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Will Digital Pathology Retire the Microscope?

Digital technology is changing medicine, but many pathologists still use old-fashioned microscopes to ply their trade. They load them with tissue samples, analyze them through the eyepiece and dictate findings to a voice recognition system or an administrative assistant.

It can be a pain. “Every time I reach for a new slide, I have to take my eyes off the lens and check the forms for that case,” says Ian Cree, professor of pathology at Warwick Medical School in Coventry, UK. “You can get a sore neck from hours at the microscope.”

Those hours are getting longer. As cancer rates rise, pathologists play a critical part inside cancer care teams, and their assessment often becomes the foundation of an oncologist’s recommended treatment plan. Yet the College of American Pathologists expects their number decline by a fifth over the next 15 years.

But engineers are working on digital systems connected to the Industrial Internet that can make the pain go away. Three years ago, Cree and his team started testing a machine that allows them to digitally scan images of tissue slides and patient histories, attach matching barcodes and upload everything to a database. Cree can study tissue samples on a computer monitor and control their flow with a mouse.

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A pathologist can control the flow of tissue samples with a mouse. Image credit: GE Healthcare

The system is efficient in many other ways. The slides, which hold prepared biopsied tissues about 5 microns thick – a tenth of a human hair – no longer travel to Cree’s desk as they once did, but go straight back to storage after scanning. This makes it easier to preserve them and keep track of them, while pathologists analyze their images and search for diagnoses.

The technology allows one pathologist to study around 150 slides a day, increasing the lab’s efficiency by about 13 percent. “Digital pathology puts everything directly on the screen in front of you, including the paperwork,” Cree says. “Everything is linked and I can even collaborate with my colleagues without stepping out into the corridor. It’s much quicker and better for everyone, including the patient.”

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Above: Omnyx’s Image Analysis Application can help with measurements for Dako HercepTest, a test commonly used by pathologists to assess treatment options for breast cancer patients. Top image: Skin melanoma sample showing digital measurements of Breslow’s depth, describing the depth of the cancer’s spread, and the distance to the tumor’s margins.

The system in Cree’s office is called Omnyx Integrated Digital Pathology. It was developed by Omnyx LLC, a joint venture between GE Healthcare and the University of Pittsburgh Medical Center.

Omnyx takes advantage of the power of the Industrial Internet, connectivity and data analysis. In the future, it could allow doctors to reach beyond hospital walls and create global “pathology networks.”

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Doctors can access patient images and files from their desktop monitors. Image credit: GE Healthcare

“Pathology is a crucial diagnostic skill that can be contemporized with digital technologies,” says Omnyx CEO Mamar Gelaye. “We can connect doctors in rural and underfunded hospitals with pathology experts. The technology helps eliminate access as a variable in quality of care.”

Similar Big Data systems are already helping doctors in Sweden to analyze X-rays images of rural patients and improving diagnostics in Washington State.

Omnyx first scans samples with a high-resolution camera and stores the images in a digital archive. Pathologists can access the archive in real time and pull up desired samples.

The system can be easily scaled up from just one lab to a hospital or even an entire healthcare network. Doctors can use it to collaborate and share slides with peers and specialists, make measurements that are more consistent, improve the accuracy and speed of diagnosis, and quickly obtain second opinions. “The human eye is extremely good at looking for patterns on a slide,” Cree says. “But we are very bad at determining how much of something is on it. That’s where digital pathology adds value for the patient.”

The system could analyze samples stored in the database and look for hidden correlations. Doctors can also use it to share information about new discoveries in molecular and genomic testing. “With these new tools, pathology can rise to deliver an elevated level of patient-centered care,” Gelaye says. “We know pathology will evolve, and our solution is committed to stand ready for that transformation.”

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