Digital-Pathology-Today

“We shall not cease from exploration and the end of all our exploring will be to arrive where we started and know the place for the first time” - TS Eliot. Is it possible to predict molecular biomarkers from H&E sections through deep learning and computer vision? After all the Hematoxylin and Eosin section was one of our first tools in our arsenal. Molecular diagnostics came center stage in the 1990s and 2000s. Can we know can we now go back to the H&E and predict the molecular features? Our guest is Heather Couture of Pixel Scientia, where she accelerates machine learning projects for pathology startups. She has a PhD in Computer Science and has published in top-tier computer vision and medical imaging venues. She is the host of the Impact AI Podcast and writes regularly on LinkedIn, for her newsletter Pathology ML Insights, and for a variety of other publications. We're going to be talking about artificial intelligence and computer vision in digital pathology. First of all, what do we even mean by artificial intelligence? What is the difference between AI, a computer program, or simply just crunching large amounts of data? How do we develop tools for digital pathology; what are some of the challenges and pitfalls? And yes the “V” word - what do we mean by validation? How do we go about validation in the digital era? And finally, what about those pesky preanalytical factors? Will it even be possible to develop new tools without standardizing or accounting for variability in tissue processing, staining, and scanning?

Amidst this digital transformation in pathology, it's not only the review of histologic sections that is going digital and moving online, but practically everything else is too. What does this mean for the future of publishing and pathology education with the advent of online content and delivery mechanisms? Our guest is Jason Hornick, MD, PhD, Director of Surgical Pathology and Immunohistochemistry at Brigham and Women's Hospital, Professor of Pathology at Harvard Medical School, a pathologist with expertise in soft tissue tumor pathology, gastrointestinal pathology, and diagnostic immunohistochemistry. He is the Editor-In-Chief of the 5th series of the AFIP Atlases of Tumor and Non-tumor Pathology. Dr. Hornick serves on 14 editorial boards, including the American Journal of Surgical Pathology and Modern Pathology. He is dedicated to the advancement of diagnostic surgical pathology, and teaching approaches to diagnostic pathology to trainees and practitioners We're going to be talking about the mission and history of the American Registry of Pathology, the publishers of the beloved fascicles atlases of tumor and non-tumor path now in its fifth series. What is the future of publishing going to look like with the advent of online content which can be updated much more frequently than the traditional 5-to-10-year cycle of publishing hard copies of books? What does online content social media and other forces mean for peer review and scientific authority? And what is the future of education going to look like not only for pathology trainees but also education for all pathologists?

One of the biggest pieces of news we've gotten in 2022 is the announcement of new CPT codes from the American Medical Association specifically for digital pathology. What are CPT codes? Why should we care? How will these new codes help us to elevate the practice of anatomic pathology and allow us to more concretely articulate a value proposition for digital pathology? Our guest is Nathan Buchbinder, Chief Product Officer and cofounder at Proscia. We discuss the new CPT codes and much more. We get a current lay of the land for digital pathology in mid-2022. How far have we come in the past five years or so? How far have we come in the past year - which has seen dramatic changes and acceleration in many areas. How do the US and Europe differ in adoption and outlook and what are some continuing barriers to the adoption of digital pathology?

Conquering cancer through Artificial Intelligence is the goal of our guest this week on Digital Pathology today. We're talking with Brandon Suh, MD, CEO of Lunit, a South Korean company creating applications utilizing Artificial Intelligence in both digital pathology as well as radiology. Lunit stands for “learning unit,” which is fundamental to the company's philosophy which embodies the belief that they can learn just about anything and is foundational to the Artificial intelligence, which involves continuous learning. The company has developed algorithms focusing on disease screening in the areas of mammography and chest X-ray in radiology and predictive and prognostic markers in digital pathology - in particular an AI based algorithm for immunotherapy, which outperforms the current standard of care. Lunit is looking to capitalize on the growing trend of Artificial Intelligence in medicine and is also capitalizing on another trend by developing a unique partnership in the liquid biopsy space as well.

As we kick off this third season of digital pathology today our guest is Dr. Kevin Sandeman, from the Region Skane in Sweden, who is going to be taking us through their digital transformation. The Region Skane covers a population of over 1.4 million people, involves four health care systems including two academic and two community centers. The caseload is over 110,000 cases per year - generating over 680,000 scanned slides. This is a wonderful story, and the benefits are maybe not what you would expect. In addition to the obvious benefits of not having to he tethered to a microscope, according to Dr. Sandeman, the number one benefit resulting from the digital transformation is “Peace of Mind.” The departments in the region enjoyed much higher quality in terms of histologic preparations and output, enhanced engagement and understanding among the histotechnologists, reduction of hystertechnologist FTE requirements and complete elimination of the need to work overtime. Turnaround time for case reporting has dropped an astounding 33% and clinician satisfaction is remarkably increased. We also talked about some of the challenges in adopting the digital workflow not to mention the IT infrastructure requirements and storage demands but at the top of the list appeared to be the initial pathologist resistance to adopting the digital workflow.

