Digital pathology: a brief history

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As the use of digital pathology becomes increasingly common globally, many pathologists are trying to figure out whether this approach is right for their labs, their patients and their healthcare facilities. While some have not yet adopted digital pathology systems, the COVID-19 pandemic is causing changes in laboratory workflows that are altering attitudes towards the technology.

How it all started

Digital pathology got its start 20 years ago with the first scanners capable of imaging an entire histopathology slide. It has grown more popular thanks to recent advances in internet speed and access, data storage capacity and computational analysis (check out this review article [1] from the Journal of Pathology Informatics for a detailed history of this technology).

The concept of digital pathology is simple: instead of requiring pathologists to sit at a microscope all day — encountering the challenges of eye and neck strain, among others — the digital imaging of whole slides makes it possible for these talented professionals to analyse slides and make diagnoses from a computer screen or mobile device. Slides are scanned with extremely high resolution to allow substantial magnification — with image clarity comparable to conventional microscopy.

While digital pathology changes the technology used for viewing slides, it does not change the need for highly trained pathologists to evaluate specimens. The process of reviewing a slide and making a diagnosis is virtually identical to standard pathology practices.

The impact of COVID-19

Recently, interest in digital pathology has surged due to the COVID-19 pandemic. Regional and country-wide lockdowns have created an environment in which remote access to slide images is crucial to ensure continuity of care. In the United States, for example, the College of American Pathologists secured government permission that allowed remote sign-out [2] so pathologists could make diagnoses from home when necessary.

With this increasing interest in digital pathology, many lab teams are learning one of the most important lessons: it is not an all-or-nothing proposition. Whether you work in a niche lab with just a few staff members or the largest pathology lab in your country, there are small steps any pathologist can take to give digital pathology a try.

One simple way to begin is to contact companies offering whole slide imaging platforms. The best representatives will be able to provide detailed information about digital pathology regulations in your country. They will also work closely with your organisation to better understand your needs and make recommendations on ways to best utilise the technology.

[1] Pantanowitz, L., et al., 2018. Twenty Years of Digital Pathology: An Overview of the Road Travelled, What is on the Horizon, and the Emergence of Vendor-Neutral Archives. Journal of Pathology Informatics, 9(40).

[2] Remote Sign-out of Cases with Digital Pathology, College of American Pathologists

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