At AZ Sint-Jan, Bruges, Belgium
Sint-Jan hospital has around 1,000 beds which generate around 17,500 cases a year, pathology cases, and they generate around 80,000 slides a year. If in general you would ask to a student will you do pathology, then they will tell you “Oh no, I get a headache from staring all day long into the microscope.” So digital pathology will make an end to this.
First of all as you can see, our desks are clean. We don’t have slides anymore on our desk which is a fantastic thing. The second thing is that I go home without neck pain that is great as well. The third thing are the collaboration tools. Digital pathology allows us to share cases with a click on the mouse, to share a case with a colleague in the department or wherever in the world where there’s internet.
Before we spend lot of time sorting out the slides by case number and by pathologist and now we just have to put the slides into the racks and load them into the scanner. Through our LIS the slides are assigned to the correct pathologist. So that way, it makes the work less stressful for the lab technicians and there’s more balance in their job.
First of all it is very easy to handle. With the mouse and the wheel of the mouse you can magnify the slides or go back. Second thing is, you can make measurements. Any pathologist everyday has superficial basal cell carcinomas. As they know if they measure less than 1mm, you can treat them with a topical, abrasive cream. And if they measure more than 1mm, they have to be surgically excised. So the tools that are very easy to use in digital pathology can help you very much with this.
Since digital pathology I can tell you, we sleep better, as the patient safety has improved a lot. This because of the unique barcode where the request form through this barcode is always connected to the right slides.
Another example of working with digital pathology is the interpretation of immunohistochemistry stains. As all pathologists know, a Ki67 is interpreted visually and in some cases it is very important if the positivity is either 14% or 16% and can even decide whether to give chemotherapy or not to a patient, so we’re still in the validation phase of this, but it can be very decisive in therapy.
In Lymphoma pathology you always typically have a lot of immunohistochemistry stains. With digital pathology you can open up to 10 slides in one screen and you can align them and then it’s very easy to compare different regions in the same lymph nodes.
Another big advantage of digital pathology is when we have multi-disciplinary consultation meetings, mostly it is in another location where we don’t have the slides available. With digital pathology this is history, we just login to the system: we have all the slides available of all the patients that are discussed.
The next steps for our department regarding digital pathology is the validation of the HALO software. The other step is to expand the digital platform consultancy where we will try to add as many hospitals as possible, either national or international.
Digital pathology in difficult and diagnostically rare diseases will lead to centralization of expertise through the consultancy platform, and this will lead to expert diagnosis. And this at the end, will lead the best patient care.