Pathology Diagnosis Faster and Smarter with Digital Technology: Acupath Laboratory’s Dr. Joon Yim on the Evolving Benefits of Immunohistochemistry

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Today a digitized, or computerized, form of immunohistochemistry (or IHC) is revolutionizing the clinical pathology industry, helping pathologists make diagnoses at almost the click of a button. The benefits in improved accuracy, efficiency and speed are an invaluable benefit to the doctors and their patients who rely on pathology results.

Imagine this. You’ve just had a biopsy. 24 hours later, your doctor calls to tell you it’s benign. It may not happen quite that quickly, but with a new technique, it’s happening much sooner, and a lot more accurately, than ever before.

“Today a digitized, or computerized, form of immunohistochemistry (or IHC) is revolutionizing the clinical pathology industry, helping pathologists make diagnoses at almost the click of a button,” says Dr. Joon Yim, a pathologist with Acupath Labs of Plainview, NY. “The benefits in improved accuracy, efficiency and speed are an invaluable benefit to the doctors and their patients who rely on pathology results,” adds Dr. Yim.

IHC is a test used by pathologists to detect disease and determine its source and how advanced it is, through the use of staining and dyes. The process was first founded in the 1940s, when researchers for the first time were able to identify abnormal cells using this technology. IHC allows pathologists to differentiate abnormal, or diseased, cells from healthy cells. IHC is used widely, especially in cancer diagnosis, where a delay in results can sometimes mean the difference between life and death.

Today, digital pathology solutions for IHC use image analysis tools to help pathologists provide accurate, consistent, almost-instant diagnoses for more informed decision-making. Digitized IHC allows pathologists to create digital copies of slides, and then analyze them instantly, while reading the slides on a computer. This is a long way from the hand-written and subjective record-keeping of the past.

In the “pre-digital” era, diagnoses were dependent upon the observations of multiple researchers using an arbitrary scale to grade the presence and extent of disease. Early attempts at turning IHC into a computerized process involved converting analog images into a digital format and then transforming the 256 separate shades of red, green and blue into a gray scale that could then be divided into sections for measuring and evaluating, leaving much room for mistake.

“What’s so fantastic today is that digitized IHC gives pathologists a much clearer picture than was previously possible of what is going on,” notes Dr. Yim. With digitized IHC, biopsy slides are scanned into a computer, and pathologists can enter data about them, and then allow others to view the same exact slides on a computer screen, even video-conference with them. Digitized IHC also ensures that all pathologists see the same true-color image of a slide every time.

Using the IHC technology, pathologists can find out where in the body a cancer originated by looking for cells which don’t belong in the culture. For example, breast cells in a liver would indicate that the tumor was actually breast cancer, which had metastasized to the liver, a vital finding when deciding treatment and prognosis. Before digitization, IHC results took much longer, delaying treatment and possibly allowing the malignancy to grow and threaten a patient’s overall outcome.

The use of this new upgraded technology also saves time by counting. With digitized IHC, pathologists can now count thousands of cells in seconds, a critical part of diagnosing an illness, versus hundreds previously counted manually. When speed is of the essence in diagnosing an illness, as it often is with cancer and other serious illnesses, digitized IHC dramatically reduces the amount of time between diagnosis and treatment.

Just as important, the data is then stored electronically for use by any other medical professional who needs access to the case, the tissue sample and digital slide information, anywhere, any time.

Not so long ago, when a tissue sample was sent to a lab, pathologists mostly looked under microscopes to tell what it was, using cell size and other kinds of measurements to determine the existence of disease. But a lot of that is hard to tell under a microscope (sometimes, cells of one disease can mimic another, and cell size, another important sign of abnormality, cannot always be differentiated).

In addition, slides weren’t always available to other medical professionals, when needed, and since looking under a microscope and identifying what you see is subjective, there was often a wide range of readings of the data itself. But digitized IHC now makes all that moot.

Hundreds of pathologists all over the world are now using this new technology. Digitized IHC has only been around for several years, but is changing the way pathologists view, and handle, disease, making it easier and less stressful for patients awaiting biopsy results.

Dr. Yim overviews the key benefits of digitized IHC:

  • Allows pathologists to view biopsies in far more detail,
  • Analyze them more quickly and consistently for diagnosis,
  • Tell the source and stage of cancer, and Share the information with other medical professionals,
  • Allows patients to obtain results much more quickly and accurately, alleviating the stress of waiting, and beginning treatment sooner.

Bio: Board-certified in anatomic pathology, Dr. Joon Yim serves as a staff pathologist for Acupath Laboratories, Inc., where he is responsible for the daily sign-out of a broad spectrum of surgical cases. Prior to joining Acupath, Dr. Yim served as an attending pathologist and an assistant professor in the Department of Pathology at New York University Medical Center from 2002 to 2006. Previously, Dr. Yim fulfilled fellowships at New York University Medical Center for surgical pathology. Prior to his fellowship, Dr. Yim completed his residency at St. Luke’s-Roosevelt Hospital Center, University Hospital of Columbia University. Additionally, Dr. Yim holds positions in various medical organizations, including the American Medical Association, College of American Pathologists, University of California, Los Angeles (UCLA) Medical School Admissions Committee, and Association for Pathology Informatics. He received his medical degree from UCLA.

Acupath Laboratories, Inc. located in Plainview, New York, is an anatomic pathology and cancer genetics laboratory.

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