The digital transformation in pathology is well underway but what kind of opportunities does this present to us? We've heard all the buzz words such as machine learning artificial intelligence and heard all the hype about enhanced workflows and making pathologists' lives easier. What is the future practice of pathology going to look like? Our guest is Beatrice Knudsen, MD, PhD, Medical Director of Digital and Computational Pathology at ARUP Laboratories, as well as Professor of Pathology at the University of Utah. Dr. Knudsen has built a program that integrates histopathology, multiplex tissue staining, digital image analysis, as well as computational pathology. She is applying this approach to close the gap between laboratory research and clinical care and to develop novel algorithms for diagnosis, prognosis and the treatment of patients.

They're coming - AI and machine learning algorithms in digital pathology. How do we go about assessing the robustness and suitability of these new tool for use in actual clinical practice? Our guests are Dr. Angelique Levi, Associate Professor of Pathology and Vice Chair and Director of Pathology Outreach Services and Dr. Sudhir Perincheri, Assistant Professor of Pathology and Director of Digital Pathology, both from Yale School of Medicine. We're talking about how new tools are going to be incorporated into clinical practice, and the impact of these new tools in various practice settings, such as academic medical centers, community outreach, and private practice. What does this mean for the training of the next generation of pathologists? We're only human, after all, but what about machine algorithms? What level of mistakes or "misses" is allowable? And what if these tools are too sensitive, could they actually slow us down and make life more complicated for us?

Too many systems or components in a pathology workflow adds complexity and cost. How can we create an elegant end to end solution to enhance workflows, while decreasing both complexity and costs? Our guest is John Wirthlin, CEO of Lumea, a company reimagining pathology - beginning and ending with the patient. We discuss the end-to-end solution in digital pathology. One of the promises of digital pathology is making the pathologist's workflow more streamlined and more efficient. But can we bring the Laboratory Information System (LIS) into the clinic and improve the workflow flow for our clinician colleagues as well. How can we improve the tissue handling or preanalytic phase of testing? It's often easy to forget who the customer is. By utilizing enhanced workflows, can we improve satisfaction for the clinician, who is ultimately treating the patient?

Amidst this digital transformation in pathology the talk seems to be largely centered around whole slide imaging of H&E-stained tissue sections. But what about cytology? Why don't we hear much talk about digital cytology, and what are some of the unique challenges in cytology in terms of going digital. Our guest is Michael Quick, Vice President of Research and Development and Innovation at Hologic. We discuss the history and evolution of cervical cancer screening all the way from pap smears to thin prep to incorporating digital pathology and image analysis in the process. Will we finally be able to say goodbye to the light microscope? And what are some of the parallels and lessons learned comparing cervical cancer screening by cytology in pathology to breast cancer screening by digital mammography in radiology.

What is going to surprise us in digital pathology in big ways and in small ways? How can seemingly small changes make a big impact in what we do as pathologists and in the lives of patients? How are we going to make use of the large datasets that we will inevitably be generating through the widescale adoption of digital pathology? Our guest is Louis Culot, General Manager for Genomics and Oncology Informatics at Phillips. We're going to be talking about the current landscape of digital pathology in 2022, where we've been in the past 20 years and even earlier, and the impact of the COVID-19 global health emergency on the acceleration of the adoption of digital pathology. And what is the future of integrated diagnostics, incorporating digital pathology radiology and molecular diagnostics.

It's easy to get caught up in the hype surrounding digital pathology. But what is actually involved and going digital? What are the steps involved? We know about scanners and viewing images, of course. But what other pieces of software might be necessary or helpful? Coleman Stavish is co-founder and CTO at Proscia, a leading provider of digital and computational pathology solutions. At Proscia, Coleman works with a team of engineers and scientists who develop enterprise software in use at leading laboratories and large biopharma companies around the world, as well as novel image classification. We're going to be talking about workflows in digital pathology and the importance of the image management platform. What are the considerations in going digital, how can all of our software work together and how can we truly realize the promise of digital pathology by incorporating AI algorithms and other tools?

NVIDIA is involved in computer graphics, artificial intelligence, computing and processors across variety of industries including gaming, entertainment, finance, and health care. What are the commonalties of all these industries and what lesson from other fields can we apply to healthcare? Our guest is Craig Rhodes EMEA Industry Lead - AI for Healthcare and Life Sciences at NVIDIA. There is the perception that healthcare lags other industries in terms of AI applications. Is this true or is it a misconception? How is AI changing healthcare now and for the future How can we accelerate the adoption of AI and new technologies in health care? NVIDIA has launched Cambridge-1 - a powerful supercomputer in the UK. We will learn about this and what results we can expect from Cambridge one in the difference this will make in healthcare in the lives of patients.

