A digital system that allows scientists to scan images of tissue slides and patient histories, attach matching barcodes and upload to a database has been suggested as the future of digital pathology.
Many pathologists still wield a microscope as their main weapon. They load it with a sample slide, analyse the contents through the eyepiece and dictate their findings to a voice recognition system or an administrative assistant who transcribes them into a report.
It is a process that can become arduous.
“Every time I reach for a new slide, I have to take my eyes off the lens and check the forms for that case,” says Ian Cree, a pathology professor at Warwick Medical School in Coventry, UK.
“You can get a sore neck from hours at the microscope.”
Two years ago, Cree and his team started testing Omnyx Integrated Digital Pathology - a system developed by Omnyx LLC, a joint venture between GE Healthcare and the University of Pittsburgh Medical Center formed in 2008.
“Digital pathology puts everything directly on the screen in front of you
It allows users to scan in images of tissue slides and patient histories, attach matching barcodes and upload everything to a massive computer database.
Cree now views his samples on a computer monitor and controls their flow with his mouse.
After biomedical scientists scan the slides, which hold prepared biopsied tissues some 5 microns thick, the samples do not travel to the scientist’s desk as they once did, but instead go straight back to storage.
This makes it easier to preserve and keep track of slides while their images are viewed by the pathologist to find the diagnosis.
The technology allows one pathologist to study around 150 slides a day, increasing efficiency in the lab by about 13%.
“Digital pathology puts everything directly on the screen in front of you, including the paperwork,” says Cree.
“Everything is linked and I can even collaborate with my colleagues without stepping out into the corridor. It’s much quicker and better for everyone, including the patient.”
Omnyx LLC aims to take advantage of the power of the Industrial Internet, connectivity and data analysis.
Developments could allow doctors to reach beyond hospital walls to create global ’pathology networks’.
“We can connect doctors in rural and underfunded hospitals with pathology experts,” says Omnyx chief executive officer Mamar Gelaye.
“The technology helps eliminate access as a variable in quality of care.”
Similar Big Data systems are already helping doctors in Sweden to analyse X-ray images of rural patients and improving diagnostics in Washington State.
Omnyx first scans samples with a high-resolution camera and stores the images in a digital archive. Pathologists can access the archive in real time and pull up the desired samples.
The system can be easily scaled up from one lab to a hospital or even an entire healthcare network. Doctors can use it to collaborate with peers and specialists, improve the accuracy and speed of diagnosis, and quickly obtain second opinions.
Once Omnyx has gathered sufficient data, the system could also help pathologists analyse the data to seek hidden correlations.
“The human eye is extremely good at looking for patterns on a slide,” Cree says.
“But we are very bad at determining how much of something is on it. That’s where digital pathology adds value for the patient.”
There are, for example, nine grades of prostate cancer tumour. The grade a doctor gives a tumor determines whether a patient receives radical surgery or a more conservative drug treatment.
Cree claims that pathologists are about 60% successful in identifying the right grade when they use only a microscope and their eyes.
Machine vision and software analysis could improve the odds.
“It may be that in the future we find the optimum cut for radical surgery is a tumor grade 4.3 and above, rather than 4, so that we are able to refine our advice and offer a more individualised level of care to patients,” says Dr. David Snead, the pathologist who leads the Omnyx implementation at Coventry and Warwickshire Pathology Services.
The Coventry team has used the new system to study samples from 300 patients.
They are now in the middle of a 10-month-long validation study that will include 3,000 cases. The team will compare results generated from Omnyx versus to those using only a microscope to ensure there are no discrepancies.
“We know pathology will evolve, and our solution is committed to stand ready for that transformation,” says Gelaye.
“We want to use information technology to bring patient pathology cases to the right pathologist for the right diagnosis at the right time.”