Contributing lab leader: Daniel Plews
Cancer continues to be one of the leading causes of death worldwide, accounting for nearly one-in-six deaths in 2020.1 The numbers continue to increase year on year and have been further exacerbated by the unprecedented backlog of cancer cases that have gone untreated or undetected due to the disruptions to healthcare services at the height of the COVID-19 pandemic.
We are also seeing an increase in complexity when it comes to diagnosing cancer cases. Many of the latest and greatest cancer treatments are linked to companion diagnostic tests, requiring a positive result before the drug can be administered, and the scoring of these tests can often be very complex and time-consuming.
On top of this, the number of pathologists is decreasing each year.2 Virtually all histology laboratories in the UK say they do not have enough staff to meet demand with nearly half of pathology laboratories having to send work away.3
We believe that entire patient pathways, across tissue, molecular, and sequencing, need to be integrated into laboratory workflows in order to deliver truly personalized care to patients. A key part of this will be harnessing advances in software and artificial intelligence (AI) to help with the processing of the ever-growing volume of clinically relevant data, crucial if we are to succeed in delivering ever more individualized care solutions.4
For pathologists, digitization will help to address many of the challenges they face every day.
For example, through digitization it will be possible to instantaneously share slide images with anyone, anywhere, significantly reducing the time it takes to process a slide, saving transport costs, and lowering the potential risk of damage to sample slides in transit.
It will also allow for greater flexibility and efficiencies within Multidisciplinary Team (MDT) meetings. Traditionally these meetings require a team to collate all the slides that need to be discussed, and for the pathologist to attend in person to review the cases. Digital pathology removes the need for all these steps, allowing the cases to be viewed and discussed virtually.4
Finally, and most excitingly, digitization allows the opportunity to develop AI algorithms to assist pathologists with their reporting workflow.
By making systems more interoperable and accessible, it will be easier than ever to share work, information, and expertise. As a company, Roche is keen to ensure our solutions are as open as possible.4 This will result in our customers having access to emergent cutting-edge technologies and the kinds of solutions that will help to take personalized healthcare to the next level.
Although it may take some time for digital pathology to become the norm, the advent of digital pathology is an obvious and exciting next step and looks set to revolutionize the future of diagnostics for the pathology lab.
Before making the jump to whole slide imaging, and digital reporting, we first need to modernize the traditional histology workflow, which traditionally relies on pencil and paper to track specimens throughout the lab. This can be achieved via workflow solutions that allow all specimens to be barcoded and tracked. This not only facilitates the adoption of Digital Pathology, by providing the barcodes and interface for automatic case assembly, it also improves lab efficiency by enabling the tracking of quality issues, and increasing patient safety by introducing positive identification to every process.
Adopting Digital Pathology will likely be the largest workflow transformation a Histology lab will ever undertake, as it touches every aspect of the laboratory, and opens up new diagnostic possibilities. Therefore the people and workflow change management is arguably as, if not more important, than the scanning hardware and software, so choosing a partner with the relevant expertise will be crucial to a successful transition to digital.
While preparing for the adoption of Digital Pathology may pose some challenges, it also opens up many opportunities. For sites looking to make the most of the collaboration enabled by Digital Pathology, working together to standardize processes beforehand will help greatly when it comes time to share cases.
It’s also an opportunity to perfect the quality of the glass slides produced within the lab, to maximize the information captured in the digital image. This isn’t just important for the diagnosis made on the image today, but for the future information that will be extracted by algorithms yet to be released in the future.