology in cancer research provides a major opportunity as the growing amount of research performed on cancer treatment will be helped massively by the convenience and efficiencies offered by digital pathology.3
Fighting cancer, the “dark side,” is a complex matter. Pathologist shortages, smaller biopsies and major declines in reimbursement are forcing laboratories to look for new solutions without compromising patient care. Fortunately, with the emergence of digital pathology, anatomic pathology labs can overcome these challenges-meeting demands for quick analysis, increased precision, providing immediate access to pathology expertise and expanded services.
The Force
Digital pathology is the practice of converting microscopic glass slides into digital slides that can be viewed, managed and analyzed on a screen anywhere in the world. The power of digital pathology includes easy-to-use accessioning programs, digital archiving of data and images, precision analysis, instantaneous retrieval of records and quick access to second opinions. This combined force enables a smoother workflow and reduced turnaround times.
While the use of digital pathology for primary diagnosis has been approved in Europe and other countries, it has not yet been approved in the United States. However, digital pathology still brings important value to pathologists, hospitals and reference labs in the USA. The top 14 hospitals in the USA today employ digital pathology to enable features such as archival and retrieval, tumor board preparation, prognostic applications, and internal and external collaborations.
In fact, a dramatic improvement in workflow due to the implementation of digital pathology occurs when it is used to facilitate collaborations. “Digital pathology holds the promise of moving beyond ordinary reviews to truly collaborative pathology. The old passive model of sending glass slides to a single subspecialist and waiting for a fax will give way to a broadly linked digital network of experts. Instant access to the best minds in pathology will be possible,” noted Eric F. Glassy, MD, medical director, Affiliated Pathology Medical Group, Rancho Dominguez, CA.
The potential of digital pathology continues to evolve-with increasing sub-specialization of pathologists, many organizations want to enable the best-trained physician to review the results. Unlike glass slides that need to be packed and shipped from one location to another, digitized slides can be shared with a speed and certainty that was inconceivable a generation ago. “Remote sharing of glass slides for expert subspecialist input is a growing need,” said Puneet Sarin, Leica Biosystems vice president and general manager, Pathology Imaging. “Digital pathology can be leveraged to ensure that those difficult cases requiring a second review get to the correct subspecialist anywhere in the world.”
May the Force Be With You (and the Team)
Digital pathology can improve transparency and, thus, advance quality assurance. Most importantly, digital pathology can bringe the healthcare team closer to the patient. With digitized images and connectivity software, institutions can conduct virtual tumor boards; bringing together pathologists, radiologists and treating physicians (regardless of their location) to review options. “Patient care is requiring a more comprehensive team effort instead of single provider input at various stages,” remarked Ossama Tawfik, MD, PhD, professor and director, anatomic and surgical pathology, University of Kansas Medical Center. “The benefit digital pathology provides is the transformation in which physicians are changing their ways of practicing medicine. Digital pathology is enabling them to break out of the ‘silos’ they have been in by providing the tools for a more collaborative team environment.”
The Future
Adoption of digital pathology is providing another solution for the ever-growing needs of anatomic pathology laboratories in today’s challenging healthcare environment. The applications of digital pathology are limitless, just as we have seen with the expansion of other electronic technologies. Of all the benefits of digital pathology, improved access to care for those in remote areas will be one of the most significant. Digital pathology can make a dramatic difference in quality of life for thousands of people in rural and remote locations in the United States, and around the globe, where remote populations do not have easy access to pathology services.
When selecting a digital pathology vendor, it is important that they have a thorough understanding of pathology, workflow integration expertise and information technology experience. These are three critical areas for success in the implementation of digital pathology.
The future of Digital Pathology will be driven not only by the need for its presence in the everyday life of the pathology laboratory, but also by the visions of pathologists to expand its capabilities as it becomes a standard in laboratory operations.
Fighting cancer is a complex matter. While cancer may not be concord by digital pathology altogether, its purpose will have an impact throughout the galaxy today and in the future. The Force is strong in digital pathology, now we must unite and use it in the battle against the Dark Side (cancer).
Sherri Heffner is a freelance writer; and Anne Brumme is vice president, Image Capture Devices, Pathology Imaging, at Leica Biosystems.
References
1. Hedvat CV. Digital microscopy past, present, and future. Arch Pathol Lab Med. 2010;134:1666-1670.
2. Weinstein RS, Graham AR, Richter LC, et al. Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future. Hum Pathol. 2009;40(8):1057-1069.
3. U.S.-based Transparency Market Research (TMR). Digital Pathology Systems Market-Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2014-2020.
