Digital Pathology Blog

This article is the second in a four part series highlighting the evolution of digital pathology and its impact on the access to pathology services throughout the world. If you missed it, you can find Part 1 here.

Many pathology practices associated with academic medical centers have begun using digital pathology to facilitate the sharing of cases through the use of internet services, private networks, and now, cloud technology. As the use of whole slide imaging (WSI) and digital pathology consultations becomes more widespread, hospitals can access experts in any pathology subspecialty from any location around the globe. Secure, web-based access to expert centers and remote subspecialist colleagues is now a reality.¹

This article is the first in a four part series highlighting the evolution of digital pathology and its impact on the access to pathology services throughout the world.

"In 2012, there were 14 million new cases of cancer reported and 8.2 million cancer-related deaths worldwide. The number of new cancer cases will rise to 22 million within the next two decades.”¹

With cancer among the leading causes of death worldwide, the demand for pathology services is becoming more critical. However, the number of new pathologists entering the field is decreasing while the projected demands of the patient population are expected to grow by more than 150% over the next 20 years.

Quality Control (QC) and Quality Assurance (QA) activities in anatomic pathology are embedded into the daily work. These efforts are put into place to assist with error reduction and prevention and for improved patient safety. No one denies their value.

Digital pathology has played a role in laboratory workflows for decades. Early use of static images for teaching and tumor boards has grown to include today’s clinical applications including remote assisted fine needle aspirations and frozen sections and the use of whole slide images (WSI) for expert consultations and quality assurance (QA).

In April, the field of digital pathology achieved a major milestone with the FDA giving clearance to Philips Medical Systems to market its whole slide imaging (WSI) system for primary diagnosis. While a significant step forward, there is still much work to be done before digital pathology (DP) becomes a mainstream technology for clinical use. 

Telepathology and whole slide imaging have become integrated into pathology laboratories worldwide. With applications in teaching and research well established, it is now recognized that digital pathology has a role in the clinical realm as well. 

Digital pathology provides clear advantages for pathologists’ quality assurance processes and performance evaluations as well as streamlined workflows for consultative expert collaborations and multi-disciplinary tumor boards. With the advancement of artificial intelligence and histopathology analytics, there is no limit to the application of digital techniques to the practice of pathology.

Whole slide scanning of pathology slides is becoming more affordable and convenient for building the foundation of a laboratory’s digital pathology service.  

Once you’ve obtained a whole slide scanner and your laboratory has developed an effective workflow for scanning images of pathology slides from your cases, you can store your whole slide images (WSI) on a server making them easily accessible from your laptop or tablet. As your image repository grows, however, finding the images you need becomes a challenge.

Most WSI directories are based on laboratory accession numbers.  When needing to access images to demonstrate certain features, whether for research, teaching, publication, creating digital study sets or other applications, you must first determine which cases will potentially have the images that best demonstrate what you want to show.

At Pathology Visions 2015 Corista hosted a reception featuring guest speaker, Dr. Arief Suriawinata, Chief of Anatomic Pathology at Dartmouth-Hitchcock Medical Center in Lebanon, NH. Dr. Suriawinata spoke on “The Dartmouth Experience: Whole Slide Imaging, Workflow and Quality Assurance”.

Dr. Suriawinata noted that while whole slide imaging is here to stay, its implementation is not without challenges in terms of integration, workflow, support, data storage and, last but not least, pathologists’ comfort. He emphasized that the key to successful implementation is a well-designed workflow providing whole slide images (WSI) of excellent quality to pathologists and residents where and when they need them.

Dartmouth-Hitchcock’s experience using WSI for its quality assurance program and how the program prepares pathologists for the utilization of telepathology generated a lively discussion on today’s key issues in digital pathology.