Digital Diagnosis by Graciela Gutierrez

From Baylor College of Medicine Solutions Magazine Online

http://www.bcm.edu/solutions/v3i2/tissues.html

In pathology, computers are replacing microscopes, resulting in faster diagnoses for patients and improved education for students.

Television’s gone digital, as has phone service. When was the last time you needed film for a camera? As digital technology invades daily living, it’s no surprise that it is helping doctors and researchers improve patient care.

Baylor College of Medicine is one of the first medical schools to begin using digital slides in its pathology department.

"It’s just like using a microscope," said Clay Goodman, M.D., Professor of Pathology at BCM. "Instead of one person putting his or her eye to the microscope, a number of different doctors can view the sample on a computer screen."

This allows patient’s tissue samples to be viewed easily by a number of different doctors to help create more efficient consulta-tions and diagnosis. It also provides better training for future doctors.

The process starts with a traditional glass slide. Tissue samples from patients are routinely made into slides so specialists can help diagnose a disease or illness. A doctor sends the sample to a pathology lab, where technicians create the slide by preparing thin slices of the samples. Each sample can result in as many as 20 slides, and it’s not unusual for a hospital to create 200,000 slides a year.

"Now we can take a glass slide and scan it, but it’s more than just making a copy," said Francis Bui, Administrator of Computer Systems of Pathology at BCM. "Each scan is so detailed it takes about four hours to make sure the image is copied correctly under different magnifications."

The scans are made with a specially equipped microscope. They are then stored onto a secure internet server that doctors can view wherever they have Internet access. There are multiple layers of security where log-on information is needed so personal medical records are protected. Patient information is not transmitted in a way that can be linked to the image.

MICROSCOPES GATHER DUST
Doctors are using their microscopes less often these days thanks to leading-edge technology that creates amazing scans of patient tissue samples, which can be viewed on the computers of experts to speed the diagnosis process for patients.

"So if a patient in Houston needs a specialist who happens to be in New York or even Europe, all that specialist has to do is log on, and he or she has a detailed microscopic view of the sample," Bui said.
Many times, the pathologist at BCM will talk on the telephone to the consulting pathologist while both are viewing the digital image from their own computers.

"We can both manipulate the computer image just like a microscope during a consult," Goodman said. "We can change the magnification and also move the image as you would move a slide. It’s really amazing."

Without this program, glass slides are shipped to the different doctors. There is always a chance the slide might break, be lost, or get damaged in some way. It’s also time consuming if a doctor needs to view the slide again, or send it off to another expert. With a digital image, the original slide doesn’t risk damage and doctors always have instant access to a high-quality image. With critical patients, every second counts.

The digital slides are also being used in the classroom. Histology students at BCM began using digital slides in 2006. Goodman said students usually share microscopes, but by viewing the image on a computer screen, students and professors can interact without having to take turns with a slide.

The digital slides can also be copied onto a DVD so students can view them on their home computers to help in their studies. There is no patient information attached to the slides students use, and privacy is always protected.

BCM pathology residents who did not have this technology while they were students are offered a weekly session so they can get experience with the program and digital slides.

"We are only going to keep moving forward with the use of technology in medicine," Goodman said. "We would be doing a disservice to our students and patients if we didn’t expose our future doctors and researchers to this sort of technology."