DIGITAL PATHOLOGY
Delete, retain or utilise? How to approach digital pathology storage
For NHS Trusts and healthcare bodies across Europe, making the move to digital pathology has been a huge undertaking, but there is still much to learn. There’s a risk that planning ahead, especially with a view to the size and type of storage required, could be forgotten about as purchasers look to get the best short-term deals, says Imogen Fitt.
Pathology departments in the UK are amongst the most sophisticated worldwide, thanks to an abundance of public funding and a willingness from the workforce to invest in advanced technologies. So, for a laboratory outsider it may seem strange that compared to departments such as radiology and cardiology which are already fully digitised, most pathologists are still diagnosing many of their cases using an analogue microscope.
The digital pathology (DP) market has
in recent years benefited from a spike in adoption of scanner, software and associated DP service revenues (Figure 2) but as the COVID-19 pandemic has eased, it has become clear that this rapid shift to accommodate remote workflows in lockdown environments has not (yet) been translated to full-scale digital diagnosis.
A mountain of changes Today, most NHS trusts have some form of digital workflow within their departments, and it’s become clear that to make the switch to DP is no mean feat. Significant shifts in pathologist workflows are required, accommodating everything from changes in staining protocols to order assignment processes – in short, for management, it’s a
Gross image acquisition
Integrate information with relevant LIS/EHR data
Sample preparation (Digital process can be different to analogue)
Case distribution:
View/interpret slide (may use image analysis)
Image retention
policy (if needed later), retrieve or delete and re-scan
Engage in
internal/academic RWD projects
huge logistical challenge. Whilst guidance from the NHS and the Royal College of Pathologists does exist to help smooth these transitions, despite all the progress that has been made in recent years there is still much to learn
Biopsy
about DP and the best way to deploy it, both in the UK and worldwide. The UK and Northern European countries are, however, leading this change for public healthcare laboratories globally, and as such it is imperative that each step forward is made with careful thought for future positioning to set good precedence for other institutions worldwide, and crucially avoid costly mistakes as much as possible. The decision-making process during digital pathology adoption, described in Figure 3, involves a great number of steps.
Because of the complex deployment
process and finite budgets, often some decisions offering short-term wins are given priority over others.
For example, in the initial phases of digitisation, image quality and speed
Is an MDBT meeting necessary?
Diagnose and report results
Scan
Image uploaded and pre-processed
Engage in third party RWD projects enabling personalised medecine development
Fig 1. The acquisition, use and post-use stages of digital pathology files.
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