The microscope is the cornerstone of surgical pathology and, though the field has seen significant changes over time, the microscope has only recently been reimagined for the computer-centric world we live in today. I cannot imagine a scenario in which the microscope is completely replaced – but I am confident that digital pathology and artificial intelligence (AI) will play an even larger role in anatomic pathology’s future. Digital pathology and AI are now FDA-approved for primary diagnosis – and together they can revolutionize surgical pathology. Digital platforms can serve as a re-envisioned microscope, a logistics solution, and a medium to allow pathologists to take advantage of AI tools.
Most of my practice’s pathologists work at hospitals throughout the state, remote from our technical laboratory – so it is fortunate that we have already had the opportunity to work with new FDA-approved software. Digital platforms allow us to share material or collaborate with our colleagues instantaneously, negating the need to commute or wait for slide delivery. I am currently based in the Denver, Colorado metro area, but I have been able to get secondary consultations from a dermatopathologist in Indianapolis within minutes. These platforms have also enabled remote collaboration and sharing at multidisciplinary tumor boards with more meaningful pathology involvement than traditional static photomicrographs allow.
AI, on the other hand, has the potential to add significant value to pathologists’ work. It has immediate applications for technical laboratories using digitized slides, improving digital workflows and scan validations. For our patients, AI enables modules for enhanced detection of some of the most common cancer types, such as prostate and breast. It is easy to see the benefits this approach has for pathologists and patients, particularly when it comes to personalized diagnostics. With the promise of so much added value, digital and computational pathology have me excited about the future of our field.
A recent study found that the number of pathologists in the US decreased by nearly 18 percent between 2007 and 2017 (1). Given the average age of most pathologists, many have predicted that retirement will cause a workforce shortage over the next 10 years (2) – and this doesn’t even account for the lack of pathologists in developing countries. By enhancing the role of the pathologist and enabling easy remote work, digital pathology and AI have the potential to increase access to critical subspecialized expertise – improving accuracy and quality of diagnosis and, ultimately, patient care. Surgical pathology remains a field based on interpretation, requiring clinical, radiographic, and laboratory correlation. AI will find its place in aiding the pathologist to perform qualitative and quantitative tasks and allowing them to focus on the art of the practice.
Developments in healthcare and an increased adoption of molecular testing have elevated the critical role of the pathologist. Emerging markets outside the US have a need for pathologists, too; digital services allow for connections to be made without physical presence. Access to efficient tools that allow pathologists to add value in these key areas can help move healthcare forward. Though it may be cost-prohibitive for many organizations to adopt digital technologies, forward thinking in adopting cutting-edge technology will pay off in the future. With medicine only growing more complex, any technology that can elevate the role of the lab is needed and, by refocusing on quality and innovation, pathologists can leverage digital pathology and AI to improve diagnostic quality and deliver the best possible patient outcomes.
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References
- DM Metter et al., JAMA Netw Open, 2, e194337 (2019). PMID: 31150073.
- SJ Robboy et al., Arch Pathol Lab Med, 137, 1723 (2013). PMID: 23738764.
