In pathology, not only is technology enabling access to specialists, it is also helping address a deficit of qualified staff. ‘There is a severe shortage of pathologists in most parts of the world, including Japan, Canada, Australia, New Zealand and the UK,’ explains Dr Jared N. Schwartz MD, former president of the College of American Pathologists and chief medical officer of digital pathology systems suppliers Aperio Technologies. ‘So these countries are increasingly adopting a new technology, called ‘whole slide scanning’ where you scan the tissue sample on a slide and end up with an identical digital microscopic image of what you would have seen, had you been looking through the microscope.’
This scan does not suffer distortion during transmission, so can be sent to another location either via a secured network or over the Internet as long as patient identity is protected. This not only helps hospitals with no pathology staff on site, but provides access to pathologists specialising in particular areas, such as neuro-pathology when a second opinion is required, without lengthy delays and potential risk of loss or damage when mailing samples. In the future, digitising slides could reduce the need for storing the original samples for years, which Schwartz says ‘would save significant space and money’.
Digitising the slides also enables computer-assisted diagnostic tools to be used. In general, pathologists are looking for a particular pattern or cell type within a tissue sample. Finding these specific cells involves looking through a microscope at hundreds of them, and the results are bound to be subjective. ‘Five pathologists might give three different opinions, but a computer-assisted algorithm that counts thousands of cells may give the pathologist a statistically more standardised result,’ says Schwartz. ‘One of the hopes is that by using computer software that will improve over time, there will be increased standardisation of diagnoses, and we can be confident that our interpretation is more accurate.’