Advancing Pediatric Diagnostics through Digital Pathology at Nationwide Children’s Hospital

Overview

Nationwide Children’s Hospital has developed a pioneering Digital Pathology Laboratory that integrates clinical and research programs to enhance pediatric pathology. Despite challenges like limited resources and system integration, the lab successfully implemented prospective digital scanning for primary diagnosis, improving collaboration and patient care without increasing turnaround times.

Background

Digital pathology has been part of Nationwide Children’s Hospital since 2006, initially supporting large-scale research projects such as The Cancer Genome Atlas. Early attempts at primary diagnosis using digital pathology faced technological limitations, but advances around 2020 accelerated adoption. The establishment of a dedicated Digital Pathology Laboratory under Andrew Mullen’s supervision marks a significant step in integrating digital tools into pediatric pathology workflows, supporting both clinical diagnostics and global research collaborations.

Data Highlights

Key milestones include the acquisition of the first scanner in 2006, validation of the first scanner for primary diagnosis in 2024, and the operation of a hybrid scanning model that maintains slide availability while providing digital access. The lab supports major research initiatives like the Children’s Oncology Group Molecular Characterization Initiative and serves as a primary biobank distributing large image datasets globally.

Key Findings

• Nationwide Children’s Hospital has maintained digital pathology capabilities for nearly two decades, contributing to foundational datasets for AI development.
• Primary diagnosis via digital pathology was validated and implemented prospectively in 2024 despite incomplete laboratory information management system integration.
• The lab operates a hybrid model scanning all slides first, enabling digital access without delaying turnaround times or compromising patient care.
• Staffing and informatics resource limitations necessitate cross-training and contingency planning to ensure operational continuity.
• Digital pathology enhances collaboration, remote work capabilities, and global research efforts, critical in a field with limited pediatric pathology expertise.
• Current pilots of image analysis software aim to provide objective insights into complex pediatric cases, shaping future diagnostic approaches.

Clinical Implications

Digital pathology enables improved collaboration and case review flexibility, especially important in pediatric pathology where expertise is scarce. Hybrid scanning models can be effectively implemented without disrupting clinical workflows, even in resource-constrained settings. Remote work facilitated by digital pathology supports recruitment and retention of specialized pathologists, directly benefiting patient care.

Conclusion

Nationwide Children’s Hospital’s Digital Pathology Laboratory exemplifies how strategic adoption of digital tools can transform pediatric pathology, enhancing diagnostic capabilities and research impact despite operational challenges. This model sets a foundation for future innovations in pediatric diagnostics.

References

1. Mullen AM -- Scanning New Horizons (in Digital Pathology)