Coventry hospital leads the way on digitisation of samples for clinical diagnosis

UK first means pathologists can view samples in high resolution from any location, and paves way for computer-assisted analysis

The pathology equivalent of moving from vinyl LPs to iPods is happening for the first time in the country at Coventry’s University Hospital.

University Hospitals Coventry and Warwickshire NHS Trust (UHCW), which runs the hospital, in conjunction with Coventry and Warwickshire Pathology services (CWPS), is the first nationally to use software and digitised slides of tissues for clinical diagnosis, allowing pathologists to view samples in high resolution on their computer screens and from any location.

Traditionally, if a pathologist was working from another site and got a call about a case, they would need to return to the lab, physically find the slides and view them under a microscope in order to come to a conclusion. Or they would have to wait for the slides to be taken to them, creating delay in diagnoses and the risk of tissue slides being damaged or lost.

Digital images may have become part of everyday life, but for pathology the technology was never at the level we needed

Using the new Omnyx Integrated Digital Pathology system, once the tissues have been processed onto slides, they are scanned into the pathology computer system so the pathologist can access them securely from another site.

It also means the slides can be viewed quickly by several pathologists for second opinions as they are not all working from one physical set of slides. Therefore, this new system will help improve accuracy and speed up diagnosis and care decisions for patients.

Pathologists routinely interpret biopsy samples to advise clinicians about the diagnosis and prognosis. Now, more than ever before, this information is crucial in treating patients. In cancer diagnosis, for example, often the tumour grade can affect whether patients may be offered radical surgery, or more-conservative drug treatment.

It is also anticipated that pathologists will be able to view and decide on 10% more cases, which will help the NHS cope with the increasing demands of new treatments and an ageing population.

However, one of the most-exciting aspects of Omnyx and digitising pathology slides is the possibilities it opens up for computer-assisted analysis, which could have huge benefits for patients.

Once enough slides have been digitised, it is expected that computer algorithms can be designed to assist in many quantitative and qualitative tasks currently done by eye, such as tumour grading.

For example for prostate cancer, there are nine grades of tumour. Currently pathologists make a decision of what grade the tumours are using their eyes, a microscope, and their experience, and then a second opinion is obtained from a colleague who uses the same technique. That tumour grade is one of the major factors in deciding which treatment option will be recommended to the patient. For example, those over a Grade 4 may be offered surgery or radical radiotherapy, but those under will not.

It is hoped that eventually computer-aided algorithms will be able to refine this by spotting patterns and variances in a consistent manner.

This is where pathology has wanted to get to for years and it’s extremely exciting that we are launching this first step here in Coventry

Dr David Snead, consultant histopathologist and clinical service lead for CWPS and UHCW, is the lead for the Omnyx implementation. He said: “It may be in the future we find the optimum cut-off for radical surgery is a tumour grade 4.3 and above, rather than 4, so we are able to refine our advice and offer a more-individualised level of care to patients.

“This is where pathology has wanted to get to for years and it’s extremely exciting that we are launching this first step here in Coventry.”

CWPS, GE Healthcare - Omnyx is a joint venture of GE Healthcare and UPMC, affiliated with the University of Pittsburgh - and the University of Warwick are jointly developing a Digital Pathology Centre of Excellence aimed directly at producing these algorithms.

Andy Hardy, chief Executive Officer at UHCW, said: “Digital images may have become part of everyday life, but for pathology the technology was never at the level we needed.

“It is ready now and means that in the future our patients will have a better level of care, specific to their individual health needs.

“This is a world-class piece of technology making a difference to patients locally.”

Mamar Gelaye, chief executive of Omnyx, said: “With Omnyx, GE Healthcare is helping to transform pathology by making it possible for pathologists to quickly access relevant patient information, supporting their review and diagnosis of each patient. Our goal is to enable the use information technology to bring patient pathology cases to the right pathologist for the right diagnosis at the right time.”

The technology also opens the door to wider collaborations across pathology laboratories in the UK and beyond, allowing the transfer of histology images between centres for specialist reporting and second opinion. The technology is a key advance, enabling the efficient use of pathology expertise across hospital departments, which is one of the key strategies in delivering savings in pathology for the NHS.

It starts now with 3,000 cases over the next 10 months being viewed both digitally and on a microscope to ensure there are no discrepancies between the two.

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