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Sunday, April 29, 2012

Integrated Digital Pathology - no more microscopes?

At the Advances in Health Informatics Conference a few days ago, we saw several amazing presentations on digital pathology.  Dr. Slyvia Asa talked about integrated digital pathology with telepathology, robotics, and streamlined processes for diagnoses to the point of care - all with a rapid turn around time.  She quoted something by Sir William Osler, which I was able to find on the net for another talk she gave on pathology and informatics < here > and that was "As is your pathology, so goes your clinical care".  When Osler was a young student he used to study bacteria from a reedy marsh not far from where I am typing this, and examined it with the greatest new technological marvel of that age - the microscope.  Listening to Dr. Asa describe their integrated pathology labs at Toronto's University Health Network, it sounds like radiologists are exclusively using digital imaging to read pathological sample slices and make diagnosis.  This was evident to me as well when I visited an anatomy lab in the Faculty of Health Sciences at McMaster, where the instructor showed us how digital imaging was being used more frequently than microscopes.  He took a picture of a human cardio sample with his iPad, and then displayed the image on a big screen.  He was able to zoom in with great detail on the pixels.  

To quote from this article by Dr. Asa:

The future of pathology will be reports that are comprehensive clinical consultations that incorporate all of the imaging, biochemical, histologic, molecular, cytogenetic, and epigenetic data. Pathologists will not have two screens in front of them; most will have four. And they won’t want that microscope at their desk because it’s not good for their neck.

So what I see in the year 2020 as pathology is digital radiology, digital endoscopy, digital cardiology, digital genetics, all the relevant information on my four-screen computer in front of me, wherever I happen to be, always with quality assurance as an important part of it, and as the center of personalized medicine.