Bringing Digital Pathology to Life

Would you be able to grow your business if you could offer new digital pathology services?

• The digitization of pathology is happening now, as it did before in radiology. The ability to work digitally creates many new opportunities — you can work more efficiently, offer new services and tests, attract new customers, and create new businesses.
• The benefits of "Quantitative Image Analysis for IHC" have been well recognized and the American Medical Association (AMA) has created a specific reimbursement code (CPT 88361) for the use of computer assisted technologies that makes this a financially viable service that can be offered to pathologists.
• Aperio provides you with a complete solution for IHC on our versatile digital pathology platform. Get started with IHC and then leverage the multiple uses of our system to offer many other digital pathology services, including slide scanning services, secondary consultations (for FDA cleared applications), tumor boards, quality assurance programs, proficiency training and testing programs, telepathology, archival and retrieval, electronic medical records, education programs, research projects, and more.

When pathologists are reading IHC slides, would their accuracy and consistency be improved if they could use quantitative image analysis to help them classify cells consistently and accurately count large numbers of cells?

• Standardization of IHC has been recognized as a problem and the American Society of Clinical Oncology (ASCO) and the College of American Pathology (CAP) have recently published guidelines for the treatment critical marker HER2. Image analysis was identified as an effective tool and encouraged for achieving consistent interpretation. [American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer; Antonio C. Wolff, e. al; Archives of Pathology Laboratory Medicine — Vol 131, 2007]
• Aperio provides a suite of quantitative image analysis tools for IHC that emulated the sophisticated cell based analysis and scoring as performed by pathologists — classifying each cell accurately and consistently based on its staining characteristics, and then accurately counting all classified cells. Aperio's image analysis achieves unmatched performance and pathologists can intuitively evaluate and relate to the results provided.

When performing IHC testing, would the turn-around-time be improved, if: 1. Pathologists could view slides as soon as they are prepared in the lab? 2. Pathologists could have access to all information at their fingertips? 3. Pathologists could review IHC cases more efficiently using computer assisted technologies? 4. Pathologists could get secondary consultations (for FDA cleared applications) at the same time they read a case? 5. The transcription step could be eliminated?

• One huge benefit from digitizing medicine is the improvement in workflow efficiency, as we have already seen when radiology went digital. Think about the time it takes today to collate and deliver slides, organize the work, read slides (identify the invasive tumor regions, and classify and count hundreds of cells), get additional information (e.g. gross images, slides from previous biopsy), get secondary consultations, transcribe findings, and generate, review, and sign the report.


• Aperio provides an optimized clinical workflow for IHC with the goal to make the process from slides to reports as efficient as possible.

1. Slide Scanning
Aperio provides high-quality and high-throughput slide scanning with walk away automation (like autostainers). You can use barcodes and integrate Aperio’s digital pathology information management system to your Laboratory Information System (LIS) to completely automate your data entry. IHC cases are ready to be read as soon as the slides are scanned, which only takes a few minutes.

2. Instant Access and Comprehensive Case Information
Pathologists can log securely into Aperio’s web-based digital pathology information management system (anytime, anywhere) and start working on their work lists of pending cases or re-visit a patient’s previous case. When pathologists open a case, all case, specimen and slide information, including gross images and assay controls, are conveniently at their fingertips.

3. Side-by-Side Viewing
One considerable advantage of moving from a microscope to reading slides on a computer monitor is that multiple slides can be viewed simultaneously side-by-side. Being able to annotate H&E slides and to look at the H&E and the IHC slides simultaneously will help you to identify the tumor regions in the IHC slides faster and more reliably.

4. All-Digital Solution
Aperio provides a new approach to IHC with an all-digital workflow. Pathologists can now use quantitative image analysis efficiently with a click of a button while reading slides on a computer monitor, all integrated into a single solution. The image analysis classifies and counts thousands of cells for you accurately and consistently in just seconds.

5. Automatic Scoring
Aperio automated the data flow from quantitative analysis to reports for you providing automated score and interpretation calculators that can support any scoring scheme you choose (e.g. Allred Score, H-Score).

6. Secondary Consultations
Digital slide conferencing allows pathologists to get interactive secondary consultations (for FDA cleared applications) while reviewing a case. Institutions can build secondary consultation networks where pathologists are connected to a number of specialists.

7. Reports
Pathologists can enter data easily, accurately and quickly using canned comments and create error free professional reports with embedded images from the slides while still reviewing the case.

When managing your workforce of pathologists, could access to pathologists, as well as their efficiency and work conditions, be improved if pathologists could work anytime, anywhere, such as remotely from another institution?

• Overall, the number of pathologists is decreasing, creating a staffing problem for many institutions. External pathologists groups often serve multiple hospitals and must travel between institutions. Not every institution has easy access to pathologists or specialists 24/7. Today, pathologists must be at the same physical location where the slides are located, creating logistical problems, delays, and inefficiencies either for the slide handling process (e.g. shipping) or for the pathologists (e.g. travel).
• Aperio provides a digital pathology system that allows you to create high quality images of the whole slide where the slides are prepared and allows pathologists to read the slides remotely, anytime, from anywhere, as soon as the slides are ready.

When providing IHC reports to oncologists, would it be more effective to provide professionally designed reports that include representative slide images so that they could better visualize your pathology findings and explain them to their patients?

• Effective communication is most important in healthcare. Patients today are much more informed and involved than before; they want to see with their own eyes how the tests work and what they mean.
• Aperio provides a reporting tool that allows you to create professionally designed reports. It is easy to designate any region of the whole-slide image to be automatically incorporated in the report. The report can also easily be customized to the specific needs of an institution.

When looking at your current slide handling process, could you reduce costs, improve turn-around-time and simplify your process, if you could immediately put the glass slides into archive and handle all slides just digitally using a web-based information management system?

• Slide handling is a manual, labor intensive, and time-consuming process as the physical glass slides need to be properly identified and moved around. Think about the time it takes today to collate, deliver, and retrieve slides for reviews (e.g. QA) or presentations (e.g. tumor boards); re-cut and re-stain misplaced or degraded slides; prepare slides for shipping; ship slides; receive slides; and find and prepare cases for education or research studies.
• Aperio provides a complete solution for managing your slides digitally, starting with high-quality, high-throughput slide scanning with walk away automation (like autostainers). Slide scanning becomes just another part of the slide preparation process and takes only a few minutes. Using our slide scanners is easy and does not require special laboratory personal. You can use barcodes and integrate our system to your Laboratory Information System (LIS) to completely automate your data entry. Our web-based digital pathology information management system, Spectrum, provides secure access to read slides on a computer monitor anytime, anywhere, and sophisticated database searches to retrieve slides instantaneously.