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Inside the Lab Digital and computational pathology, Microscopy and imaging, Software and hardware, Technology and innovation

Empowering Precision Diagnosis Through Digital Pathology

sponsored by Roche

As digitization continues to sweep the diagnostic arena, pathologists are increasingly using digital solutions instead of microscopes to review slides and cases. Why? Because the technology offers easy access to images, simplifies external consultations, reduces the need for physical storage and transport of slides, and holds promise for a computer-assisted future. But although the benefits of digital pathology are clear, not everyone has leapt in with both feet, often citing the slow speed of slide scanning or the differences between microscope and slide images. To win over those with any doubts, digital pathology must offer a seamless, efficient user experience.

Making the leap

Digitization is becoming more affordable and accessible than ever, but whether your laboratory is low- or high-volume, you may still face obstacles to your transition to digital pathology. For instance, you may wonder whether it truly adds workflow efficiency – after all, digitization adds a step to the process of preparing slides for diagnosis.

When I ask users to open the images they’ve just scanned, it’s rewarding to see their surprise at how good the images look.

Enter the VENTANA DP 200 slide scanner, which tackles that issue head-on with its ability to rapidly scan slides. Its dynamic focus technology can track tissue depth in real time to achieve high image resolution and it uses color management to ensure that scanned images closely match what pathologists see under the microscope. Dr. Joachim Schmid, Vice President of Research and Development at Roche Tissue Diagnostics, is particularly proud of the scanner’s built-in calibration and color management. “Together, they ensure that the output shows a very high level of consistency and quality,” he says. “Everyone likes the simplicity – and when I ask users to open the images they’ve just scanned, it’s rewarding to see their surprise at how good the images look.”

Another barrier to the adoption of digital pathology may be the handling of errors and artifacts introduced during the slide preparation and scanning process. “It is quite challenging to reliably produce an image that accurately replicates what the pathologist sees in the microscope,” says Michael Rivers, Vice President, Digital Pathology, Roche Tissue Diagnostics. Schmid agrees: “Scanners in the past were sensitive to variations in slide dimensions and preparation artifacts. The VENTANA DP 200 uses a slide tray to move slides around and can be run with a no-touch interface, meaning the user can load slides and the system will automatically scan them.” By minimizing physical contact with the slides, the scanner helps to eliminate errors and slide damage. “The aspect of the VENTANA DP 200 that I appreciate the most is the simplicity of the design, with one moving part during scanning, which leads to robust operation and reliable performance,” says Rivers.

Case management software is another concern for some laboratory managers considering a move to digital – there are seemingly endless options, each with its own set of pros and cons. Dr. Eric Walk, Chief Medical and Scientific Officer at Roche Tissue Diagnostics, says, “As a pathologist, I’m really drawn to the ‘case view’ functionality in the Roche uPath enterprise software. The ability to view a digital tray of slides and seamlessly zoom into any one of them to conduct diagnostic analysis is a game-changer in my opinion.”

It should come as no surprise that smart software is key to an efficient workflow. “The VENTANA DP 200 uploads images immediately to uPath software and makes it easy to access slides within the software environment,” says Schmid. “By automatically identifying the barcodes on the slide and getting information from the LIS to sort the slides into cases, a pathologist is able to start working on a case right away.” Rivers concurs: “The ability to scan high-resolution whole-slide images and present them in a viewer that supports the pathologist’s workflow brings a new level of speed and efficiency to anatomic pathology.”

The ability to view a digital tray of slides and seamlessly zoom into any one of them to conduct diagnostic analysis is a game-changer.

Such ease of access plays to one of digital pathology’s major strengths: the ability to view cases regardless of one’s location for a variety of applications. “The digitization of anatomic histopathology enables a completely new diagnostic ecosystem that ultimately leads to better patient care,” says Walk. “Whether through faster, telepathology-driven second opinion consultations, novel pathologist education and training programs, or even crowdsourcing approaches, this technology is having a transformative effect on the practice of pathology.” There is tremendous potential value in the use cases made possible through digital pathology that go beyond routine scanning. Digital pathology can enhance workflows for frozen sections, tumor boards, and even education. “Making the review independent from the location of the slide allows for very different ways of practicing pathology,” says Schmid. “It makes it easy to access expert pathologists anywhere in the world and improves the quality of diagnosis.”

A longtime player in the digital pathology space, Roche is laying a new foundation with the launch of the VENTANA DP 200 and uPath software. The goal? To make digital pathology simple and reliable for pathologists and laboratory medicine professionals. Not all labs are able to go fully digital at once. It’s important for labs to have digital pathology partners that allow them to gradually scale to full digitization – and to offer improved quality assurance, speed, and diagnostic accuracy.

A digital future

The digital transformation is revolutionizing every industry – and pathology is no exception. “We’re rapidly entering a new era in which pathologists are adopting a new mindset and acceptance of digital and artificial intelligence (AI)-based assistance,” says Walk. As workloads continue to increase and precision interpretation of complex biomarkers becomes increasingly essential, Schmid predicts that digital pathology will become the standard in pathology practice and replace the microscope as the pathologist’s main tool. “A key for the digital transformation will be to create a seamless experience for the user – from the lab to the slide review to the analysis of images. Having a system that allows the user to be as efficient as they can be with the microscope is critical for the success of digital pathology.”

[Digital pathology] has the power to transform pathology in two key areas – workflow and medical value – which ultimately results in better patient care.

Walk cites the VENTANA DP 200 in combination with uPath software as an excellent example of meeting this need. Rivers adds, “I think we now have solutions that provide real value in terms of both workflow efficiency and new medical insights. In the near future, we will see image analysis moved into routine use in clinical pathology. Roche is leading the way in developing new analysis tools to enable more consistent results and more diagnostic confidence for pathologists.”

In short, digital pathology is more than just a buzzword. It has the power to transform pathology in two key areas – workflow and medical value – which ultimately results in better patient care. “On the workflow side, telepathology allows ready access to cases even when the pathologist is geographically separated from the histology laboratory,” says Walk. “On the medical value side, image analysis algorithms and telepathology consulting support more accurate diagnoses.” A pathologist’s work starts with a great image and ends with the best possible standard of care for patients – and that’s what Roche Digital Pathology strives to support.

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