Comparing the Accuracy of Digital Pathology Images and Traditional Glass Slides

Jun 4, 2020 | Digital Pathology

Whole-slide imaging is a qualified alternative to traditional microscopy. With approximately 1,000 pathology labs around the world converting to digital pathology systems, the accuracy of digital pathology images compared to glass slides is no longer an obstacle.

Modern dermatologists are turning to whole-slide imaging to take advantage of remote access, portability, ease of sharing, virtual archiving, and user-friendly tools. By examining the concordance with glass slides, technology training, and intraobserver variability, we will demonstrate why clinics should embrace laboratories that have undergone a digital transformation.

Digital slides are reliable and accessible.

Ensuring every patient receives the highest quality of care means dermatologists require complete trust in the results of their reads. With diagnosis from digital slides equivalent to diagnosis from glass slides, digital pathology is a proficient, high-tech replacement for optical microscopes.

Surprisingly, less than 5 percent of global pathology sites use digitalized workflows to handle all of their primary diagnoses. Misconceptions about the barriers to entry—including cost, labor, software, and memory—prevent dermatologists from moving to whole-slide imaging. However, partners like PathologyWatch remove these barriers because they can, in the context of providing tissue processing and/or interpretation, carry the burden of cost and provide the necessary hardware, implementation, labor to digitize, and software maintenance to make it simple for clinics to access electronic records. 

The only remaining hurdle is familiarity, which is essential to building confidence in any new form of technology. In a study from the Department of Pathology, University of Pittsburgh Medical Center, pathologists who received proper training interpreted digital imaging with 16 percent greater accuracy than those without training. 

Digital pathology provides significant clinical benefits.

Incorporating whole-slide imaging into your practice means providing patients with industry-leading, state-of-the-art processes. “When patients come to my office I can show them the whole slide image on the computer screen, point out things of significance, and tell them what they mean,” says Sylvia Asa, MD, PhD. “Sitting with patients and reviewing their pathology is a critical element that brings us to the patient and makes patients understand the importance of what we do. And that has always been a big challenge for pathology.” 

Intraobserver variability is a chance for collaboration. 

Because glass slides and digital pathology images are equivalent, a challenging read on a digital device will result in the same challenges when analyzed through a microscope. For this reason, it is expected that the same dermatologists or pathologists will render a different diagnosis on a certain percentage of cases depending on the day or modality on which they are viewed. 

However, digital imaging offers dermatologists an advantage when it comes to challenging reads. Unlike glass slides, specimens on a digital image viewer* can be simultaneously viewed and annotated by colleagues around the world at a moment’s notice. With the demand for pathologists in the US expected to increase 16 percent by 2030, adapting to the efficiency and collaborative offerings of digital imaging can keep your practice up to speed with a higher workload. 

Aligning with a laboratory like PathologyWatch will help your dermatology practice access the performance and productivity of whole-slide imaging. By understanding the concordance between digital pathology images and traditional microscopy, the value of appropriate training, and intraobserver variability in analog and digital reads, you have the assurance that digital pathology is right for your practice.

*Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.

PathologyWatch Featured on VatorNews to Discuss Series A Funding, Digital Pathology, and AI Technology

Jun 1, 2020 | Digital Pathology

PathologyWatch cofounder and CEO Dan Lambert was recently featured by Steven Loeb on VatorNews in a conversation about series A funding, digital pathology, and AI technology.

During the interview, Loeb asked Lambert about the services PathologyWatch provides dermatologists. “PathologyWatch provides a digital display so the dermatologist can actually view the case and discuss with the pathologist when needed,” explained Lambert. “We also integrate the reports directly into the dermatology electronic medical records systems.” 

Researchers estimate 5 percent of US adult patients experience diagnostic errors every year. Studies show half of those errors are potentially harmful to the patient. With this new technology, dermatologists can review pathology quickly and begin what is often life-saving treatment faster. 

Right now, around 20 dermatology offices are using PathologyWatch’s services. The most notable benefits of this service include better patient care from increased case visibility, as well as “a lot of time and errors saved in the office copying reports over,” said Lambert, adding that, in some cases, the company’s model can potentially result in more revenue to the practice. 

“We don’t charge the dermatologist anything as we’re reimbursed by insurance for the cases that we read. Anecdotally, the turnaround time is faster, and more cases receive enhanced clinicopathological correlation by the dermatologist since they have immediate, 24/7 access to the diagnostic digital slides,” he explained. 

