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Digital pathology takes the PACS route to earlier diagnosis

The Northern Cancer Alliance aims to improve cancer survival rates across the North East of England and North Cumbria with an integrated digital pathology system that will see scanned pathology slides delivered to a centralised data repository via PACS for the first time.

The consortium has signed a five-year contract with Sectra for the delivery of a platform that will enable 115 pathologists at nine hospitals to instantly access and share images and information between departments and locations.

With an annual average of 300,000 examinations conducted between them, pathologists will be able to access all images produced across the alliance and get a consolidated view of a patient record from a single interface. Clinicians working anywhere within the consortium will be able to ask for second opinions and hold multi-disciplinary team meetings.

WHAT’S THE IMPACT?

As well as giving pathologists digital access to current and historical images from anywhere and at any time, the digital solution will provide them with assistance at critical decision points, such as grading or doing more precise measurements.

It will also enable image analysis, reducing variation and improving the precision of tasks such as cell counting. Digital access will further facilitate second opinions, external reading resources, specialist consultations and regional MDT case review meetings.

Dr Paul Barrett, histopathologist at County Durham and Darlington NHS Foundation Trust and co-clinical lead of the project, said the development represents the biggest and most exciting chance to the way cellular pathologists work in a generation.

“Digital pathology will be an enabler for collaborative working across large geographic areas, streamlining pathology diagnostic decision making, particularly for cancer diagnosis and multidisciplinary team meeting discussions,” he said.

According to Alison Featherstone, Northern Cancer Alliance manager, the new system will also improve clinical safety, ensuring the best use of skilled pathology staff to achieve faster earlier cancer diagnosis.

“The system will support earlier diagnosis of cancers by using computer-aided algorithms that can highlight areas of images where cells are dividing rapidly and guide the clinicians to those areas for examination,” she said. “It will also enable more accurate measurement of and comparison of images using panoramic images.”

WHAT’S THE TREND?

While digital pathology has become widely used in research during the last decade, this is the first time it will be deployed on such an extensive regional scale. The system will use PACS-based reporting, integrated with local patient administration and Laboratory Information Management Systems (LIMS) to facilitate workload balancing across the consortium and equal access to specialists for all patients in the region.

In the long term, the system will be used to enable trusts to develop regional workflows, optimise use of available pathologists, develop best practice, and create structured reports to help extract information for analysis and research.

ON THE RECORD

Dr Sonali Natu, histopathologist at North Tees and Hartlepool NHS Foundation Trust and co-clinical lead of the project, said: “As an integrated health and care system, we need to move away from isolation and head towards integration. This platform will deliver a large part of that ambition for the patients we serve. The digital access to pathology images and digital tools for reviewing them will in the end translate into easier collaboration, more resilient services and improved patient care.”

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