The accuracy of digital pathology compared to traditional pathology is not well studied, and some factors favor one over the other. Here are some things to keep in mind when considering implementing digital pathology in your practice:
Favoring Traditional Pathology
1. Direct Microscopy
Traditional pathology involves the direct examination of tissue-bearing slides under a microscope, providing the ability to focus through the third dimension of a tissue section: its thickness (or z-plane). While these sections are only about 4-5 microns thick (less than the size of a red blood cell), viewing all levels of tissue specimen does allow for evaluation of nuclear and cytoplasmic detail that is superior to a single-plane image that typifies most digital scans.
Having said that, viewing the z-plane is not required in most specimens, and veteran digital pathologists do not seem to “miss” it. For those concerned, there are two alternatives: 1) use a scanner that allows for z-plane scanning with its associated larger file size, and 2) view the glass slide when needed.
2. Familiarity
Pathologists have extensive experience with traditional microscopy, especially those who have been in practice for decades, and this comfort may, at least initially, contribute to more accurate diagnoses. Another advantage for some using a glass slide is the ability to speedily navigate the slide. However, this difference is often minimized with experience using digital viewing software and image navigation devices.
3. No Digital Artifacts
Digital pathology may occasionally introduce artifacts due to image capture, display, or compression. Traditional pathology avoids these potential issues.
Favoring Digital Pathology
1. Enhanced Visualization
Digital pathology creates high-resolution images that can be viewed on high-quality displays. Such viewing can provide pathologists with a detailed and magnified view of histology, potentially aiding in the identification of subtle or very focal abnormalities. The quality of the whole slide image scanner, viewing software, and screen resolution will impact the appearance of the image, so it is critical to ensure the products you select provide a high-quality result that you are comfortable with.
2. Image Analysis Tools
Artificial intelligence algorithms are becoming increasingly available and accurate and can assist pathologists in identifying, quantifying, and characterizing various diagnostic entities. These tools can reduce human error and improve intra- and inter-observer consistency. Lumea’s digital pathology platform integrates with many AI companies that are available with the click of a button. Over time, access to these tools will likely have the greatest impact on diagnostic accuracy.
3. Easier Remote Consultations
Digital pathology facilitates easier remote consultations and second opinions, allowing pathologists to collaborate with experts from different locations. Lowering the barrier of access to colleagues and other experts can lead to more accurate diagnoses.
4. Ready Retrieval of Archived Material
Archived digital slides are easier to retrieve for comparison with prior pathologic material, which can improve the accuracy and quality of a diagnosis. While also true for glass slides, timely access is often a barrier to practical use.
5. Creative Viewing
Digital images are available for creative viewing. For example, Lumea’s technology allows for multiple section levels and special stains to be viewed simultaneously, even allowing for simultaneous image navigation and zooming of up to 3 images at a time. Not only can this speed up viewing of all available levels, but it can also allow for easy tracking of a single focus of interest across levels and various stains, possibly helping improve diagnostic accuracy.
Several studies have compared the accuracy of digital and traditional pathology in various contexts. The results have been mixed, with some studies showing comparable accuracy between the two methods while others highlight potential advantages in specific scenarios for digital pathology.
In summary, whether digital pathology is more accurate than traditional pathology can vary depending on the circumstances, the specific case, and the familiarity of the pathologist. Digital pathology offers advantages in terms of image analysis, unique viewing options, ready access to archived materials, and easy remote collaboration. Traditional pathology has the advantage of familiarity and the ability to focus through the thickness of a tissue section. The choice between the two methods will depend on the specific needs and resources of the healthcare institution.
Interested in learning more about how digital pathology could positively impact your practice? Request information today about our unique product lines like our histology tech that improves specimen quality downstream for better diagnostic accuracy, our all-in-one LIS, or our consulting services. You can also try our IMS/Viewer for free today!
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