Amid the ongoing COVID-19 pandemic, digital pathology technologies are being used in new ways and helping to ensure continuity of care despite widespread lockdowns, travel restrictions and social distancing measures. Three exciting use cases were presented in recent webinar hosted by Roche Diagnostics Asia Pacific, with experts from Australia, India, Myanmar and Thailand sharing their experiences.

Remote Meetings in Australia

Dr Chris Douglas, Medical Director of Histopath Diagnostic Specialists in Australia, said that he had hoped digital pathology would help reduce the need for in-person meetings in a country with extremely long distances between cities and towns. The COVID-19 outbreak inspired his colleagues to give it a try.

Now, digital pathology tools have been widely accepted and are enabling remote meetings, such as important tumour board presentations. Dr Douglas noted that he has received very positive feedback from other participants in these meetings. “It’s been very advantageous to have the digital platform to be able to scan slides and to be able to show them remotely,” he said.

Dr Douglas said that the image quality delivered by digital pathology has been impressive. With no microscope — and therefore no need to change objectives to zoom in or out — it is much easier to manipulate digital slide images, he added. Moving them around, marking spots of interest, and zooming in and out are all quick and simple compared to working directly from slides.

He compared the shift from conventional to digital pathology to that from film to digital cameras years ago: while digital resolution originally seemed inadequate, it quickly surpassed the standard method and became the strongly preferred approach.

Primary Diagnosis in India

Before COVID-19, Dr Sangeeta Desai, Professor and Head of the Department of Pathology at Tata Memorial Centre in India, one of the largest specialty cancer centres in India, had already been conducting validation studies of digital pathology with the goal of using it beyond the educational and quality assurance efforts for which it was previously implemented. “We want to make use of digital pathology for primary diagnosis,” Dr Desai said.

When her whole country went into lockdown, Dr Desai and her team quickly shifted to a remote sign-out approach to allow them to analyse slides and make diagnoses from home. They reported nearly 500 cancer cases this way, providing patient care that would not have been possible without digital pathology.

Importantly, the digital pathology approach was successful despite the broad range of internet connectivity pathologists encountered at home. The team had to find ways to accommodate many different types of workstation setups, Dr Desai said, but they overcame the challenge in order to continue delivering top-notch care to cancer patients.

Accelerating Access in Myanmar

A compelling example from pathologists in Thailand and Myanmar underscores how digital pathology supports cooperation across country borders. Dr Pairoj Junyangdikul, Deputy Managing Director of N-Health Pathology in Thailand, and Dr Myat Wai Hsu, Consultant Pathologist at N-Health in Myanmar, shared their experience using digital pathology tools to improve care in a region with too few pathologists.

Before this approach was implemented, it took 14 days for N-Health pathologists in Thailand to receive samples from their new lab in Myanmar, process them and report results. Now that digital pathology techniques have been implemented at both sites, Dr Pairoj said, that workflow has been reduced to a single day.

The Myanmar lab is still scaling up (Dr Hsu said they were scanning about 90 slides per month) but already the improvement in getting results to patients quickly has been substantial. Pathologists who have used this approach have told Dr Hsu that the “image quality is up to diagnostic quality and they really appreciate it,” she said.

A Life-Changing Technology

The insights presented in the webinar mirrored results from a survey conducted among clinical lab professionals in the Asia-Pacific region between May and June 2020. Nearly two-thirds of respondents expected to see change in anatomic pathology labs as a result of COVID-19. Due to the outbreak, 66% of respondents reported considering or strongly considering incorporating digital pathology in their labs.

With digital tools, pathologists can expand their reach to broader patient populations, and even serve patients in other provinces or countries as regulations permit. They can also streamline workflows and ensure continuity of care in times of disruption, such as the current pandemic. The benefits cannot be understated. As Dr Pairoj Junyangdikul of N-Health Pathology put it, digital pathology will “change your life.”