From Still Images to Real-Time Insights: Static, Dynamic, and Hybrid Modalities in Digital Pathology

Digital pathology has transformed the field of diagnostic medicine by allowing the acquisition, storage, and analysis of pathological data in a digital format. Among the various approaches within digital pathology, static and dynamic modalities play pivotal roles. In this blog, we will delve into static and dynamic digital pathology, understanding their unique characteristics, advantages, and applications.

STATIC DIGITAL PATHOLOGY:

Static digital pathology involves the transmission and analysis of still images of pathological specimens. It relies on the acquisition and sharing of high-resolution digital images, enabling remote consultations and second opinions. There are several key aspects of static digital pathology worth exploring:

Image Capture and Transmission:

Static digital pathology begins with the digitization of glass slides through whole slide imaging (WSI) technology. High-resolution scanners capture the entire slide, preserving microscopic details. These digital images can then be transmitted via secure networks to pathologists for analysis, consultation, and archival purposes.

Remote Consultations and Second Opinions:

Static digital pathology facilitates collaborations among pathologists regardless of their physical locations. Pathologists can review and analyze digital images on computer screens, enabling remote consultations, expert opinions, and second opinions. This enhances access to specialized expertise, especially in areas where pathology resources are limited.

Education and Training:

Static digital pathology is valuable for education and training purposes. Digitized slides can be used in educational institutions to teach pathology students, providing access to a wide range of case studies and rare pathological conditions. Furthermore, the ability to annotate and add annotations to images facilitates the sharing of knowledge and expertise among students and educators.

DYNAMIC DIGITAL PATHOLOGY:

Dynamic digital pathology involves the real-time transmission and interactive discussion of digital images and pathological findings. It enables remote collaborations, consultations, and diagnoses, replicating the experience of face-to-face interactions. Key aspects of dynamic digital pathology include:

Real-Time Video Conferencing:

Dynamic digital pathology relies on video conferencing technology, enabling pathologists to interact and discuss cases in real time. With the integration of digital pathology software and high-resolution cameras, pathologists can view and discuss digital slides together, simulating the experience of conventional microscopy-based discussions.

Remote Grossing Assistance:

Dynamic digital pathology extends beyond microscopic analysis by allowing remote grossing, which refers to the examination of surgical specimens outside the laboratory. Pathologists can remotely guide technicians or surgeons during specimen dissection, providing real-time feedback and guidance. This enhances efficiency, reduces delays, and ensures accuracy in the initial assessment of specimens.

Multi-Disciplinary Team Collaboration:

Dynamic digital pathology facilitates multi-disciplinary team collaborations by bringing together pathologists, surgeons, radiologists, and other specialists in a virtual setting. Real-time discussions enable comprehensive and integrated decision-making processes, leading to improved patient care outcomes.

Therefore, static and dynamic digital pathology represent two distinct yet interconnected modalities within the realm of diagnostic medicine. Static digital pathology enables the transmission and analysis of still images, fostering remote consultations and second opinions. On the other hand, dynamic digital pathology offers real-time video conferencing capabilities, promoting interactive discussions, remote grossing, and multi-disciplinary collaborations.

HYBRID DIGITAL PATHOLOGY:

Let us now talk about the third modality i.e., hybrid digital pathology. In hybrid mode, a telepathology system combines the advantages of both static and dynamic telepathology. It enables the transmission of static high-resolution images for detailed analysis and documentation, while also providing the option for real-time interaction and discussion using dynamic telepathology tools. This hybrid approach can enhance the efficiency and effectiveness of teleconsultations, allowing pathologists to have a comprehensive understanding of the case while enabling immediate collaboration and decision-making. For example, using WSI telepathology and dynamic real time imaging systems, in different layers, and toggling back-and-forth among layers, in a single diagnostic session. In a hybrid system, the system operator can jump back-and-forth between the whole slide image modality and the dynamic modality.

Remote Collaboration and Consultations:

Hybrid digital pathology enables remote collaboration and consultations among pathologists and other healthcare professionals. Digitized slides can be shared securely, allowing for real-time discussions and decision-making regardless of geographical barriers. This remote collaboration fosters knowledge sharing, enhances diagnostic accuracy, and facilitates interdisciplinary discussions.

Enhanced Training and Education:

Hybrid digital pathology leverages the capabilities of image analysis and quantification offered by digital pathology. Pathologists can also capture digital images for subsequent analysis using computational pathology algorithms. This integration enables the extraction of quantitative data, such as cell counts, staining intensity, and morphological features, enhancing objectivity and precision in pathological assessments.

Quality Assurance and Research:

Hybrid digital pathology facilitates quality assurance activities and research endeavors in pathology. Digital images can be stored in a centralized database, allowing for standardized and systematic review. Pathologists can compare and discuss challenging cases, contributing to continuous quality improvement. Furthermore, the availability of large-scale digitized datasets paves the way for research projects, biomarker studies, and the development of predictive models for various diseases.

