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Understanding the value of digital pathology

March 13, 2019
Pathology
From the March 2019 issue of HealthCare Business News magazine

DP for clinical use is primarily used for bright-field imaging (a white light source, typically LED based) for H&E slides, composing the clinical majority, and special slides, such as IHC; and there are also scanners that address FISH (fluorescence in situ hybridization) and other more research based purposes.

The digitization of pathology is producing many (and promises many more) of the same benefits we saw when PACS transformed radiology thirty years ago. Some benefits, rationale for adoption and use cases include:
• Tumor board meetings are clearly beneficial, since representatives from different specialties and subspecialties (including patients) can virtually convene, show and discuss multiple disciplinary findings in order to identify best treatment courses.
• Software is available that allows straightforward tissue identification, type and structure classification as well as nuclear, membrane cell and density quantification for IHC.
• Frozen sections from surgery can be immediately viewed by digitally scanning the slide in or near surgery without having a Pathologist on hand in the surgery department, thus saving time and money.
• Teaching software is available that provides customized education that can be quickly adjusted and enhanced for new content, learning and testing.
• Analogue data such as slides are impossible to mine, as computers require ones and zeros in order to perform calculations. Massive databases can be developed from gathering institutional, local, national, and genome correlated populations, allowing specialized discoveries in personalized medicine thorough mining and machine learning. This, along with digital input from other medical disciplines, should benefit outcome-based medicine through more accurate drug development and treatment.
• Consolidation of laboratory services is enabled as digital images can be moved and reviewed anywhere there is internet.
• Remote diagnosis and second opinion can be set up as ancillary services.
• Quality control on slide processing can be automated.
• Workflow can be streamlined and automated in regard to subspecialty slide distribution, interpretation difficulty, workload and availability
• In the near future algorithms performed on slides scanned and in system workflow will have the ability to redirect the slide for additional needed stains based on preliminary findings through artificial intelligence, improving turnaround times.

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