A Digital Pathology Leader
Sitting Down With… Marilyn Bui, Anatomic/Clinical Pathologist and Scientific Director of the Analytic Microscopy Core at Moffitt Cancer Center, Tampa, Florida, USA
Michael Schubert | | Interview
How did you find your way to pathology?
I became a medical doctor because it is a noble and humanitarian profession. Pathology attracted me because it is a specialty in which medicine, science, art, and humanity intertwine perfectly. Through pathology, I became a “doctor’s doctor” – with the ability to leverage critical thinking, innovation, and investigational research to create new knowledge.
And digital pathology?
My first exposure to digital pathology in practice was using image analysis to interpret breast cancer immunohistochemical testing. My first experience in research digital pathology was my 2005 appointment as Scientific Director of the Analytic Microscopy Core (AMC). One of the AMC’s key services is to support researchers in-whole slide image acquisition and analysis. To learn this novel technology, I joined the Digital Pathology Association (DPA), which fosters collaboration among pathologists, scientists, and industry to advance digital pathology.
For hundreds of years, pathologists’ main tools were microscopes and H&E slides. The first revolution was the incorporation of immunohistochemistry into our practice; the second was molecular pathology. I am excited to practice pathology in the era of the third revolution: digital pathology and artificial intelligence (AI). I am grateful that my training, experience, and involvement in digital pathology have prepared me to embrace this transformation in research, teaching, and clinical practice.
Tell us about the Digital Pathology Association…
The Digital Pathology Association (DPA) is a nonprofit organization of pathologists, scientists, technologists, and industry representatives whose mission is to facilitate awareness, education, and adoption of digital pathology and AI in healthcare and life science. I joined the DPA to connect with other pathologists and scientists in this niche area, so that I could do a better job as Scientific Director of the AMC. After working as a volunteer board and executive committee member, I am now the association’s president.
I am very proud of the DPA’s members and leadership team. The talent, enthusiasm, collaborative spirit, and effectiveness are impressive for such a young society.
The DPA just hit 10 years old – how did you celebrate?
It was an honor and a privilege to cut the birthday cake for the DPA’s 10th anniversary during my presidency – and I hope to continue building a successful team, fostering collaborations among members, and expanding the DPA’s reach globally.
Pathology Visions is the DPA’s annual showcase of technology and insightful scientific and educational presentations. The 2019 event attracted a record number of presenters, exhibitors, and attendees from around the world and featured talks on “Digital Pathology and Artificial Intelligence: The Evolution towards Digital Disruption of Diagnostic Pathology” and “Medical Artificial Intelligence at Scale: Changing Clinical Practice One Petabyte at a Time.”
How does the DPA make a difference?
Through annual leadership strategic planning, our committees and task forces work to expand membership; form alliances to facilitate regulatory path clarity in computational pathology and AI applications; facilitate interoperability and connectivity; partner with allied societies in education; and expand our education portfolio. Every initiative is important, but our three most recent are the Alliance for Digital Pathology, our white papers, and the Digital Anatomic Pathology Academy.
The Alliance for Digital Pathology is a regulatory science initiative to harmonize and standardize digital pathology processes to speed up innovation to patients. The Alliance seeks participation from all stakeholders to identify key elements necessary to move the field forward.
The Digital Anatomic Pathology Academy is a free, web-based slide image teaching platform for pathology residents and fellows. It offers high-yield cases in various organ systems that trainees must know before their board certification exam. The slides can be used for unsupervised learning or incorporated into lectures. We hope the Academy will prepare the next generation of pathologists for the era of precision medicine in digital health.
What was your transition to digital pathology like?
Moffitt Cancer Center’s commitment to digital pathology is reflected in the center’s 10-year strategic planning, which features digital health as one of its three pillars. My department is taking a stepwise approach to digitizing. We started by updating the pathology informatics system, which will eventually be integrated with our enterprise informatics system. Currently, we use whole-slide imaging for tumor boards, teaching, and research. Telepathology for frozen section and rapid on-site evaluation is in development. I can’t wait for the day we catch up with some of the best digital pathology practices in the world, because our patients deserve the best.
Improved patient care is presumably the ultimate motivator for the digital transition…
I pursued a career as a physician to take care of patients. Being a pathologist allows me to connect with patients on a much deeper level – sometimes at a DNA level! I strive to provide the best possible care to our patients – and my recent Distinguished Patient Care Award from the College of American Pathologists reassures me that I’m on the right track!
Digital pathology and AI are here to stay. Our choice to embrace this transformative technology will extend the longevity and relevance of our specialty. With pathologist numbers decreasing and diagnostic demand on the rise, digital pathology is more important than ever – and the transition is only a matter of time. As individual pathologists, we can prepare ourselves by becoming familiar with digital sign-out and by actively engaging in the creation and validation of digital pathology applications. That way, we can oversee the safety and efficacy of computational pathology and AI – and help improve the services we offer our patients.