Our guests are Dr. Garth Bryson Consultant Pathologist and Clinical Director for Laboratory Medicine at the NHS Greater Glasgow and Clyde and Dr. David Harrison, Professor of Pathology from the University of Saint Andrews, and both from ICAIRD - the Industrial Center for Artificial Intelligence Research and Digital Diagnostics a program matching AI solutions and research with health and social care priorities across Scotland. We talk about the long journey of implementing digital pathology in a large health care system, barriers to adoption of digital pathology, the promise of artificial intelligence, the business case for digital pathology – have we finally been able to articulate one? And finally, we discuss our guests' experience so far in creating a digital slide sharing network throughout Scotland.

Our guest is one of the giants in the field of digital pathology and image analysis. And if he has seen further than others, he will tell you, it is because he was able to stand on the shoulders of giants as well. His unique multidisciplinary approach has allowed him to breakdown silos and see across the often-artificial barriers and distinctions imposed by academic disciplines and patient treatment paradigms. We're talking with Professor Anant Madabhushi, Director of the Center for Computational Imaging and Personalized Diagnostics and Professor of Biomedical Engineering, Radiology, Pathology Urology and Radiation Oncology at Case Western Reserve University. We discuss silos in academic departments and disease states and how looking beyond these limitations can propel progress. What exactly is image analysis, what if we've been able to do with it so far and what predictive and prognostic information can we unlock from histologic features. And finally, how can an image analysis and non-tissue destructive computational and AI powered methods help to democratize access to care and lead to better outcomes for patients across the world.

What have we been waiting for? What's taking so long? Much of the technology surrounding digital pathology has been with us for over 20 years. After fits and starts and initial excitement we've been left with disappointment in the past ten years. But now, it seems like the tide is turning and the digital transformation is here. Our guest is Richard Lash, MD, Chief Medical Officer from Lumea, a company re-imagining pathology by developing a comprehensive end to end workflow. Dr. Lash has had a long career as a pathologist as well as holding leadership positions in addition to Lumea at several prominent organizations including Inform Diagnostics, Ameripath and Mount Sinai Medical Center. We're going to be talking about how the lack of a cohesive business for digital pathology, lack of a vision to integrate exciting new technologies into everyday workflows has hindered the adoption of digital pathology; what has changed and why now with compelling new technologies including artificial intelligence, we can finally begin to develop and incorporate end to end solutions that can enhance pathologist performance and improve outcomes for doctors and patients.

We've all seen it in science fiction movies and maybe somewhat in consumer tech culture with things like Google glasses, or Pokémon GO. Augmented reality – an enhanced version of the physical world through the use of digital visual elements - does it have a role in digital pathology? Gabe Siegel is the CEO and co-founder of Augmentiqs, a company that develops augmented reality and digital pathology capabilities for the existing microscope. Prior to starting Augmentiqs, Gabe worked for multiple medical device and digital pathology companies, focusing on marketing strategy and communications. Gabe developed the concept for augmented reality microscopy & microscope-based digital pathology. We discuss what exactly is augmented reality? What are the benefits - can it really save time and money?

In this digital transformation of pathology, much of the focus is, of course, on the imaging of histologic sections or glass slides, which were once viewed under the microscope. It's often easy to forget that the examination of the specimen begins much earlier in the process - in the gross room or even in the operating room. Our guest is Vikram Butani, CEO and founder of Kubtec, whose passion is developing transformative specimen imaging, and specimen radiography systems that enable medical professionals to provide the best quality of care for their patients. Kubtec has developed range of advanced specimen radiography systems provide high resolution specimen X-ray for the biopsy suite, the operating room, the pathology gross room and the morgue. In addition, KUBTEC Specimen Radiography Systems include proprietary workflow management tools to help reduce turnaround time and labor costs. We're going to be talking about the history of Kubtec from humble beginnings, what the digital transformation of radiology has meant for imaging in other parts of the hospital - specifically the pathology gross room and the OR. We discuss the critical role of the pathologist's assistant in the diagnostic process, the value of specimen imaging and how it can impact cost, time and efficiency. And finally, what does the future hold? and how will 3D imaging enhance what we do and ultimately bring better care to patients?

The big trend in oncology over the past few years has been immunotherapy. this trend is converging with the digital transformation we are undergoing in pathology we seem to be at the crossroads of immune-oncology, digital pathology, image analysis, artificial intelligence, and the increasing ability to Multiplex. Our guest is Keith Wharton Jr., MD, PhD from Ultivue, a company looking to reveal actional biology through multiplex immunofluorescence to make immunotherapy a reality for patients with cancer. Keith is a board-certified anatomic pathologist with diverse achievements in research, drug and diagnostic development, and clinical investigation. He leads Ultivue's Pathology and Biomarker Analytics team. We'll be discussing what is the need for multiplexing. How much information can Multiplexing add above and beyond standard methods. When do we reach the point of diminishing returns? what are some challenges to implementation and risks of complexity and system failure? In addition, we'll talk about specific applications for immunofluorescence and multiplexing versus the current state of the practice including immunohistochemistry and quantifying tumor infiltrating lymphocytes on good old-fashioned H&E sections.

