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Driving Advances in Cancer Diagnostics: First Digital Pathology Center of Excellence in the UK

Last month, the University Hospitals Coventry and Warwickshire (UHCW) NHS Trust was named the first Center of Excellence in Digital Pathology in the UK. The Center will focus on discovering new ways to use digitization during the diagnosis process, from how a pathology lab is set up to more computer-assisted algorithms used in the diagnostic process.

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One year ago, the UHCW NHS Trust, in conjunction with Coventry and Warwickshire Pathology Services, became the first in the UK to use a suite of technology that digitizes slides of tissues for clinical diagnosis. Having this new technology helps pathologists at the Trust view digitized images of human tissue in high-resolution on their computer screens from any location*, instead of being reliant on the physical slides.

Pathologists have a critical role being at the front line of a patient’s diagnosis – it is their work which informs clinical decisions around what treatment and therapies to offer a patient. This makes a swift and accurate assessment vital.

“We are at the forefront of a new era of digital pathology which has the power to transform how we share and collaborate as an industry and provide patients with  the peace of mind that they are getting access to the best expertise around the world,” said Olivier Croly. “But it’s going to take several visionaries around the world to demonstrate the true value of digital pathology for the field, the hospital and most importantly, the patient. One group of visionaries are the people at the University Hospitals Coventry and Warwickshire.”

Because the Trust uses the OmnyxTM Integrated Digital Pathology system, pathologists can take advantage of the digital scanners, a knowledge-driven software platform, and being fully integrated into the cancer care team – all to help pathologists provide more individualised therapies for patients.

After a patient’s tissue is processed on a glass slide, this system digitizes the images and indexes the images onto the pathology computer system. Those slide images can then be accessed securely by the pathologist from any location*, and shared virtually to get second or third consultations from colleagues in other sites, or even other countries.

Studies have shown that seeking a second opinion or collaborating with the care team has the potential to improve the diagnosis and treatment plan in nearly one in 10 patients.[i], [ii]

Another recent academic study in the Journal of the American Medical Association (JAMA) suggests that pathologic interpretation of breast biopsies is inadequately understood, including between the pathologist and the care team.

There is a need to bring the pathologist into the care team, to increase collaboration and communication when diagnosing a patient’s case.

”This is precisely what technology within Omnyx is designed to do,” said Olivier. “Bringing the slides into a digital space enables pathologists to consult with other experts virtually. We have the opportunity to tap into the explosion of knowledge and data which in order to be effective, it needs to be synthesized and organized in a way that makes the review process as objective as possible.”

A rising challenge

Cancer cases are expected to rise by an estimated 70 percenti in the next two decades, against a backdrop of soaring healthcare costs and a shrinking clinical workforce. Statistics also suggest that a 10 percent error rate of misdiagnoses in pathology is not uncommon, which currently leads to an estimated 1.41 million cancer cases being misdiagnosed.4, [iii], [iv], [v], [vi]

Healthcare providers must find new ways to help patients tackle cancer head-on. One of the roles of the Center of Excellence will be to work with its partners and share information in order to discover new ways to use digitization as part of the diagnosis process.

This in turn may improve greater clarity in the diagnostic accuracy and the quality of treatment that is being offered, bringing direct benefits to patients in terms of better outcomes.

“If we can gain a better understanding of the individual properties of tumors when they are first identified and diagnosed, we may have a better chance of applying more personalized therapies to treat them,” said Olivier. “So, the role of the pathologist operating in a digital age is set to become ever more vital in the global battle against cancer.”

 

* With an internet connection



[i] Newman EA, Guest AB, Helvie MA, et al. Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board. Cancer. 2006;107:2346–2351.

[ii] Romanoff, et al. Breast Pathology Review: Does It Make a Difference? Annals of Surgical Oncology. Published 24 May 2014.

[iii] Hamady ZZ, et al. Surgical pathological second opinion in thyroid malignancy: impact on patients’ management and prognosis. Eur J Surg Oncol. 2005 Feb;31(1):74-7.

[iv] Coblentz TR, et al. Impact of second opinion pathology in the definitive management of patients with bladder carcinoma. Cancer. 2001 Apr 1;91(7):1284-90.

[v] Staradub VL, et al. Changes in breast cancer therapy because of pathology second opinions. Ann Surg Oncol. 2002 Dec;9(10):982-7.

[vi] Nguyen PL, et al. The impact of pathology review on treatment recommendations for patients with adenocarcinoma of the prostate. Urol Oncol. 2004 Jul-Aug;22(4):295-9.

More Information

http://www.omnyx.com/ 

http://www.nytimes.com/2015/03/18/health/breast-biopsies-dcis-atypia-diagnosis-leave-room-for-doubt.html?_r=0

http://jama.jamanetwork.com/article.aspx?articleid=2203798