PathologyWatch will use this funding to do more outreach to dermatology clinics around the country, while also expanding its sales force. The company—comprised of 10 full-time employees and a number of highly specialized contractors—will expand marketing efforts and implement a channel partner strategy while investing in the development of technology and supervised artificial intelligence for various cancer lines. The ultimate goal for PathologyWatch is to implement AI technology into these services to identify certain cancer lines. 

“Our AI is being used internationally right now,” said Lambert. “It’s still in the early stages, but we’re seeing that AI can help physicians move faster through certain cases and draw attention to problematic areas where the pathologist should be spending more time. It’s clear that the technology will be used in tandem with humans.” 

To read the full VatorNews article, click here. To learn more about digital pathology and AI technology at PathologyWatch, click here.

What to Look for in a Digital Pathology Image Viewer

May 26, 2020 | Digital Pathology

Digital pathology enables dermatologists to manage and view information captured on digital slides. With no clinical differences to glass slides in 99.3 percent of cases, whole slide imaging allows clinics to access data anywhere and anytime using a digital pathology image viewer. When it comes to image viewers, there are a variety of features, benefits, and limitations. Digital pathology enables ease of access, quality assurance, functionality, and the ability to collaborate. Exploring these features will help you better understand what to look for in a digital viewer for your whole slide imaging.

Ease of Access and Technical Requirements

Entering the digital era does not require dermatologists to make capital investments in costly scanners and computing platforms. All they need to access a patient’s high-resolution slide is a web-based image viewer, which is available online through most modern devices (e.g., mobile, tablet, or laptop). Because the viewer is stored online, faster processors and high-speed internet connections will result in quicker image retrieval. While only 20 percent of dermatologists are reading their slides, the other 80 percent would still like to view them on demand. When processing laboratories provide viewers, dermatologists can view a patient’s entire history of digital slides in just a few clicks, without having to log into a separate site. Digital pathology partners like PathologyWatch provide pain-free access to the latest in image display technology as part of their services model.

Quality Assurance

Using the right digital pathology image viewer can help dermatologists support traditional microscopy with whole slide imaging to increase their level of quality control. As dermatology represents 5.7 percent of all physician office visits in the United States, quality assurance is requisite to ensure patient outcomes, professional fulfillment, and efficiency within the practice.   By linking to patient data from the processing laboratory information systems (LIS), image viewers enable pathologists or dermatologists to review patient slides while accessing important case details at the same time. Thus, a dermatologist can view an entire slide, see the slide’s label, and then compare the findings to other documented patient information to ensure the highest quality of care.

Functionality

Image viewers enable dermatologists to experience a new level of control by maneuvering around digital slides in a way similar to using Google Maps. Look for viewers that combine an instinctive, user-friendly interface with the tools you need to support your viewing experience.  Standard image viewers allow users to magnify and toggle across digital slides and measure and record the distance between two spots. There are also viewers designed for annotation, making it possible to mark up and rapidly navigate to areas of interest. 

Collaboration

Collaborating with others in a secure environment is a significant benefit to working with whole slide imaging. “Collaborating outside your silo allows you to see the world with different eyes,” notes Sandra Camelo-Piragua. “[It] helps you tackle the problems from different perspectives and opens your mind to new possibilities.” In a survey of academic pathologists, 97.6 percent agreed that digital pathology could improve collaboration in their department. There are image viewers that permit people to analyze data from multiple devices and locations around the world simultaneously. Additional conference tools allow members of the group to discuss and share notes.   As the digital pathology industry continues to grow, more image viewers will start coming to the market. By understanding the simple accessibility, quality control, intuitive functionality, and collaborative features of digital image viewers, you will be able to select the one that is right for you and your practice.   *PathologyWatch dermatopathologists use an independently validated digital software platform. The systems referenced are not FDA approved for use in primary digital diagnosis. Digital images may be made available to referring dermatology providers upon request through a digital display. Displays used are FOR EDUCATION AND RESEARCH USE ONLY, NOT FOR USE IN DIAGNOSTIC PROCEDURES. When referring providers or other providers choose to perform primary interpretation on any specimen, the corresponding glass slides are mailed for diagnostic purposes. For more information, please contact [email protected].

The Transformation of Dermatology with Digital Dermatopathology: Challenges and Opportunities

May 18, 2020 | Digital Pathology

Digital dermatopathology is quickly proving itself superior to traditional practices. In 2017, a study revealed complete clinical concordance between whole-slide imaging and microscopy in 98.8 percent of cases.* With a near-equivalent diagnosis to glass slides, the modern advantages of digital dermatopathology make it a valuable asset for every dermatology clinic.