The Armed Forces Institute of Pathology (AFIP) was in existence from 1862 to 2011. Many of us in pathology know it as the publisher of the “tumor fascicles” or the Atlas of Tumor Pathology series, originating in 1947, as well as a center of consultation and tissue repository unparalleled in the world. The AFIP was reborn as the Joint Pathology Center (JPC), whose mission is to deliver cost-effective, high-quality, multidisciplinary pathology consultation and education; and preserve, modernize, and grow the nation's oldest tissue repository to promote biomedical research. The JPC is home to the largest collection of human pathologic specimens in the world, unparalleled in size, age, and diversity. The challenge now is to digitize this collection. In this episode of Digital Pathology Today, our guests are COL Joel Moncur, Director of the Joint Pathology Center and Katie Olson, Acting Director of the Defense Digital Service (DDS). Dr. Moncur became the Director of the JPC in August of 2018. His priorities as Director include digitally transforming the JPC repository and ethically using the data to develop collaborative artificial intelligence algorithms that can lead to new insights into specific disease states or clinical scenarios. At DDS, Katie Olson oversees products and operations for the 80-person rapid-response team working within the Office of the Secretary of Defense. As a Highly Qualified Expert (HQE), Olson brings both her government and private sector experiences to bear on these important initiatives. We discuss the history of the AFIP through its disestablishment in the early 2000s and its rebirth as the JPC. What is DDS and what types of projects do they work on? The massive undertaking which many people are excited about is the project to digitize the JPC collection. We'll learn about the size, scope and goals of the project. And, of course, artificial intelligence (AI) is a very hot topic - particularly in digital pathology. How will AI be incorporated in this project?

We hear that multiple file formats or perhaps, more importantly, lack of a uniform file format seems to be a big issue in digital pathology. Why is this? What do we even mean by a file format? And will we be able to overcome this barrier on the road to full scale adoption of digital pathology? Yves Sucaet, a PhD in Bioinformatics, has a research background in systems and network biology. In 2012, he became intrigued with the idea of applying bioinformatics algorithms to virtualized microscopic material (whole slide images). Back in Belgium, he went on to co-found Pathomation, together with Dr. Wim Waelput and Dr. Mark Kockx. The mission of Pathomation is to provide software (middleware) for digital pathology, allowing any organization to efficiently implement any digital pathology workflow imaginable. We discuss why there are multiple file formats and the challenges this causes. Do different types of applications necessitate different file formats? (i.e. 2d vs. 3-d imaging, H&E staining vs. fluorescence?) How does evolving technology and new vendor specific applications create problems? And of course, DICOM seems to be the most talked about format. Why has it become the standard in radiology but not pathology?

Imagine a world without staining… in the excitement of digital pathology we often forget that we're using with a legacy system of staining tissue pink and purple, which is time-consuming and tissue-destructive. There's got to be a better way. Our guest is Dr. Gideon Ho, who co-founded HistoIndex to develop and commercialize the world's first fully automated, quantitative, stain-free imaging system. Under his direction as the CEO, the laser-based stain-free imaging system has been successfully implemented in academic, clinical and commercial research centers in major universities, hospitals and research facilities around the world. Dr. Ho has multiple patents and journal publications in medical imaging, lasers and optics to his credit. We're going to discuss the promise of Stain-free digital pathology and the technologies developed at Histoindex. What is multiphoton technology? What is second harmonic generation (SHG)? The clinical applications Histoindex is focusing on first is NASH – nonalcoholic steatohepatitis. What is NASH? what is the unmet need? How does it affect society. What are the diagnostic challenges?

What is The State of the Practice of digital pathology as we enter 2022? Where are we in terms of integrated workflows, predictive and prognostic algorithms based on H&E morphology, and incorporating AI into workflows or diagnostic assistance? Perhaps most pressingly, have we finally made the business case for wide scale adoption of digital pathology? Our guest is Michael Feldman, MD, PhD, Professor of Pathology and Laboratory Medicine at the University of Pennsylvania as well as Vice Chair for Clinical Services and Director of the office of Pathology Informatics. We're going to be talking about all these things and in addition perhaps a perspective on digital pathology in an academic setting. Will digital fellows become a reality - artificial intelligence enabled machines that will organize, prepare, preview, maybe even diagnose cases and prepare the report for sign out? We'll discuss what image analysis and computational algorithms mean for the diagnostic acumen of trainees in the next generation of pathologists.

In addition to interpreting patient biopsies and signing out cases, pathologists perform a wide variety of functions - including intraoperative consultation or frozen section, presenting cases at tumor boards or other conferences, doing procedures, or assessing the adequacy from image guided biopsies. This is done in a wide variety of practice settings. Many times, it's done over a very large geographical area where the physical presence of a pathologist may be impractical or highly inconvenient. Our guest is Hannah Gilmore, MD, Chief of the Division of Anatomic Pathology at University Hospitals Case Medical Center in Cleveland. We're talking about the unique challenges and pain points pathologists face in the large hospital system covering a large geography. How can digital pathology help alleviate some of these challenges? What are specific applications that, if implemented, would give us immediate benefit? How can digital pathology make pathologists more productive - particularly in areas not strictly related to primary diagnostic activity?

