Digital pathology globally and in Nepal, the present and the future.

1. Digital pathology:
Developed and Developing countries, the two
worlds apart

3. PATHOLOGY IS GOLD STANDARD
OF DIAGNOSIS

4. Digital Pathology
• Digital pathology is a branch of pathology that focuses on data
management based on -
 Information generated from digitized glass slide
specimen converted from glass slides

5. Light microscopy Digital microscopy

6. • The digitized slides can be viewed, managed,
shared and analyzed on a computer monitor.

7. Glass slides are converted into digital slides

8. • In pathology we do not need to feel texture of
the slides to make the diagnosis.
- Thus, apparently, digitalization in
pathology sounds more meaningful.

9. • Whole-slide imaging allows entire
slides to be imaged and
permanently stored at high
resolution.
- Telepathology.
- Solves physical storage
problem.

10. Advantage of digitalization in Pathology
include:
 Assistance in primary diagnosis
 Telepathology
 Peer review
 Intraoperative diagnosis
 Training
 Improved accuracy and speed
 Immunohistochemistry (IHC) and can have a pivotal role in
clinical research

11. Global digital pathology market
• 2012: 1.98 billion dollar
• 2020: 5.7 billion dollar (Estimation)

12. • Expensive equipment, instable technology, lack of standards
and lab information.
• Personalized medicine and "big data" will remain nothing but
Buzz words.
• Dependencies.
• Even in the digital future the pathologist has to be able to dust
off and use the microscope as analogue assessment tool.

13. Risks
Quality as good or
better as light
microscopy?
Differences in human
interactions.
Misdiagnosis.

14. • Overstated Value of Digital Pathology? Or…
Misunderstood Advantages

15. Digital pathology in Nepal

16. Digital pathology in Nepal
Pros:
• Can reduce laboratory expenses, improve operational efficacy,
enhanced productivity, and improve treatment decision and
patient care.
Cons:
• The high cost of scanners and AI-based software.

17. Future of digital pathology in Nepal
???
• Digital pathology could have much more
significant improvement in the developing
countries than in the developed ones.

18. Future???
 When digital pathology is pathology
 Digital pathology is on the verge of becoming a mainstream
option for routine diagnostics
 “ In a time of drastic change it is the learners who inherit
the future. The learned usually find themselves equipped
to live in a world that no longer exists”

19. Things to be considered
RISK VS BENEFITS
LIMITATIONS
STANDARDIZATION

20. Ashish Lakhey

21. References
1. Abels, E. et al. (2019) ‘Computational pathology definitions, best practices, and
recommendations for regulatory guidance: a white paper from the Digital Pathology
Association’, Journal of Pathology, 249(3), pp. 286–294. doi: 10.1002/path.5331.
2. Fontelo, P. et al. (2012) ‘Digital pathology-implementation challenges in low-resource
countries’, Analytical Cellular Pathology, 35(1), pp. 31–36. doi: 10.3233/ACP-2011-
0024.
3. Jahn, S. W., Plass, M. and Moinfar, F. (2020) ‘Digital Pathology: Advantages,
Limitations and Emerging Perspectives’, Journal of Clinical Medicine, 9(11), p. 3697.
doi: 10.3390/jcm9113697.
4. Moxley-Wyles, B., Colling, R. and Verrill, C. (2020) ‘Artificial intelligence in
pathology: an overview’, Diagnostic Histopathology. Elsevier Ltd, 26(11), pp. 513–520.
doi: 10.1016/j.mpdhp.2020.08.004.
5. Niazi, M. K. K., Parwani, A. V. and Gurcan, M. N. (2019) ‘Digital pathology and
artificial intelligence’, The Lancet Oncology. Elsevier Ltd, 20(5), pp. e253–e261. doi:
10.1016/S1470-2045(19)30154-8.
6. Betigeri, A. M., Aparna, P. and Pasupathi, P. (2010) ‘Could India become the digital
pathology hub of the future?-A consideration of the prospects of telepathology
outsourcing Digital Pathology View project Could India become the digital pathology
hub of the future? A consideration of the prospects of telepa’, International Journal of
Biological & Medical Research Int J Biol Med Res, 1(4), pp. 300–302. Available at:
www.biomedscidirect.com.