When it comes to diagnosing cancer, radiologists examine digital images and pathologists scrutinize slides. Only occasionally do the two collaborate prior to meetings of the tumor board or multidisciplinary team (MDT). Wouldn’t it better serve all parties involved—oncologists, surgeons and, first and foremost, patients—to unite the two main diagnosticians in a common, speedy workflow that launches the moment each sits down to interpret his or her respective visuals?
For sure and we are on the path, says Daniel du Plessis, MD, of Salford Royal Hospital NHS Foundation Trust, a 728-bed hospital in Salford, U.K., and one of the sites that has piloted a digital pathology system in development by Sectra. Du Plessis specializes in neuropathology and leads the institution’s Department of Cellular Pathology. He and a colleague were part of a 6-month pilot utilizing the Sectra solution.
“There are some things for which the microscope will always be my fallback tool, but, as a first port of call, the digital images are vivid and, in many ways, superior,” says du Plessis.
Enabling better cancer care
Making things better for pathology and radiology is a Sectra objective. “Our vision is to provide a diagnostic solution where the pathologist does not need to use the microscope and he or she can easily share and take part of findings with radiology and other specialties,” says Simon Häger, Sectra’s digital pathology product manager. “Cancer care providers should be able to access all relevant imaging and information for patients in one system to create a more accurate diagnosis in much less time. It will be a big improvement over today, where we have totally different departments and very limited exchange of information.”
Häger has helped lead the charge as Sectra has developed and now launched a digital pathology system built on the same platform as Sectra’s radiology PACS. By reducing or eliminating the cumbersome handling of glass slides, the solution frees up pathologists to compare many slides at once while remaining in an upright, ergonomic position. Undistracted by discomfort, poring over high-resolution scans of slides on computer monitors—much like radiologists viewing imaging scans—they navigate sections of stains easier, compare stains faster and combine efforts with radiologists sooner.
The improved teamwork, he says, will allow early cross-specialty review of not only reports but also of images, the end result being better accuracy, efficiency and service to the interventional members of the cancer care team.
A must for the MDT
It becomes apparent the success of the coming “rad-path” alliance rests on the willingness of pathology to embrace Digital Age capabilities.
Häger is convinced that, once pathologists get a taste of the new way, the technology will make a lot of new friends.
As things tend to work right now, attendees of MDT meetings look at radiology images projected from a PACS. In striking contrast, most pathology departments haven’t gone digital yet, Häger points out. “Because digital pathology images are so large, pathologists have not been given the opportunity until now to utilize PACS technology with high performance. The available and most common way has until now been to carry in their microscopes and project their slides onto the wall where sometimes the other physicians in the room have to wait. This can be very time-consuming,” and, considering the attendees, “the MDT meeting is probably the most expensive meeting in the hospital.”
And that’s just at the MDT meeting. Pathologists’ preparation often means assigning staff to identify and pull slides for patient cases to be reviewed at the meeting, then navigating the relevant slides for key sections. It’s not hard to imagine how all of this is much less laborious using a computer and an ergonomic interaction device rather than a microscope and slides. So it is that the digital system facilitates both MDT preparation and MDT presentation.
“One of the best parts of preparing with the digital solution is the capability to make comments and mark noteworthy features right over the images,” says Häger. “With physical slides, this is so time-consuming that a lot of pathologists end up doing it on their own time, after work hours.”
Mitigating the fatigue factor
Du Plessis is one neuropathologist who can relate. Ease of handling is just one of many benefits he reports enjoying with the Sectra system. “What stood out to me was the confidence I felt in navigating