We welcome back Professor Hamid Tizhoosh from KIMIA Lab and now of the Mayo Clinic. Dr. Tizhoosh was one of our most popular guests from last season. We talked about artificial intelligence, but it seems like we barely scratched the surface. AI is such a hot topic - so before we go any further, we'll go back to a rough definition of Artificial Intelligence. In Machine learning a theme we keep hearing about is supervised vs. unsupervised learning. What does that mean and why is it important? The concept of validation is critically important in pathology and laboratory medicine. What does this mean in the context of Artificial intelligence? What is image archiving? And how does image search work? We discuss the difference between tissue representation and patient representation and why this distinction will be critical for the future of digital pathology and moving precision medicine forward.

We all want to do the right thing - but how do we know what that is? What is ethics and what is the difference between ethics and the law? Our guest is Brian Jackson, MD, medical director of IT, business development and support services at ARUP, as well as associate professor of Pathology and adjunct associate professor of biomedical informatics at the University of Utah. We're talking about the foundational principles of ethics in science and medicine. What are the limits of informed consent as it applies to developing new products utilizing patient data? Is technology evolving faster than our ability to regulate it? How do we get comfortable with and regulate algorithms and devices that appear opaque or black box? And what will the future hold as we increasingly have the ability and responsibility to develop these great new tools to help patients?

We keep hearing that one of the promises of digital pathology is the ability to develop AI based algorithms and tools that will allow us to do things that we never have before. This gets many people excited in the industry - particularly computer scientists, programmers and machine learning specialists - but what about the role of the pathologist? How can we the keep pathologist engaged in the development of AI algorithms and digital pathology workflows? One of the things that has hindered surgical pathology (maybe just in perception) is lack of standardization and reproducibility both in terms of molecular and IHC testing as well as interpretation of H&E images. Part of the promise of digital pathology is that we could eliminate this variability or subjectivity. But wouldn't pathologist developing their own algorithms recreate similar problems? Rish Pai, MD, PhD is Professor of Laboratory Medicine & Pathology and serves as a Consultant Pathologist at the Mayo Clinic, Arizona and Associate Chair of Research. Dr. Pai has lectured nationally and internationally on many aspects of gastrointestinal and hepatic pathology and has directed multiple GI and Liver CME courses. He is Past-President of the Rodger C. Haggitt Gastrointestinal Pathology Society. Dr. Pai is a regular reviewer for numerous pathology and gastroenterology journals and serves on the Editorial Board of the American Journal of Surgical Pathology. He has published 130 articles and written multiple book chapters in the fields of gastrointestinal and hepatic pathology. Pathology is a unique specialty. Much of what we do becomes a “permanent record,” and yet there remains an inherent subjectivity and imperfection. Do we have a special obligation to get it right?

Our guest is Michael Valante, Global Business Leader for Dell Technology's Healthcare Division and Dell's Chief Technology Officer for Digital Pathology, where he is a subject matter expert in the areas of enterprise imaging and pathology informatics. Mike is deeply focused on the healthcare industry and the intersection of medical imaging and information technology. We're going to discuss lessons learned from Dell's involvement in IT infrastructure throughout healthcare and disciplines outside of pathology. Digital Pathology, as a field is, moving incredibly fast. It seems like we've hit an inflection point in the past year. We'll discuss the trajectory and the velocity of the digital transformation. Pathology certainly has different stakeholders – lab managers, hospital administrators, IT staff, the pathologists, other physicians. Roughly what are the concerns of each of these varied groups of stakeholders? And what is Dell's approach to balancing both the technical and clinical aspects of digital pathology?

Immunotherapy and immune-oncology have become such hot areas of exploration in the past few years. We're going to explore the forces which have coalesced to make this a reality. Our guest is doctor Katir Patel, PhD a scientist with a keen interest in immunotherapy and diagnostics. We're going to be exploring the role of digital pathology in immune-oncology. How will we use the tools in our arsenal, such as image analysis, multiplexing, artificial intelligence and even good old-fashioned H&E sections to bring pathology to the forefront of immune-oncology.

There's so much excitement and hype around AI, but what does it mean for the practicing pathologist? Workflows seem very fragmented and antiquated, particularly in this new era of digital pathology. Can we add value in the pre-analytic or specimen handling phase and also in the post-analytic or reporting phase? Our guest is Hillel Kahane, MD, founder of Starpath diagnostics, a renowned and well-respected board certified uropathologist with over 28 years of experience in the commercial USA laboratory industry. He has personally signed out over 1,000,000 prostate needle biopsies throughout the USA serving well over 6,000 urologists and radiation oncologists nationwide. Dr. Kahane has served as the Chief Medical Officer & Director of Uropathology at Acupath Laboratories, Medical Director of Bostwick Laboratories, and Executive Medical Director, Uropathology DIANON Systems- LabCorp. There seem to be many different use cases for AI. We're going to discuss potential to enhance workflows, quality assurance application and primary diagnosis. Pathologists have long been changed to their desks and microscopes. What is the future of remote sign-out? Pathologists are very good at what they do, but how can we improve upon conventional light microscopy? And can come up more innovative ways of capturing the value we have created?

