#10 Whole-Slide Imaging for Management of Digital Data In Pathology

Overview

For well over a century, pathologists, the medical experts who identify disease through the study of human tissue, did their job by peering through high-powered microscopes at glass slides that held tissue samples. And if a pathologist wanted to share the slide with a colleague, that person had to come to the lab to see. For those at a remote location, the specific slide had to be mailed or else the pathologist hand delivered it.

Thanks to whole-slide digital imaging—a new technology that converts glass slides into digital slides with excellent image quality that can be viewed, managed, stored, streamed over the internet, and analyzed on a computer—all of that has now changed. Computer monitors have now been transformed into virtual microscopes, allowing pathologists to deliver extremely accurate results.

While digital CT scans and x-rays have been commonplace in medicine for years, the era of digital pathology, and telepathology where pathologists can effectively work remotely, is now upon us.

Pathologists can now share their slides immediately, conveniently, and easily with peers anywhere in the world.
Digital slides don’t have to be returned, nor should they ever get lost or misplaced, thanks to electronic search
capabilities that can identify slides by bar code or other identifiers. The good news for patients is that they no longer have to wait for their slides to be shipped to a consulting pathologist, something that used to take anywhere from hours to days. And with a difficult case, it’s no problem to have multiple pathologists looking at the slide at the same time.

“The new whole-slide imaging technology allows the pathologist to scan and digitize an entire slide, or group of slides, and transmit the images over the internet to any consulting pathologist,” says Kandice Kottke-Marchant, MD, PhD, Chair, Pathology and Laboratory Medicine Institute, Cleveland Clinic.

“For example, this allows a pathologist to diagnose patients in Cleveland from a beach in Maui. Using a large-screen computer monitor, the pathologist can also view multiple digital slides or review digital slides through different fields of depth. The slides can also be compared side-by-side, something that can’t be done so easily with a microscope.”

The ability to electronically scan a slide quickly has been a major reason why pathology is embracing high-speed, automated whole-slide imaging. Just a few years ago, it took minutes to scan a slide. This has now dropped to seconds. And with hospitals typically generating more than 200,000 slides annually, whole-slide imaging now allows hospitals to scan and store this important medical information, while having them accessible remotely, 24 hours a day.

Whole-slide imaging also means quicker diagnoses and potential health care cost savings. The faster an accurate diagnosis can be delivered and definitive therapy started can translate into reduced patient morbidity and mortality along with lower medical costs.

Where Are They Now

The ability of whole-slide imaging to digitalize glass slides is responsible for revolutionizing digital pathology into one of the most promising avenues for medical diagnostics. These images are allowing physicians and professionals all over the world to predict, diagnose and treat cancers and other diseases faster, cheaper and more efficiently than ever before. This field has grown so quickly with huge effects in the medical world that the FDA recently released updated guidelines for regulation of these digital imaging devices. In 2016 a medical IT company worked to create a software where the large amounts of data transferred from the Whole-Slide Imaging (WSI) can be stored securely while also being retrievable over long periods of time.  In April 2017, the FDA authorized the marketing of this first whole-slide imaging (WSI) for interpreting digital surgical pathology slides on the basis of biopsy tissue samples. This advancement will enable pathologists to read slides digitally, rather than looking directly under a microscope.

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