Practical considerations for implementing a digital pathology system

Anatomical Pathology (AP) is undergoing a series of rapid and dramatic changes as new technologies and capabilities arrive to allow pathologists to pursue the same type of dramatic changes that their colleagues in radiology have experienced in
the last decade. Advances in image processing, Internet bandwidth capacity, and the declining cost of storage have coalesced to make digital pathology a reality for every day use in the pathology lab.

A digital pathology system can be expected to improve lab capacity in some or all of the following areas: whole slide imaging, image analysis, enhanced reporting capability, remote consultation, quality control and quality assurance, adherence to emerging guidelines, image archiving, and operational cost savings. However there are practical considerations that each lab must review when deciding to implement digital pathology.

Quality of Image

Pathologists are dependent on the quality of the image presented to make an accurate diagnosis. After all, the image is a very important factor for an accurate and consistent AP diagnosis. At a minimum, the digital viewing experience needs to replicate that of using an optical microscope. Prospective users must consider factors such as monitor resolution and size, true color reproduction, smooth image viewing, and ease of use when deciding which solution to choose.

Physical Size

Laboratories in general, and anatomic pathology labs in particular, have limited space, especially bench space. Any system intended for use in the AP lab must be designed with space restrictions in mind. A small footprint is critical to minimize the bench space consumed.

Ease of Use

One aspect of digital pathology that is exceptionally important is the ease of use of the system and its software. A pathologist using a digital pathology system spends hours daily within the software environment reviewing slide images, choosing relevant fields of view, annotating relevant structures to support the diagnosis, and then storing those images away for future reference.

The software environment must be flexible enough to facilitate moving among different platforms, communicating with the laboratory or hospital information systems, and outside parties such as the oncologist or a consulting pathologist. The pathologist and lab staff need to evaluate the graphical user interface (GUI) for ease of use and ability to replicate the workflow that the lab staff uses daily in evaluating slides and signing out cases.

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 Image Management

Any modern medical facility deals with image data not just from pathology, but also from radiology, cardiology, etc. All these different modalities along with relevant patient information should ideally be provided through one unified view.

Image management is the backbone of the software platform because digital pathology is driven by images. A useful system must be comprehensive in its ability to handle a wide range of image types and must be robust enough to allow the pathologist to move rapidly and reliably from one image type to another. In addition, the system must enable the pathologist to retrieve or assemble images from other sources to illustrate the patient report and to support the diagnosis. The ideal system must also allow a comprehensive approach to image annotation, storage, and retrieval of specific fields of view or, if desired, the entire whole slide image.

Technical Factors

Before implementing any digital pathology solution, the lab staff must consult the hospital informatics group to discuss the impact on the hospital considering such factors as the size of the images stored and transmitted, the ability to upload and download related images to and from other imaging databases, the impact on the internal bandwidth and Internet provider, the file formats and compression approaches used, how images will be archived, and the ability to interact with other imaging approaches such as radiology.

System Installation and Integration

Another factor that needs to be taken into account is how quickly and with what effort a system can be deployed. The ideal system should be able to be deployed rapidly, with little if any, optimization and should be intuitive in operation so that training is straightforward and brief. In addition the manufacturer should have the ability to support integration with either lab or hospital information systems.

Meeting the Needs of Today's AP Laboratory

In designing a digital pathology system, BioImagene sat down with pathologists, histotechnologists, and lab managers to discuss these considerations and how best to meet the demands of today's AP lab. The result of these discussions is BioImagene's iScan^TM family of automated digital slide scanners coupled with its Virtuoso^TM software.

The iScan Coreo Au slide scanner, incorporates a 160-slide capacity with the most current advances in scanning technology. In addition, iScan Coreo Au Live is a novel feature of the iScan Coreo Au that supports remote microscopy without having to first scan a slide.

BioImagene's Virtuoso application software has been developed using state-of-the-art web technologies, and is designed to work through an Internet browser. Some of the functionality supported by Virtuoso includes image management, fast viewing performance for digital images, quantitative image analysis, image sharing, and customized reporting.

Our solutions allow pathologists to digitize pathology slides, provide consistent diagnoses*, as well as collaborate and take pathology education to the next generation. BioImagene's professional services group works hand in hand with the hospital and lab staff to integrate the Virtuoso Software and iScan systems with laboratory information system.

BioImagene is the only end-to-end workflow management company with a suite of leading edge products for image acquisition through image analysis, to decision support to report. Our solutions are used in academic medical centers, teaching hospitals, community hospitals, reference laboratories, and pharmaceutical and biotech companies.

*BioImagene products are FDA cleared for specific clinical applications and are intended for research use for other applications.