There is so much rich information imbedded in the histologic and molecular features of tissue sections which can be extracted through digital pathology. We seem to be at the convergence of AI-powered image analysis and precision medicine. Our guests are Jonathan Daniels and Ori Zelikov, MD from Nucleai, who are committed to bringing the power of spatial biology to reality by providing pharmaceutical companies and clinicians with AI- powered image analysis applications. We're going to be talking about the promise of digital pathology and image analysis and how these technologies can be leveraged in drug discovery and ultimately patient care. What does the future hold and how a higher throughput of patient biopsies through a digital pathology system will result in a new age of information and discovery analogous to the revolution we have seen in sequencing the human genome. We will also talk about the rich ecosystem in med-tech in Israel and what makes Nucleai unique in its makeup and approach.

The technology in digital pathology has been with us for some time. It now, though, seems we've hit an inflection point and things are accelerating. Perhaps we are even in the perfect storm. There seems to be a certain sense of inevitability and it may be time to open the floodgates and release the promise of digital pathology. Our guests are Colin White - Senior Vice President and General Manager, Advanced Staining & Imaging at Leica Biosystems and Frank Gannon, Professor of Pathology at Baylor College of Medicine in Houston Texas. Colin White is an IVD industry veteran with more than 20 years of experience in conceiving, developing and commercializing systems that advance the practice of pathology. Colin's passion is innovation and motivating teams to develop solutions that advance patient care whilst also meeting the needs of healthcare providers and regulating bodies. Dr. Gannon has over 25 years' experience as a practicing pathologist with subspecialty expertise in Orthopedic Pathology. Prior to joining Baylor College of Medicine in Houston Texas, he spent 8 years at the Armed Forces Institute of pathology in Orthopedic Pathology, 2 years as chair of the department. Dr. Gannon is co-author on an Orthopedic Pathology book, numerous book chapters, and over 110 publications in peer reviewed journals. We're going to be talking about the value proposition of digital pathology. What are the challenges to implementation? What's been holding us back and are these barriers beginning to crumble? What does digital pathology mean for patient involvement? And we're going to be talking about artificial intelligence, machine learning, remote sign out, remote case sharing and what going digital means in terms of workflows for the typical pathology department.

Our guest is Esther Abels, Chief Clinical Officer and Chief Regulatory Officer at Visiopharm, as well as the president-elect of the Digital Pathology Association. Esther also leads the regulatory and standards task force at the DPA with a focus on FDA collaborations to drive regulatory and standard classifications for interoperability and computational pathology in the field of digital pathology. We're going to be talking about standardization in digital pathology - not only in preanalytical factors such as fixation and staining - but also in the interpretive or analytic component, as well which is becoming increasingly important to ensure optimal diagnostic results for patients and incorporation of digital pathology data into diagnostic and drug discovery programs. We discuss regulation. What are some misconceptions about regulation how can we use regulation as a tool to protect patients and better develop and provide products and services? And how can we partner with regulators to help advance the science. What is the DPA working on now and what is their long-term vision for the future of the field? The annual meeting of the Digital Pathology Association, Pathology Visions is going to be held this October in Las Vegas.

Is your lab or institution ready for a disaster? Dr. Elizabeth Neyens has over 15 years of experience in translational drug development and has held various staff pathology positions in contract research organizations, the pharmaceutical industry and as well as research institutes worldwide. Dr. Neyens currently supports academia, biotechnology and pharmaceutical companies with a variety of nonclinical services at Flanders ToxPath Consulting. She is an active scientist on social media and keeps a blog and has been a regular on podcasts about Pathology & Toxicology. We are talking about preparing your disaster plan in digital pathology. What is data Integrity and why is it important? How do we keep our data safe? What types of threats do we face in the areas of drug development and digital pathology? We talk about cloud computing - the bad, the good and the ugly. And how can we prepare for the unexpected such as climate disasters and pandemics where stakeholders are suddenly shifted from an office environment to working from home?

With digital pathology, we are utilizing new methods to view images acquired from a very old technology - Hematoxylin and Eosin stained sections from formalin fixed paraffin embedded tissue, which have been prepared the same way for over 100 years. This method actually adds steps, time and expense. But what if we could also reinvent the way we handle tissue to instantaneously view images from samples without having to process to fix and process them in the traditional way? Can we move beyond paraffin? David Tulman is a biomedical engineer, cancer researcher, and entrepreneur. He earned a PhD in Bioinnovation from Tulane University, focusing on the development of novel microscopy systems for point-of-care pathology evaluations. David is a founder of Instapath, a company that formed in 2017 to build and commercialize systems that image pathology tissue without fixing or cutting. Instapath operates out of the Texas Medical Center in Houston. Instapath introduces an innovative solution utilizing optical scanning microscopy to evaluate the composition of the entire fresh sample within minutes at the point-of-procedure and preserve it for downstream testing. David is also the host of beyond the scope of the podcast from the digital pathology association will talk to him about that as well as the upcoming DPA annual meeting, Pathology Visions, this October in Las Vegas.

