Digital-Pathology-Today

Heather Couture, PhD, talks about AI and computer vision in digital pathology. They discuss the definition of AI, challenges in developing tools, validation in the digital era, and addressing pre-analytic variability. They also explore the benefits of using algorithms in molecular tests and understanding intra-tumoral heterogeneity.

Amidst this digital transformation in pathology, it’s not only the review of histologic sections that is going digital and moving online, but practically everything else is too. What does this mean for the future of publishing and pathology education with the advent of online content and delivery mechanisms? Our guest is Jason Hornick, MD, PhD, Director of Surgical Pathology and Immunohistochemistry at Brigham and Women's Hospital, Professor of Pathology at Harvard Medical School, a pathologist with expertise in soft tissue tumor pathology, gastrointestinal pathology, and diagnostic immunohistochemistry. He is the Editor-In-Chief of the 5th series of the AFIP Atlases of Tumor and Non-tumor Pathology. Dr. Hornick serves on 14 editorial boards, including the American Journal of Surgical Pathology and Modern Pathology. He is dedicated to the advancement of diagnostic surgical pathology, and teaching approaches to diagnostic pathology to trainees and practitioners We’re going to be talking about the mission and history of the American Registry of Pathology, the publishers of the beloved fascicles atlases of tumor and non-tumor path now in its fifth series. What is the future of publishing going to look like with the advent of online content which can be updated much more frequently than the traditional 5-to-10-year cycle of publishing hard copies of books? What does online content social media and other forces mean for peer review and scientific authority? And what is the future of education going to look like not only for pathology trainees but also education for all pathologists?

One of the biggest pieces of news we've gotten in 2022 is the announcement of new CPT codes from the American Medical Association specifically for digital pathology. What are CPT codes? Why should we care? How will these new codes help us to elevate the practice of anatomic pathology and allow us to more concretely articulate a value proposition for digital pathology? Our guest is Nathan Buchbinder, Chief Product Officer and cofounder at Proscia. We discuss the new CPT codes and much more. We get a current lay of the land for digital pathology in mid-2022. How far have we come in the past five years or so? How far have we come in the past year - which has seen dramatic changes and acceleration in many areas. How do the US and Europe differ in adoption and outlook and what are some continuing barriers to the adoption of digital pathology?

Conquering cancer through Artificial Intelligence is the goal of our guest this week on Digital Pathology today. We're talking with Brandon Suh, MD, CEO of Lunit, a South Korean company creating applications utilizing Artificial Intelligence in both digital pathology as well as radiology. Lunit stands for “learning unit,” which is fundamental to the company's philosophy which embodies the belief that they can learn just about anything and is foundational to the Artificial intelligence, which involves continuous learning. The company has developed algorithms focusing on disease screening in the areas of mammography and chest X-ray in radiology and predictive and prognostic markers in digital pathology - in particular an AI based algorithm for immunotherapy, which outperforms the current standard of care. Lunit is looking to capitalize on the growing trend of Artificial Intelligence in medicine.

As we kick off this third season of digital pathology today our guest is Dr. Kevin Sandeman, from the Region Skane in Sweden, who is going to be taking us through their digital transformation. The Region Skane covers a population of over 1.4 million people, involves four health care systems including two academic and two community centers. The caseload is over 110,000 cases per year - generating over 680,000 scanned slides. This is a wonderful story, and the benefits are maybe not what you would expect. In addition to the obvious benefits of not having to he tethered to a microscope, according to Dr. Sandeman, the number one benefit resulting from the digital transformation is “Peace of Mind.” The departments in the region enjoyed much higher quality in terms of histologic preparations and output, enhanced engagement and understanding among the histotechnologists, reduction of hystertechnologist FTE requirements and complete elimination of the need to work overtime. Turnaround time for case reporting has dropped an astounding 33% and clinician satisfaction is remarkably increased. We also talked about some of the challenges in adopting the digital workflow not to mention the IT infrastructure requirements and storage demands but at the top of the list appeared to be the initial pathologist resistance to adopting the digital workflow.

The digital transformation in pathology is well underway but what kind of opportunities does this present to us? We've heard all the buzz words such as machine learning artificial intelligence and heard all the hype about enhanced workflows and making pathologists’ lives easier. What is the future practice of pathology going to look like? Our guest is Beatrice Knudsen, MD, PhD, Medical Director of Digital and Computational Pathology at ARUP Laboratories, as well as Professor of Pathology at the University of Utah. Dr. Knudsen has built a program that integrates histopathology, multiplex tissue staining, digital image analysis, as well as computational pathology. She is applying this approach to close the gap between laboratory research and clinical care and to develop novel algorithms for diagnosis, prognosis and the treatment of patients.

They're coming - AI and machine learning algorithms in digital pathology. How do we go about assessing the robustness and suitability of these new tool for use in actual clinical practice? Our guests are Dr. Angelique Levi, Associate Professor of Pathology and Vice Chair and Director of Pathology Outreach Services and Dr. Sudhir Perincheri, Assistant Professor of Pathology and Director of Digital Pathology, both from Yale School of Medicine. We're talking about how new tools are going to be incorporated into clinical practice, and the impact of these new tools in various practice settings, such as academic medical centers, community outreach, and private practice. What does this mean for the training of the next generation of pathologists? We're only human, after all, but what about machine algorithms? What level of mistakes or "misses" is allowable? And what if these tools are too sensitive, could they actually slow us down and make life more complicated for us?

Too many systems or components in a pathology workflow adds complexity and cost. How can we create an elegant end to end solution to enhance workflows, while decreasing both complexity and costs? Our guest is John Wirthlin, CEO of Lumea, a company reimagining pathology - beginning and ending with the patient. We discuss the end-to-end solution in digital pathology. One of the promises of digital pathology is making the pathologist’s workflow more streamlined and more efficient. But can we bring the Laboratory Information System (LIS) into the clinic and improve the workflow flow for our clinician colleagues as well. How can we improve the tissue handling or preanalytic phase of testing? It's often easy to forget who the customer is. By utilizing enhanced workflows, can we improve satisfaction for the clinician, who is ultimately treating the patient?

Amidst this digital transformation in pathology the talk seems to be largely centered around whole slide imaging of H&E-stained tissue sections. But what about cytology? Why don't we hear much talk about digital cytology, and what are some of the unique challenges in cytology in terms of going digital. Our guest is Michael Quick, Vice President of Research and Development and Innovation at Hologic. We discuss the history and evolution of cervical cancer screening all the way from pap smears to thin prep to incorporating digital pathology and image analysis in the process. Will we finally be able to say goodbye to the light microscope? And what are some of the parallels and lessons learned comparing cervical cancer screening by cytology in pathology to breast cancer screening by digital mammography in radiology.

What is going to surprise us in digital pathology in big ways and in small ways? How can seemingly small changes make a big impact in what we do as pathologists and in the lives of patients? How are we going to make use of the large datasets that we will inevitably be generating through the widescale adoption of digital pathology? Our guest is Louis Culot, General Manager for Genomics and Oncology Informatics at Phillips. We're going to be talking about the current landscape of digital pathology in 2022, where we've been in the past 20 years and even earlier, and the impact of the COVID-19 global health emergency on the acceleration of the adoption of digital pathology. And what is the future of integrated diagnostics, incorporating digital pathology radiology and molecular diagnostics.