March 09, 2008

LABMEDICINE ZOOMS IN ON DIGITAL PATHOLOGY

BY Dr. Keith J. Kaplan

CHICAGO, February 21, 2008 – Significant technological advancements have created digital pathology, allowing students and professionals to digitize a large number of glass slides, according to “Digital Pathology: A New Frontier in Education,” an article in the February edition of American Society of Clinical Pathology’s (ASCP) LabMedicine. This means that slides can be viewed and analyzed remotely, online and at home. Education is made simple with textbooks that now include CD-ROMS with pre-loaded images. According to some students, image quality is better, there is increased access and lab space, and teachers can annotate slides.

Dirk Soenksen, the article’s author, highlights the advantages of digital pathology. Health care workers are able to access a repository of digital slides rather than digging through cumbersome slides that, over time, fade, break and are lost. These repositories can be organized by annotation, specific attributes or imagery data of interest.

Everyone from high school students to the advanced pathologist can take advantage of digital imaging of slides for sharing, collaboration on cases or to make presentations. With certain software, virtual slides enhance the ability to zoom in on any part of the slide to get a closer look at tiny nuances of the sample. Both students and laboratory professionals can view and analyze everything from bacteria to blood and tissue samples from patients. Digitizing slides may allow for those findings to be shared more quickly and easily among classmates and colleagues.

Soensken is the founder and CEO of Aperio Technologies, a company that manufactures products for digital pathology in Vista, Calif.  He notes several advantages: “One of the most valuable benefits of digital slides is their use for decision support,” he said. “Unlike reference books, relevant details in a digital slide can be viewed in context to provide pathologists and students with comprehensive, evidence-based pathology content to facilitate self-teaching or decrease the time required by pathologists to research complex cases.”

The article goes on to discuss how the nature of digitizing slides can also improve online conferencing, proficiency testing and quality assurance.

Marilyn Havlik, a 30-year biology teacher in the Chicago Public Schools system and current science department chair at Walter Payton Math, Science and World Language College Prep says she is not ready to give up her microscopes. She uses both microscopes and digital images in her classroom.

“In no way are microscopes dinosaurs,” Havlik said. “They are the key to turning these students into scientists. My students love to look at things moving around under the microscope. I tell them to bring in pond water from their neighborhoods and they get so excited when they put it under the microscope and see everything from mosquitoes to crawfish wiggling around. Digitizing removes some of the personal discovery that kids in science need.”

Another high school teacher and former pathologist, Jason Lopez, says the technology would be great to have in his schools along with the traditional microscope.

“I am going in-depth with my students and would love for digital technology to be available for them,” said Lopez, a forensic science teacher at Chicago’s Whitney M. Young Magnet High School. Lopez’s forensic science course began as a club, but now is offered to seniors as a full year course. “Microscopes are great because they are hands on and sharpen motor skills,” he said, “But technology is important to today’s students and I would have no problem going digital.”

Within the profession, there is still debate surrounding digitizing slides, especially for proficiency testing. A recent report from the American Cancer Society says: “…a reliable correlation was not established between virtual proficiency testing and the actual work environment. The examinees were not familiar with the software environment or the controls used for lighting adjustment, color or magnification.” (Cancer Cytopathology, Stewart, J. et. al, March 9, 2007).

“On the practical side, we use glass slides and microscopes to make diagnoses for patients every day,” said Beverly Nelson, MD, FASCP, an assistant professor of pathology and practicing hematopathologist at Northwestern University Feinberg School of Medicine. “As far as teaching medical students, we use digital slides. But a resident physician who has chosen pathology as a career will use microscopes and glass slides as part of their training and it is a part of the everyday work environment.”

While the microscope may not become a relic, digital pathology has the potential to catalyze transformation that may create opportunities in education, decision support, conferencing, proficiency testing and quality assurance.

To see the entire article, visit http://www.labmedicine.com/pdf/featured/soenksen.pdf. The ASCP web site is www.ascp.org.

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