Our Guest is John Waller, PhD, Chief Operations Officer & Founder of Oracle Bio. John has over of 15 years as a biology project leader in the pharmaceutical industry, for companies including AstraZeneca and Merck & Co. He has expertise in the integration of translational biomarkers into drug discovery programs and considerable experience in developing in vitro, ex vivo and in vivo models involving image analysis across numerous therapeutic areas. OracleBio is a global leader in quantitative digital pathology, providing image analysis services to Pharma and Biotech clients worldwide. Leveraging multiple software platforms, the company delivers robust data packages within a quality management framework to support clinical trials and translational research. As image analysis experts, OracleBio specializes in cellular phenotyping of multiplex stained tissue and has built a strong reputation as the go-to company for complex image analysis. Their mission is to enhance decision making within R&D by leveraging Digital Pathology to deliver robust data and actionable insights. We are talking about the role of digital pathology in drug development and drug discovery. What are machine learning and deep learning? How are they different from artificial intelligence? And what role do they play in image analysis and digital pathology? How is Multiplexing evolving, what are its limits and how is it going to change what we do? What is the need for cloud computing in digital pathology? What are the advantages and disadvantages of putting our data and processes into the cloud?

One of the missing links in this digital transformation has been robust platforms for pathologists to interact with one another to share images and cases. KIKO, which stands for “knowledge in, knowledge out” is a slide hosting and sharing platform with many uses, including education, case and other content sharing, the ability to consult with colleagues, and even storing your own cases for later retrieval. Sites like KIKO help to democratize pathology and knowledge, which has been one of the key themes of this digital transformation. It also serves to enhance the careers of individual pathologists. Dr. Jonhan Ho is the Director of the Dermatopathology Division and the Fellowship Director at the University of Pittsburgh Medical Center. Throughout his career, he has trained hundreds of pathology and dermatology residents, and dermatopathology fellows. Having experienced the joy of teaching but also the frustrations of institutional silos, he founded KiKo, to democratize medical training and teaching in an easy-to-use platform. His hope is that through KiKo, doctors can begin to take back medical knowledge instantly and privately in order to make each other better.

We're talking with Leo Grady, CEO of Paige, a company developing AI-based solutions in digital pathology to optimize patient outcomes. We're going to be talking about his experiences in diagnostics, radiology, pathology, and artificial intelligence. We'll discuss the early history of Paige, its relationship with memorial Sloan Kettering, what products Paige is developing, what the future holds, and their strategy for developing partnerships. It's often said that radiology is at least a decade ahead of pathology in terms of going digital. But is this accurate or fair? Radiology images, after all are digitally native whereas pathology images are not. What do we mean by digitally native? What do we mean by AI native? is it possible to create an AI native environment for digital pathology?

The College of American Pathologists (CAP), in collaboration with the ASCP and API announced the 2021 update of guidelines for Validating Whole Slide Imaging (WSI) for diagnostic Purposes. We talk with Andrew Evans, MD, PhD, Chair of The Digital and Computational Pathology Committee and Nicole Thomas, MPH, Director of the CAP Center for Evidence Based Guidelines.

Dennis Strenk is the host of the People of Pathology Podcast and Pathologists' Assistant at the Wisconsin Diagnostic Laboratories. Dennis has created a unique podcast to get to know the people in pathology , to understand their motivations, and to hear their stories and learn from their insights. We talk with him about the origins of the People of Pathology Podcast, lessons learned and the surprises along the way. In addition, we talk about digital pathology, gross specimen handling and imaging and how new technologies such as digital pathology can enhance workflows.

This episode we speak with Dr. Michael Johnson of Visikol. We will discuss 3D imaging in digital pathology. We will look at the current and future uses of 3D imaging. What is the current state of the art in multiplexing - particularly for clinical use. We will find out more about organoids, what they are and what role they play in research and finally, what Visikol has in store for the future.

One of the many features of digital pathology is the capacity for increased connectivity among and between pathologists and the ability to share and collaborate on images and cases. This lends itself very nicely to the use of social media. We will examine the way pathologists use YouTube, Twitter, Facebook and other platforms including pathology specific ones such as PathPresenter and KIKO. We will look at how, in the past 10 years, social media has evolved and helped shape the practice, discuss how social media will continue to enhance the field of pathology as well as the careers of individual pathologists.

