- Global digital pathology is likely to reach USD 1.67 billion by 2026
- Although pathology has been a traditional domain for decades now, the emergence of Artificial Intelligence (AI) and Machine Learning (ML) has led to its digitisation.
- Digital pathology is not just used for day-to-day blood tests, but also enables cellular, molecular and genetic imaging for clinical screening and diagnosis.
In 2019, HealthCare Global Enterprise Ltd. (HCG), the cancer care specialist, became the first hospital in India to completely digitise pathology for primary diagnosis at the HCG-Strand Laboratory in Bengaluru, paving the way for several others to follow suit.
According to The Digital Pathology Association (DPA), digital pathology is defined as a “dynamic, image-based environment that enables the acquisition, management, and interpretation of pathology information generated from a digitized glass slide.”
Even though digital pathology has been around for years, it has assumed a significant role in the times of Covid. With social distancing as a norm, pathologists can now work from home and control their microscopes, as well as view slides in real-time or continue to provide diagnostics remotely, keeping high-risk communities safe. This trend is likely to be further accelerated in the post-pandemic age, say experts.
In the past, pathologies relied on conventional methods that would not just take more time but also lead to grave errors in diagnosis. Today, the picture looks more promising with an increasing number of hospitals and laboratories adopting Artificial Intelligence (AI) and Machine Learning (ML) to make healthcare more efficient and scalable.
From Microscope to Monitor
Interestingly, projections suggest that global digital pathology is likely to reach USD 1.67 billion by 2026, according to a report released by Grand View Research. This is largely driven by the need for more accurate testing and enhanced efficiency, skewed ratio of pathologists in the country and the demand for faster diagnosis, especially in fatal diseases such as cancer.
In an interview to Express Healthcare, Dr. Ajay Phadke, Centre Head, Dr. Avinash Phadke Pathology Labs shared, “The most important side of technology adoption is to deliver a faster and advanced diagnosis. With around 70 per cent of medical treatment dependent on diagnostics, it becomes imperative for the industry players to consistently provide accuracy in a timely manner. And technology will serve as a critical enabler to deliver quality healthcare support to patients as well as clinicians. Consolidation of healthcare in larger metro cities and tier 1 cities is inevitable. This will be fuelled by more automation, point of care devices and higher accessibility by providing services in the patient’s home environment.”
Besides, another huge advantage is extending these benefits to build the remote healthcare model. The patient does not have to physically travel to a clinic or get his sample transported, thereby forming a conjugal relationship with telemedicine.
In 2019, Neuberg Diagnostics and OptraSCAN, announced the launch of Neuberg DIGIPATH, Powered by OptraSCAN. The joint venture combines histopathology and cytology services provided by Neuberg Diagnostics with digital pathology capabilities offered by OptraSCAN and brings to the table a whole new array of services related to digitisation of tissue slides and telepathology, across UAE, India and South Africa.
“Digital pathology is all about going to the ground level, to the village level, to the district level, from the cities, and this helps to give the results in a more accurate and timely manner. That will be particularly useful to patients at the village level. But people are mainly concentrated in the metropolitan cities. We have to develop the infrastructure and the government also has to support it. The holistic development from end-to-end is important,” shared Bhaskar Ghoshal, Sr. Vice President – Commercial at Neuberg Diagnostics, with The Blue Circle.
With a Centre of Excellence for Genomics, AI and Data Analytics, Neuberg aims to make diagnostics more accessible and affordable. The company also plans to open technology incubation centres and clinical laboratories in USA and Europe to access the latest tools and make developing countries prepared for precision diagnostics.
“In smaller places, where there is no access to good pathologists, if they have a scanner, they can get slides reviewed by any of the best pathologists in India. This is extremely helpful and rather a game-changer in healthcare,” Bharti Ramnani, Consultant (Oncopathology), Holy Spirit Hospital, and Consultant (Histopathology), Dr L H Hiranandani Hospital, shared with TBC.
There are also other aspects that are helpful. Unlike earlier, two pathologists can view the same slide in real-time and take expert opinion, instead of viewing the sample separately under a microscope. This has brought about a huge transformation in healthcare, minimising the risk of error and providing services with utmost efficiency.
Integration with New-age Technologies
Digital pathology is not just used for day-to-day blood tests, but also enables cellular, molecular and genetic imaging for clinical screening and diagnosis. A glass slide that contains either a tissue section or a blood smear is converted into a digital file that can be studied as a virtual file, the same way it is analysed under a microscope. For a pathologist, it has now become simpler to zoom in and out to capture certain areas, thereby making it more feasible to decode complex cases.
By utilising the Internet of Things (IoT), temperature can be checked on a blood sample automatically through a software, something that was done in a manual way earlier.
Artificial Intelligence and deep learning have improved the accuracy rate of the reports, while web technology is helping patients and pathologists to connect with each other in a simple manner. Deep learning is also being increasingly used in predictive medicine to build algorithms not just for cancer, but also to analyse probable behaviour and suggest appropriate treatment.
Moreover, by turning microscopic slides into digital files, labs are able to generate big data analytics that can be further used to solve complex healthcare problems, as well as enhance medical education. It has enabled medical practitioners to gather information about individual patients, right from their daily habits to complex information such as their genetic code.
“It is also being used in academic institutes. Normally we study slides in blocks, so preserving slides and blocks over years becomes very cumbersome and even the quality of slides will degrade. For teaching cases, especially in unusual cases, it becomes extremely difficult to retrieve it. So, it is also useful for both teaching and research purposes,” added Bharti.
What Lies Ahead?
Digital technologies could transform the job of pathologists into a more creative and data-driven profession, but there are certain limitations.
“The entire setup as well as getting cloud storage is also quite expensive. The files are also very large. In a small hospital, it might not help much, but otherwise it might be useful in a large setup,” pointed Bharti.
Besides, there’s another concern expressed by pathologists and clinical experts, and that is standardisation. Acquisition of images, storage and management, transmission as well as sharing all require standardisation, which might take some time. Providing cost-effective and efficient healthcare services in India is a big challenge, and digital pathology aims to change that, one step at a time.
(Edited by Anu Choudary)
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