I graduated from Med school in 2009. The pathology department at the Medical University of South Carolina was great, and partially responsible for me pursuing a career in pathology. I loved learning path in med school.
Your enthusuasm is fantastic. As a senior (human) pathologist myself and also a digital image analyst (MSc and PhD in the latter) - I just don't understand the propensity of digital pathologists (DP) to want to get rid of glass and the microscope. I mean, there is room in this world for both - both are good and have their uses. How easy is it for a DP to do the equivalent of rotating a polariser under their condenser and assess how birefringence changes with polarisation angle? It takes me only a few seconds. How easy is is for a DP to rack the fine focus up and down to get a sense of depth and whether a particle lies on top of a cell or in it? Think of all the TB of data needed to capture all the optical properties of the physical tissue section - something that has no correlate in radiology - and how much it will cost to store and maintain that? I just put my slide in a file. The interesting innovations Prof. Levenson is talking about might, at best, be a replacement for frozen sections and a few other 'instant' pathology requirements but how would they in any way 'replace analogue' or 'replace glass'? Can you stain them for glycogen with a PAS? or mucin with a n Alcian Blue? or specific antibodies? There is a lot more to 'analogue' pathology than H&E. I think the enthusiasm of the DP to want to ditch glass and the microscope is ill informed.
Thanks. Those are very reasonable questions. I think the evolution of the field may eventually be dictated by economics as much as technical features. Being able to skip slide preparation and go directly to digital could cut out hours and dollars----benefiting patients and clinicians who now have clinical tempos (tempi?) that necessarily involve days to weeks of delay, depending on logistics. There is the additional potential that a lot of the information now obtained with PAS or Alcian Blue MAY be implicit in the FIBI images, especially if a stain cocktail is developed that included additional components that would help highlight those features. Nevertheless, the immediate application space is definitely frozens, core needle biopsies, and other rapid scenarios. Also, thinking about race horses--if they are driven 100 miles one way to the vet clinic for a bx, and then have to come back across those 100 miles a week later, that's a burden, especially for the horse.
Great perspective, and I agree that every tool hat their application. How I see the necessities/ applications of glass that you are describing is as something that would be requested as special work after evaluating the specimen without glass. These are most of the time special stains that need to be requested separately by the pathologist. This will not change, and if this will be the best modality to evaluate whatever needs to be evaluates, that's ok. If that's the best method for the job, that's totally fine, but if there is a faster/ simpler less costly method to do the same, I am for using it.
Can you imagine glassless pathology lab?
I graduated from Med school in 2009. The pathology department at the Medical University of South Carolina was great, and partially responsible for me pursuing a career in pathology. I loved learning path in med school.
So happy you chose pathology!
This glass less conference sounds intriguing. Please keep me in the loop.
I definitely will! I'm excited about this technology.
Your enthusuasm is fantastic. As a senior (human) pathologist myself and also a digital image analyst (MSc and PhD in the latter) - I just don't understand the propensity of digital pathologists (DP) to want to get rid of glass and the microscope. I mean, there is room in this world for both - both are good and have their uses. How easy is it for a DP to do the equivalent of rotating a polariser under their condenser and assess how birefringence changes with polarisation angle? It takes me only a few seconds. How easy is is for a DP to rack the fine focus up and down to get a sense of depth and whether a particle lies on top of a cell or in it? Think of all the TB of data needed to capture all the optical properties of the physical tissue section - something that has no correlate in radiology - and how much it will cost to store and maintain that? I just put my slide in a file.
The interesting innovations Prof. Levenson is talking about might, at best, be a replacement for frozen sections and a few other 'instant' pathology requirements but how would they in any way 'replace analogue' or 'replace glass'? Can you stain them for glycogen with a PAS? or mucin with a n Alcian Blue? or specific antibodies? There is a lot more to 'analogue' pathology than H&E.
I think the enthusiasm of the DP to want to ditch glass and the microscope is ill informed.
Thanks. Those are very reasonable questions. I think the evolution of the field may eventually be dictated by economics as much as technical features. Being able to skip slide preparation and go directly to digital could cut out hours and dollars----benefiting patients and clinicians who now have clinical tempos (tempi?) that necessarily involve days to weeks of delay, depending on logistics. There is the additional potential that a lot of the information now obtained with PAS or Alcian Blue MAY be implicit in the FIBI images, especially if a stain cocktail is developed that included additional components that would help highlight those features. Nevertheless, the immediate application space is definitely frozens, core needle biopsies, and other rapid scenarios. Also, thinking about race horses--if they are driven 100 miles one way to the vet clinic for a bx, and then have to come back across those 100 miles a week later, that's a burden, especially for the horse.
Great perspective, and I agree that every tool hat their application. How I see the necessities/ applications of glass that you are describing is as something that would be requested as special work after evaluating the specimen without glass. These are most of the time special stains that need to be requested separately by the pathologist. This will not change, and if this will be the best modality to evaluate whatever needs to be evaluates, that's ok. If that's the best method for the job, that's totally fine, but if there is a faster/ simpler less costly method to do the same, I am for using it.