We're speaking with Felix Faber of MindPeak and Lisa-Jean Clifford of Gestalt Diagnostics. With the recently announced partnership between Gestalt, MindPeak, and Leica for the implementation of digital pathology for Bio-Reference Laboratories, we will talk about this real world use of artificial intelligence and algorithms. We discuss how this collaboration will increase workflow efficiency and accuracy for pathologists. We will examine their AI integration for remote breast cancer diagnostics and the algorithms they will be utilizing.

Our guest is Chaim Linhart of IBEX Medical Analytics. We will discuss the unique challenges and opportunities for unlocking the tools of digital pathology. We examine the differences between a strong AI and narrow AI and how strong AI can assist pathologists. Why is AI the "killer app" in digital pathology and how did Ibex develop Galen, one of the first AI based solutions to be deployed in actual clinical practice.

With so many use cases and applications in digital pathology, how do we connect the dots and make it all work? Dr. Anil Parwani is Professor of Pathology at The Ohio State University, Vice chair of Pathology and Head of Anatomic Pathology. He is the newly elected president of the Digital Pathology Association (DPA). We will talk about some of the ways to increase adoption and possible use cases for digital pathology. We will examine how algorithms and AI tools might help and what will be the role of pathologists if these algorithms work as promised. We will also look at some of the barriers to adoption including interoperability and storage.

We are talking with Patrick Myles, the CEO of Huron Digital Pathology. In this episode, we will discuss searching images within digital pathology. We will talk about slide indexing in handling large image databases and how these new searches will open the door to democratizing digital pathology. We will examine image search for new drug discovery, clinical use, and research applications. We will also look at the new project to digitize the Joint Pathology Center's archive of glass slides.

Tom Barr is an industry veteran. He was an early adopter of digital pathology - utilizing various hardware platforms as well as commercial and custom software. We will look at some of the early challenges to whole slide imaging (WSI), software solutions, networking, storage and interoperability Tom was instrumental in developing VIPER (Virtual Imaging for Pathology Education and Research) at Nationwide Children's Hospital and developing the digital pathology network used in clinical trials for many of the large cooperative groups as well as The Cancer Genome Atlas (TCGA)program. He is currently a founder at HyperPath Solutions.

We are talking with David West, CEO of Proscia and Joseph Mossel, CEO of IBEX Medical Analytics. Recently, Proscia, a leading provider of digital and computational pathology solutions, and IBEX Medical Analytics, a pioneer in artificial intelligence (AI)-based cancer diagnostics, announced a strategic partnership to support pathologists in detecting prostate cancer. In this episode, we will learn about the history of these two companies, examine how this partnership will work to help pathologists and patients and where this will lead digital pathology in the future.

Our guest is Professor Hamid Tizhoosh, the director of the KIMIA Lab (Laboratory for Knowledge Inference in Medical Image Analysis) at the University of Waterloo. We've all heard the hype about Artificial Intelligence (AI), but what exactly is AI? In this episode, we will examine some examples of AI in everyday life. We will discuss the current and future applications of artificial intelligence in digital pathology and image analysis, the "ethics" of artificial intelligence, and why the pathologist will not be replaced anytime soon.

Our guest is Ahmed Hosny, a machine learning research scientist, author and blogger from the Dana Farber Cancer Institute, who has a developed a framework for evaluating AI startups. This episode, we are talking about artificial intelligence (AI), machine learning (ML), and deep learning. We will touch on the history of AI and how it has been used to train neural networks. Pathology seems to be behind radiology with the number AI start-ups. We will find out some of the reasons why. We will discuss how the lack of format standards in imaging has slowed the growth of AI and we will examine potential uses of AI in clinical, academic and research environments.

Our guest is Dr. Steven Hinrichs, Professor and Chair in the Department of Pathology and Microbiology at the University of Nebraska. This episode, we focus on creating an effective team to transition to digital pathology. We will learn what types of teams are needed and the challenges in building those groups. We also look at the psychology of pathology. We will examine how the brain processes black & white images and how that impacts the new era of machine learning.

Our guest is Sam Terese, president and CEO of Alverno Laboratories, an integrated laboratory delivery network serving multiple healthcare systems and hospitals in the Chicagoland and Indiana area. Sam Terese has more than 30 years of experience in the laboratory environment, including settings as varied as community hospitals, academic medical centers, as well as research based organizations. Alverno, under Sam's leadership, has pursued a strategy of growth and consolidation and offers laboratory medicine, anatomic pathology services, as well as molecular diagnostics. This episode, we're going to be talking about considerations in going digital. We will examine the advantages of digital pathology to a healthcare system, and the opportunities for improving efficiencies and consolidation. Alverno was an early adopter in taking its anatomic pathology services digital, so we will discuss what it means to be an early adopter. We will look at how digital pathology can enhance the care that pathologists provide to doctors, patients and healthcare systems. We'll discover some considerations in establishing a relationship in a digital pathology platform provider because clearly as we're going to learn, it's not a one-off transaction or a one-time thing, but an ongoing relationship or even a foundation upon which we can build.