Hybrid digital pathology represents a powerful fusion of static and dynamic digital pathology, harnessing the strengths of both approaches. Its flexibility, remote collaboration capabilities, enhanced training and education opportunities, image analysis potential, and impact on quality assurance and research make it a promising avenue for advancing diagnostic medicine. As hybrid digital pathology continues to evolve and gain traction, it holds immense potential to revolutionize pathological diagnostics, improve patient care, and drive innovation in the field.

To conclude, let’s look at a comparison table with the salient features of all the modalities for a quick review:

Comparison table between various modalities:

We hope that you will find this quick review of the various modalities of digital pathology useful, and as always, we welcome your feedback on this and any other digital pathology topics. Happy reading!

Blog Author Blog Editor

Nupur Sharma, MD Snehal Sonawane, MD

Key Considerations for Selecting the Ideal WSI (Whole Slide Imaging) Scanner

Are you in need of a whole slide image (WSI) scanner for your laboratory or organization? Are you looking for the right choice? There are many whole slide image (WSI) scanners available in the market. However, choosing the right digital pathology slide scanner can be a challenging task. The WSI scanner is an expensive and long-lasting investment, so it is important to make the right choice. In this blog, we help you define your digital pathology and slide scanning needs, to ensure that you choose the best scanning solution for your pathology lab. With the right scanner, you can increase productivity, accuracy, and efficiency in your lab.

Here are the points to keep in mind before purchasing whole slide image (WSI) scanners:

1. Demand for scanning services: Evaluate the demand for slide scanning services within your organization or lab and determine whether it warrants the investment in a whole slide scanner.

2. Expected throughput: Determine the expected number of slides that need to be scanned per day or week to ensure that the scanner can meet your throughput requirements.

3. Targeted use of the scanner: Identify the specific use cases for the scanner, both current and future, to ensure that it meets your needs. Define uses of scanners such as uses for histopathology, frozen section, cytology, brightfield or immunofluorescence imaging, and diagnostic or scientific research purposes.

4. Required magnification: Determine the required magnification for scanning slides, such as 20x, 40x, 100x, or other, depending on the use case

5. Type of scanner required: Decide on the loading mechanism needed, whether an automatic/continuous scanner or manual will suffice.

6. Resolution: It is the level of detail that a scanner can capture in an image. The higher the resolution, the more detail you can see in the image. This is an important factor to consider, especially when analyzing small structures or features. However, higher-resolution images also require more storage space and can take longer to process

7. Type of scanner required: Automatic/continuous loading or manual loading functionality

8. Image quality: This is an essential factor to consider when choosing a slide scanner. The quality of the images you produce can affect the accuracy of your diagnoses. A scanner that produces high-quality images with accurate color reproduction and sharpness is essential. Look for scanners with advanced features such as autofocus, color correction, and image stitching.

9. Compatibility with existing infrastructure: Consider whether the scanner and its accompanying software are compatible with your existing infrastructure.

10. Size of pathology glass slides: Consider the size of the pathology glass slides that need to be scanned and ensure that the scanner can accommodate them.

11. Special features and functionality: Identify any special features or functionality that you require, such as image analysis, image management, or integration with other software.

12. User-oriented functionality: Evaluate the user-oriented functionality of the scanner, such as ease of use and accessibility, to ensure that it can be used effectively by lab personnel

13. Lab space and infrastructure: Ensure that you have enough space in your lab to accommodate the scanner and that your lab infrastructure can support it.

14. Cost and budget: Consider the cost of the scanner, including any additional fees for maintenance, software, and support. Ensure it gets fit into your current budget.

15. Technical support: Technical support is an important factor to consider when choosing a slide scanner. You want a manufacturer that provides comprehensive technical support to help you troubleshoot issues and keep your scanner running smoothly. Look for manufacturers/vendors that offer training, maintenance, and repair services.

16. Long-term investment goals: Consider your long-term investment goals and how the scanner fits into your overall lab strategy. Choose the right whole slide scanner according to your need.

Benefits of selecting the right scanner:

• Compatibility: Selecting a scanner that is compatible with your operating system can save you the hassle of dealing with technical issues and compatibility problems.

• Time-saving: A high-quality scanner can save you time by scanning multiple slides simultaneously and producing high-quality results.

• Improved productivity: A faster scanner can improve your productivity by allowing you to scan more slides in less time.

• Better image quality: A scanner with high image quality can produce better and more accurate scans, preserving the quality of your original slides.

• Cost-effectiveness: Choosing the right scanner can save you money in the long run by reducing the need for re-scanning and producing higher-quality results.

In conclusion, choosing the right whole-image slide scanner is a crucial decision that can impact the quality, speed, and productivity of your scanning process. By considering the factors discussed above, you can select a scanner that meets your needs and produces high-quality results.

Choose with Confidence: Receive the PathPixel Questionnaire for a Smart Selection of Your WSI (Whole Slide Imaging) Scanner. Email at pathpixelnet@gmail.coml

Blog Author Blog Editor

Trupti Sonawane, MD Snehal Sonawane, MD

Challenges and Opportunities for Digital Pathology Workflow

Digital pathology has emerged as a transformative approach in diagnostic medicine, revolutionizing the traditional workflow of pathology laboratories. By digitizing microscopic slides and utilizing advanced imaging technologies, digital pathology offers numerous advantages over its conventional counterpart. This blog post will delve into the digital pathology workflow, highlight the key differences from traditional pathology, and explore the technological advancements that have driven its adoption.

