Real-Time Vision

Digital technology is revolutionizing microscopy for pathologists (1). Now we can capture optical images electronically and display them in their digital format directly on a PC monitor. And, because the image is projected onto a screen, there is no need for complicated optics otherwise necessary for direct human eye observation. Although based initially on commercially available microscopes coupled to video cameras and monitors, rapid technological evolution is enabling manufacturers to deliver sophisticated systems with faster real-time digital image reconstructions as well as whole slide scanning. And the cost of these new devices is becoming more attractive to hospital pathology departments, so naturally, use of them is increasing.

I have no doubt that for case discussions and residents’ sign-outs, pathology departments worldwide will soon replace their traditional multi-head microscopes with video microscopy, which will not only help with training, but will also rise in importance at multidisciplinary meetings and conferences, in particular when used with large, high-definition screens. The direct, live image feed from the glass slide on the microscope makes these meetings more interesting and proactive. Not only that, but they allow a more accurate representation of the work of the pathologists, so I see PowerPoint slides being redundant during these multi-team meetings too.

To help educate pathologists about the utility of these digital developments, the European Society of Pathology (ESP) has introduced video microscopy session masterclasses held at its Brussels headquarters and at its annual meetings.

As Chair of the video microscopy uropathology sessions during the Lisbon (2013) and more recently Belgrade (2015) annual meetings of the ESP, my overall impression is positive. Discussions are now much more interactive and informal; presenters can easily show an area of a slide to support a diagnosis or quickly respond to questions by literally showing the answers on screen! This is difficult to do using just a homemade PowerPoint presentation. Moreover, the feedback from residents and trainees attending these sessions is extremely encouraging, and they appreciate the more realistic format. The only drawback, which is minor, is that some presenters still need to master the new technologies, but this will come with more time spent using it in their daily routines. The current chair of the ESP Uropathology Working Group, professor Antonio Lopez-Beltrán (University of Cordoba, Spain), wrote in a society newsletter, “[…] slide seminars and video-microscopy sessions should be entrusted to young European pathologists with interest in the field, as a way to stimulate their active participation in ESP activities and foment their interest in uropathology.”

In my view, in the near future, we shall see the end of “digital illiteracy” in pathology. Our residents and junior specialists already digitize their personal lives, so getting to grips with digital pathology technologies will be an easy task for them. They in turn will become our teachers in this rapidly emerging new world of pathology that we have the pleasure to be a part of.