For those who don’t know, NationWide Laboratories have now gone digital with their pathology capabilities with the addition of the 3DHistech Pannoramic 1000 RX (P1000) digital scanner. The P1000 is a high-capacity scanner that can scan 100 slides an hour and about 2,000 per day. Its high resolution allows for the processing of cytology, haematology and histology samples.
The images produced by the P1000 scanner are top quality, and it also has the ability to process images via “water immersion”, making it one of the few machines in the UK that offers this outside of research facilities. Water immersion means we can achieve the same level of magnification as oil immersion, which is particularly useful in viewing cytology and haematology samples.
The machine has the capability of speeding up work efficiency remarkably.
The stalwart of histopathology has always been the haematoxylin and eosin (H&E)-stained glass slide. Normally, the tissue would come into the laboratory to be processed, cut and mounted on a glass slide before the glass slide is passed on to a pathologist – whether they are a remote pathologist, a pathologist in one of our different sites or even a specialist somewhere else. This has always been the limiting factor of pathology.
Having a digital image means it can be sent anywhere in the world as soon as it’s scanned, which speeds up reporting, particularly for second opinions or specialist opinions. It’s also great for teaching purposes.
The view yielded from a scanned image is far superior to that of a microscope, giving a full view of the entire sample all at once rather than the constraints of the field of view from a microscope objective. It also offers additional advantages, such as the more accurate measurement of surgical margins.
The addition of artificial intelligence (AI) to digital images also allows for progression towards reduced interobserver variation, resulting in quicker, more accurate and more reproducible diagnoses.
Another advantage is, of course, the fact that pathologists are not going to be just looking at H&E sections for much longer. The world of pathology is definitely changing, and we’ve already moved from just looking at H&E slides to immunohistochemistry and molecular diagnostics in histology.
Digital imaging opens up a whole new avenue of AI- and deep learning-focused diagnostics. These AI algorithms look for cell variations and patterns that are beyond the ability of the human eye. Scientists are already using deep learning for grading prostate biopsies and identifying biomarkers in breast cancer in human medicine. This is where it gets really exciting!
AI and deep learning can predict changes in the genome of a cell towards a particular type of cancer: changes called “high-level labels”. This means that where we would have needed immunohistochemistry or additional molecular testing in the past, we can now use a single sample on a simple H&E slide to get the same information with AI looking for these high-level markers. This means reducing the time for final diagnosis, prognosis and potentially, with the move to individual “personalised medicine” on a genomic level, treatment as well.
In particular, there is an increasing focus on predicting clinically relevant labels directly from histology in three major areas: inference of genetic alterations, prediction of survival and prediction of treatment response.
While veterinary medicine still lags behind its human counterparts in this arena, NationWide Laboratories stands ready to move the moment the opportunity arises with the addition of our P1000 digital scanner.