“We’re all doctors. We all got into this field for a reason: the patient is central to everything we do. Using Lumea technology simply results in a better end product for our patients,” said Dr. Cole.
Digital pathology alone can only solve so much, but you know that already. After decades of promises, there’s not much to really get excited about, right? Well, what if a device existed that could measurably improve quality, accelerate tissue workflow with remarkable cost savings, and leverage digital pathology in ways that analog microscopes simply can’t?
Adam Cole, MD, a GU pathologist, was working a full-time job at Arkansas Urology when he saw some of Lumea’s technology for the first time at the LUGPA conference for large urology groups. He was particularly impressed by the Lumea BxBoard® and BxChip®.
The BxBoard replaces formalin bottles to more safely secure and preserve up to six core needle biopsies within individual lanes on top of a formalin-soaked sponge. The BxChip is a tissue-mimetic array that holds up to 6 core needle biopsies in narrow lanes from processing through the final slide.
“To me, it was kind of a slap-in-the-face moment. It was obvious why this was a much better product because by preventing tissue twisting and fragmentation, I would see more tissue on the slide and improve my cancer detection rate,” said Dr. Cole. “What’s more, I could even indicate where along each core any cancer exists since orientation from the capsule is preserved.”
He began using the Lumea technology and has enjoyed remarkable efficiency gains since six cores are processed, embedded, and stained together. He has also significantly improved his cancer detection rate via the BxChip paired with AI software. Add to that Lumea’s streamlined molecular test ordering process that lets fewer test orders fall through the cracks. All these benefits have enabled Dr. Cole to distinguish his service and expand his practice. Here are some of the things he’s been able to accomplish with Lumea technologies:
Reduce False-Negative Prostate Cancer Results
The false-negative rate for detecting prostate cancer has been reported as high as 30%. One reason is the reduction in visible tissue available for histologic review due to the fragmentation and twisting of tissue preserved in formalin jars.
Many of the clinics Dr. Cole services have replaced formalin bottles with Lumea BxBoards. The urologist simply extracts the biopsy core directly from the needle onto a sponge in each designated lane and can easily determine the quality of the core. The BxBoard maintains the orientation of the specimen relative to the prostate capsule while holding the tissue flat and in place, minimizing tissue twisting and fragmentation during transportation.
When the BxBoard reaches the lab, a lab technician transfers the cores from the BxBoard to the BxChip. The tissue never leaves the BxChip through processing, embedding, and microtomy because the patented BxChip material behaves like the tissue itself. The result is measurably increased available tissue for histologic review with reduced fragmentation that helps reduce false negative cases. Improved performance is also aided by the use of AI algorithms on digitized slides. Lumea’s viewing software seamlessly integrates third-party algorithms for a one-touch view of analyzed images, ensuring key foci are not ignored.
“By marrying all of these improvements, we’re able to maximize tissue preservation and accurately increase cancer detection rates. TruCore Pathology currently obtains samples from about 33 different states and 44 different urology groups. Our cancer detection rates are around 60%. What does that mean? Well, the national average is somewhere around 45 to 50%, which means we’re able to identify an additional 10 to 15% of true-positive cancers just by utilizing this emerging technology,” said Dr. Cole.
Improve Molecular Test Ordering and Yield
Genomic tests are a crucial part of cancer diagnostics and treatment. The typical test ordering process is cumbersome and can result in missed opportunities for patients. The clinician must first wait for pathology results, determine whether they should order a test, order the applicable test(s), have the stored block pulled from the lab, send tissue for testing, and then wait for results. The Lumea platform streamlines the ordering process so that results come sooner. Clinicians can review both the pathology and genomic test reports at the first patient return visit.
Dr. Cole worked with his urologist colleagues to determine the criteria for ordering various molecular tests. By establishing conditional ordering parameters and utilizing Lumea’s integrated test-ordering software, he reduced the overall test turnaround time by up to 10 days.
“During that initial patient consultation post-biopsy to discuss a personalized treatment plan, the urologist can have both reports ready for the patient. They can say something like ‘Hey, the bad news is you have cancer, but the good news is we have the results of your genomic testing, and you’re a good fit for active surveillance without surgery, which is why I’m going to recommend X, Y, and Z.’”
Importantly, using Lumea’s BxBoard and BxChip has reduced over-fixation and improved tissue yield, resulting in fewer specimens rejected for inadequate genetic material for testing (“QNS”).
As Dr. Cole encountered more urologists, they came to appreciate that a uropathologist could add more value than just identifying cancer and assigning a Gleason grade. It became a sufficiently compelling argument for them to switch pathology labs, and Dr. Cole’s practice quickly grew.
Save Time and Expense with Lumea’s Version of Digital Pathology
After Dr. Cole began using Lumea’s technology, he realized how much time is wasted using traditional methods. After switching to Lumea, lab materials and labor costs have been reduced up to 6-fold. And with the streamlined annotation-based direct report generation in BxLink, much less professional time is required to sign out his cases. How? First, as with any digital pathology, by scanning slides in the lab, pathologists get access to slides on Lumea’s software wherever they are without distribution delay. But Lumea offers so much more.
“Before, I had to find the case in my LIS on the computer screen, look down to identify the slide (at least 12 per case for prostates), put each slide on the stage, mark the cancer when present, estimate the measurements and quantities, turn around and either hand type everything or dictate it and have to check it all later, and then repeat for all 12 slides. In the end, very little time is actually spent looking at the tissue.”
With Lumea, signout is different. “When I use the Lumea platform, my eyes never have to leave the screen. You’re building the report in real-time with special software that only requires circling the cancer when present. Quantifying, localizing cancer along the length of each core, and populating the report are all done automatically, so at the end of looking at the tissue most of the work is already done. All you have to do is review the report and verify it for release to the urologist.”
In the End, Dr. Cole can Provide Better Patient Care
Demonstrating the benefits of Lumea technology to urologists was the key to expanding Dr. Cole’s practice. Moreover, the significant savings created an additional return on the investment for converting to digital pathology, which has been the biggest barrier to adoption so far.
Dr. Cole achieves a much higher true-positive cancer-detection rate than the national average. Additionally, by preserving tissue orientation, he has been able to provide vital information that enables urologists to make better treatment decisions based on a more precise mapping of the distribution of disease.
Furthermore, by partnering with urologists to streamline molecular test orders, patients are getting results faster, and by utilizing Lumea technology, they also reduced QNS samples.
Finally, he can provide all these services in less time and for less cost.
“We’re all doctors. We all got into this field for a reason: the patient is central to everything we do. Using Lumea technology simply results in a better end product for our patients,” said Dr. Cole.
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