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t m c » p u l s e | o c t o b e r 2 0 1 8 36 Digital Pathology Improving Diagnoses Scanned images and computer interpretation are moving pathology into the digital realm B y C h r i s t i n e H a l l P athologists have been looking at body tissue samples under microscopes for centuries, but the digital age is bringing innovation and understanding beyond the human eye and mind to the study of diseases. Digital pathology takes the glass slide into the 21st century by switching the physical to an envi- ronment that scans, manages and interprets biological information as computer images. The field wasn't much of a reality in the United States until 2017, when the U.S. Food and Drug Administration (FDA) approved the Philips IntelliSite Pathology Solution. The automated digital system allows users to create, view, manage and interpret digital slides prepared from biopsied tissue. This technology marked the beginning of pathology's domestic conversion from microscope to digital imaging, said Gustavo Ayala, M.D., professor and vice chair for outreach in the division of urologic pathology at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth). Now, with a reliable system, Ayala said, The University of Texas System plans to outfit each of its Texas Medical Center institu- tions—UTHealth, MD Anderson Cancer Center and UTMB Health in Galveston—with a Philips IntelliSite Pathology Solution. Ayala already uses digi- tal pathology as part of a U.S. Department of Defense grant. One of Ayala's co-collaborators is Michael Ittmann, M.D., Ph.D., professor of pathology at Baylor College of Medicine and director of the human tissue acquisition and pathology shared resource at the Dan L Duncan Comprehensive Cancer Center. The pair have con- ducted research together for more than two decades. The federal money has sup- ported work to image and analyze the environmental differences of prostate cancer's stroma—or cell framework—with a focus on African American males. Digital pathology can help solve the mystery of how to prevent and address more aggres- sive forms of prostate cancer that are more prevalent and deadly in this population. "With the digital images, we Gustavo Ayala, M.D., and Michael Ittmann, M.D., Ph.D., professor of pathology at Baylor College of Medicine and director of the human tissue acquisition and pathology shared resource at the Dan L Duncan Comprehensive Cancer Center, examine a digital slide prepared from biopsied tissue. Computers can help us count. They can also take a picture of tissue at every nanometer of the spectrum. — GUSTAVO AYALA, M.D. Professor and vice chair for outreach in the division of urologic pathology at McGovern Medical School at UTHealth