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Inside the Lab Digital and computational pathology, Histology, Profession, Technology and innovation

A New Kind of Second Opinion from Diagnexia

sponsored by Diagnexia

Over the last few years, diagnostic medicine has experienced a revolution: molecular pathology and precision medicine. The next revolution, which comes hot on the heels of that one, is computational pathology – which includes everything from digital imaging to artificial intelligence. In a world where pathologists are increasingly reinventing themselves as informaticians in the laboratory space, Dr. Runjan Chetty and colleagues have developed a service that puts simplicity, efficiency, and expertise at the heart of digital pathology. Here, we speak to him to find out more about Diagnexia – and about the future of digital and computational pathology.

Tell us a little bit about yourself… 
My name is Runjan Chetty. I’m an anatomic pathologist who has trained in South Africa and worked in Australia, the UK, and Canada. I’ve been an academic all my life, having worked in academic institutions and held chairs of pathology in South Africa, Scotland, and here at the University of Toronto, where I have worked for the last 20 years. My research interests lie in the gastrointestinal tract and the pancreas.

What is Diagnexia? 
Diagnexia is a pioneer in digital pathology. The company has harnessed the “best of breed” in terms of the way diagnostic algorithms work, the way they employ software, and reporting templates to enhance pathologists’ ability to provide efficient, objective diagnoses using digital pathology.

We’ve built a systematic reporting template that will allow seamless assessment and review of digitized slides or whole-slide images and allow for incorporation into a customized report. The system easily facilitates synoptic reports based on the Royal College of Pathologists, College of American Pathologists, and International Collaboration on C ancer Reporting designated reporting templates.

What subspecialty areas does Diagnexia cover? 
Diagnexia intends to cover all subspecialties eventually. However, for the initial phase, we are concentrating on eight or nine key anatomic pathology subspecialties – high-volume, high-complexity areas, including gastrointestinal pathology, genitourinary pathology, dermatopathology, and pulmonary pathology. With this approach, we’re hoping to cover the vast number of cases that a general practice might encounter.

Our primary goal is to establish a remote second opinion expert consultation service whereby designated individuals in each subspecialty, who are well-recognized and well-versed in their areas of expertise, will provide second opinion consults. Additionally, we’d like to offer primary diagnostics as well – another area in which subspecialty services will be provided. 

Why might pathologists use Diagnexia’s services? 
The most important feature is that you get an expert opinion on your case immediately. This creates time efficiencies and reduces the cost and risk of second opinions – there are no transport expenses to ship your slides from one lab to another; there’s no risk of losing those slides in transit; and the scanned images are high-quality and can be reused for research and teaching purposes.

The most important feature is that you get an expert opinion on your case immediately.

Of course, not every lab is fully equipped for digital pathology at the moment. If labs without slide scanning capabilities want to use our consultation service, they can send their slides to our central repository, where we can scan and upload them onto our platform. If such a lab would like to use our primary diagnostic service and the volumes are sufficient, we will install a scanner in that particular department, allowing them to interface with our reporting platform and upload their cases directly.

I think this represents an important (and interesting!) departure from our usual mode of practice. It’s exciting. It incorporates computational pathology and provides a layer of objectivity to a discipline that, by its nature, is often subjective. I think the introduction of an objective, quantitative tool will significantly benefit patient care. In no way will such tools replace pathologists – they will simply supplement our armamentarium of tools to ensure that we can not only reach the best possible diagnosis, but also help guide treatments and improve outcomes.

Are you growing your team? 
We are hiring along subspecialty lines with an eye to ensuring that our clients receive the best possible diagnosis from our pathologists. At this stage, we’re looking at established subspecialists in the key areas of anatomic pathology and we welcome interest from people who are interested in our approach. If you’d like to try out new techniques and apply diagnostic algorithms to facilitate and enhance your practice, Diagnexia may be the place for you!


For more information, please visit our website ( or email us ([email protected]). 

Find Runjan Chetty on Twitter at: @RunjanChetty 
Find Diagnexia on Twitter at: @Diagnexia 

Runjan Chetty is Professor Emeritus in the Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada, and Chief Medical Officer at Deciphex Ltd. and Diagnexia Ltd. 

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