So what is preventing dermatology clinics from taking advantage of digital imaging? We’ll first discuss some of the barriers to entry preventing dermatology clinics from participating in the benefits of digital pathology. We’ll next discuss why dermatologists should digitize and then show how PathologyWatch can further support the digital transformation of dermatopathology. 

Digital Dermatopathology Barriers to Entry 

The case for whole-slide imaging in dermatopathology is strong; however, clinics acknowledge several hurdles to enabling this digital transformation.

First is the high acquisition cost of digital imaging technology. For example, the price of a state-of-the-art pathology slide scanner can reach $300,000, while the cost to implement a digital pathology system can be in the millions, depending on the size of the health system. 

The average dermatologist operates a modest practice that sends specimens out to larger laboratories. Many of those labs have not integrated digital pathology systems because the solution is cost-prohibitive. 

Second, specialized software and hardware are required to create and access the digital images. Companies like Aperio and Philips offer scanner and software packages, though licensing and implementation costs exceed the budgets of most laboratories and clinics.

Third, the idea of purchasing and maintaining the IT infrastructure to store whole-slide imaging is understandably intimidating. After all, an individual digital pathology image can be a gigabyte or bigger, which is ten times the size of radiology images. In addition to the price of setting up the system, regular technical support would be a necessity.

Fourth is the perception that digital pathology does not provide equivalent quality to glass slides. With 94 percent of patients reporting they completely or mostly trust their physicians, there is a lot of pressure to make certain every diagnosis is accurate.

Why Should Dermatologists Adopt Digital Pathology?

Despite the obstacles, there are many reasons and benefits to transforming a dermatology practice with whole-slide imaging. 

First, there can be instant access to a patient’s current and historical pathology images. By accessing data in a HIPAA-compliant manner, dermatologists and dermatopathologists can review digital images within a moment’s notice. Dr. Keith J. Kaplan claims instant access to digital pathology images “enables more efficient discussions and the ability to give detailed descriptions of findings.”

Second, quality clinical care is no longer limited by geography. The ability to instantly share digital images with specialists around the world means introducing the efficiency and assurance of remote reads, second opinions, and integrated diagnostics.

Third, digital pathology is faster. That leaves more time for viewing and communicating results to patients. In a comparative study by the Journal of Pathology Informatics, digital pathology returned shorter diagnostic times than traditional microscopy. 

Fourth, it’s portable. Instead of handling glass slides, slide images can be accessed with an online image viewer*, including an archive of historical slide images for correlation. The ability to retrieve data anywhere and anytime means dermatologists can save time and better serve their patients.

Finally, it’s equivalent to glass slides in terms of quality. In April 2017, the FDA authorized marketing the first digital pathology system for primary diagnostic use. Since then, studies indicate a major discordance rate of only 0.4 percent between whole-slide imaging and microscopy. Keep in mind that whole-slide imaging also eliminates the degradation of sample issues associated with sharing glass slides.

How does PathologyWatch help?

PatholologyWatch is innovative because it allows dermatologists the ability to harness the benefits of digital pathology by circumventing the barriers to entry. 

First, PathologyWatch bears the cost. Instead of bearing the upfront costs yourself, we carry the burden of hardware, licensing, implementation, labor to digitize, and software maintenance to ensure you have easy and affordable access to view digital slide images. By providing digital pathology to multiple practices, we’re able to use economies of scale to lower specimen costs and pass the savings along to our customers. 

Second, there is no software or storage fee. Incorporating whole-slide imaging into your practice doesn’t necessitate any on-site storage or significant software investments. Because PathologyWatch is web-based, all you need to instantly access, view, and manage your digital slides is a normal internet connection.

Third, you have access to expert dermatopathologists from around the world. As authorities in the pathology industry, they can help interpret your slides with academic-level reads. This opens the door to real-time collaboration to evaluate interpretations without geographic restraints. Plus, your reports will link directly to your patient’s chart in your EMR for easy review and quick follow-up.

Digital pathology offers dermatologists more flexibility, options, and conveniences than traditional microscopy. By examining the barriers between dermatology clinics and whole-slide imaging, exploring the advantages of digital pathology, and demonstrating the benefits of partnering with PathologyWatch, you will find that practices are ready to join the digital age of dermatopathology.

*Only considers breast biopsies, not for dermatopathology specifically.

**Images shown are not intended to be used for the diagnosis or treatment of a disease or condition.