In the late 1990s Dirk G. Soenksen imagined a new future for pathology. At the time, pathologists often sat on telephone books to get a good view through their microscopes, yet Soenksen’s children viewed high-resolution monitors when merely playing Nintendo. “Why can’t microscopists look at computer monitors, too?” he wondered.

That question sent Soenksen on an extended journey, beginning in his garage. After 18 months of intense laboring, he emerged as the head of a newly created digital-pathology company called Aperio, which he now runs in Vista, Calif. Beyond merely moving images of diseased tissues from microscopes to computers, his technology—as well as that of other start-ups and even established health care companies—promises to make anatomical pathology, which involves the interpretation of biopsies, far more quantitative. This advance should, in turn, enhance the accuracy of diagnosing diseases and help physicians track the effectiveness of a treatment so that any needed changes can be made promptly.

This article was originally published with the title A Better Lens on Disease.

4 Comments

1. 1. Kidd 10:36 PM 4/21/10

   Interesting article, too brief, not enough information on a spectrum of technologies that are being pursued.

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2. 2. DrJ 03:20 PM 4/30/10

   The real breakthroughs will come when the arsenal of tools (e.g., computer assisted diagnosis, image processing, pattern recognition) being developed for other digital medical images are applied to digital pathology images.

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3. 3. MITDGreenb 12:03 PM 5/10/10

   I think the article might have really benefited by looking at the adoption of digital imaging in radiology. Over the past 20 years, we've progressed from nascent "scan the film" technology (if only the scanners were good/fast enough) to widely adopted digital X-Ray (especially digital mammography) as well as MRI data that they'll hand you on a DVD as you walk out of the doctor's office. Automated tagging of areas for doctor evaluation... as well as color-coding tissue structures... are widely available technologies. Challenges now in radiology tend to be computationally complex (especially 3D-rendering and matching images taken at different times), bandwidth (the images are big, even when compressed), or legal/regulatory (malpractice, FDA approval, etc.). The same progression is a likely course for pathology over the next 15-20 years.
   
   I'd point out that the example given in the article of scanners' not being fast enough is ludicrous: no hospital would ever have all of its pathology specimens going through a single scanner anyway. So, one may safely assume that the 5+ years of dermatology samples generated per year would be handled by 5+ scanners in parallel. It's then a question of cost.

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4. 4. Christopher Edwards 03:54 PM 6/10/10

   In "A Better Lens on Disease" the author opens with the extraordinary statement that in the late 1990s pathologists "often sat on telephone books to get a good view through their microscopes". In over forty five years as a surgical pathologist I never found it necessary to do any such thing, nor did I ever hear of anyone else doing so. Is this a joke, or is the author really unaware that the height of laboratory stools can be adjusted?
   
   Unfortunately, this lightweight and uninformed approach continues through the rest of the article. The author seems to be unable to accept that although the technique of cutting and staining tissue sections has been around since the nineteenth century, it does actually work, and work very well indeed. Nor is there any "clunkiness" about pathologists discussing a diagnostic problem with the help of a digital camera attached to a microscope. High resolution and sophisticated equipment are not needed in this context.
   
   Digitisation as described by the author will, of course, have a place in surgical pathology, particularly in the measurement of the concentration of abnormal substances such as HER 2, but in making the initial diagnosis it is difficult to see how it will ever replace the glass slide and the human eyeball. And how will digitisation help in "forensics"?
   
   Scientific American is a respected journal with an international reputation. It can, and must, do better than this.

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