A. Digital Pathology Workflow - encompasses several stages, each leveraging technology to streamline the diagnostic process. Here's an overview of the key steps involved:

1. Preparing a tissue sample: This step is similar to the traditional workflow, where thin slices are cut from a biopsy specimen, mounted on a glass slide with a coverslip, and processed with chemicals and stains to preserve its structure and enhance its contrast. Some tips for preparing a tissue sample for digital pathology are to avoid excessive or pale background staining, folds, wrinkles, and air bubbles, as they can affect the quality of the scan.

2. Slide Digitization: This step involves using a whole slide scanner to capture high-resolution images of the entire tissue section from the glass slide. The scanner can automatically adjust the focus, brightness, and color balance of the image and save it in a digital format such as DICOM or SVS (An SVS file is a Tiled TIFF image with additional pages containing slide label, overview image, and scaled copies of the scanned slide). The scanning process can take a few seconds to several minutes, depending on the size and complexity of the slide.

3. Image Acquisition and Quality Control: The digitized images undergo quality control checks to ensure accurate representation and clarity. If the images do not pass the quality control requirements, then typically, the images are rescanned.

4. Image Viewing and Analysis: This step involves using a software viewer to display the images on a computer monitor. The viewer allows the pathologist to zoom in and out of the image, adjust its settings, annotate it with measurements and comments, and compare it with other images. The viewer can also integrate with computational tools to perform automated image analysis, such as detecting and quantifying features, classifying cells or tissues, or predicting outcomes.

5. Diagnosis and Reporting: This step involves creating a report that summarizes the findings and diagnosis of the pathologist based on the image analysis. The report can be integrated with an electronic health record or laboratory information system for easy access and retrieval or archived for future reference. The report can also be shared with other pathologists or clinicians via secure networks or cloud platforms for consultation, collaboration, or educational purposes.

B. Differences from Conventional Pathology - Digital pathology differs significantly from conventional pathology practices, offering several advantages that enhance accuracy, efficiency, and collaboration among healthcare professionals. Here are the key differences:

1. Slide Handling and Storage: Digital pathology eliminates the need for physical slide management, reducing the risk of damage, loss, or misplacement of crucial samples. Digitized slides can be securely stored in electronic databases, ensuring long-term accessibility. Traditional pathology requires physical storage, transportation, and retrieval of glass slides.

2. Remote Access and Collaboration: Digital pathology enables remote access to digitized images, fostering collaborations among pathologists regardless of geographic barriers. Expert consultations, second opinions, and interdisciplinary discussions become more accessible, enhancing patient care.

3. Workflow Efficiency: Digital images can be easily retrieved, reviewed, and shared, minimizing turnaround times and increasing overall efficiency.

4. Education and Training: Digital pathology platforms provide valuable educational resources by offering a vast repository of digitized slides for training and reference purposes. Pathology students can access a wide range of cases, gaining exposure to rare conditions and improving their diagnostic skills.

5. Quality, Consistency, and Reproducibility: Digital pathology enhances the quality, consistency, and reproducibility of pathology diagnoses compared to traditional pathology, which can be affected by variations in human observers’ opinions or interpretations.

C. Technological Advancements - Driving Adoption Digital pathology has gained traction due to significant technological advancements that have improved image quality, storage capabilities, and analysis tools. Here are some key advancements driving its adoption:

1. Development of Whole Slide Imaging (WSI) Scanners: WSI technology digitizes entire glass slides at high resolution, capturing the microscopic details required for accurate diagnoses. WSI offers advantages such as rapid scanning, reduced slide handling, and efficient storage of large datasets.

2. Image Analysis and Artificial Intelligence (AI): Digital pathology platforms incorporate image analysis algorithms and AI technologies, empowering pathologists with automated detection, quantification, and classification of tissue features. AI algorithms assist in pattern recognition, risk stratification, and prognostic predictions, augmenting human intelligence in the diagnostic process.

3. Telepathology: Digital pathology facilitates telepathology, enabling remote consultations, collaborations, and second opinions. Pathologists can share digital images in real-time, allowing for an efficient exchange of knowledge and expertise across geographical boundaries.

4. Cloud Computing, Image Compression, and Storage Solutions: Cloud-based platforms offer secure and scalable storage solutions for large volumes of digital pathology data. Advancements in image compression and storage techniques have reduced the file size and bandwidth requirements of digital images while maintaining their resolution and fidelity.

Digital pathology is a promising field with many benefits for improving patient care, enhancing diagnostic accuracy, increasing workflow efficiency, reducing costs, and advancing research. However, it also faces challenges such as regulatory approval, standardization, validation, interoperability, security, privacy, education, training, and adoption barriers. Therefore, it is vital to address these items and foster collaboration among stakeholders to realize the full potential of digital pathology.

Blog Author Blog Editor

Brandon Combs Nupur Sharma, MD