Benefits accrue as pathology’s traditions morph into digital

Dec. 1, 2010

The word “microscope” often conjures up images of white-coated laboratorians hunched over their instruments, peering endlessly through an eyepiece as they examine one glass slide after another. Advances in microscope technology have not only changed how microscopes work but also how lab techs and pathologists work with microscopes. “What ultimately is coming into play is productive efficiencies — the ability to work large numbers of applications efficiently,” says Eric Flem, communications manager for Nikon Instruments. Productive efficiency led manufacturers to study basic microscope design and to make specific design changes so that lab techs can sit for hours at their scopes without putting undue stress on their necks, backs, hands, wrists, and arms, Flem says.

Although efforts to improve the ergonomics of microscopes have taken a back seat to improving optical quality, recent design changes reflect the fact that the way labs use standard microscopes has not changed much since the first one was invented in the early 1600s. “They push a lot of glass, and there is a lot of repetition,” says Doug Giszczynski, sales development manager for the Life Sciences Division at Leica Microsystems.

Flem likens using a microscope to driving a car. If a driver could not adjust the seat or steering wheel, or if control panels were not within easy reach, even a short drive would be fatiguing. As a result, Flem says innovations — like riser tubes and telescoping eyepieces — make scopes adjustable for both tall and short users. Ergonomic-driven features include upright microscopes with tilting eyepieces; eyepieces with higher eyepoints for users with glasses; lower stage heights and focus controls to avoid repeated raising and stretching of the arm above the bench; push-button controls; and interchangeable or front-mounted controls for right- or left-handed users.

While various committees continue to debate the standards for digital pathology, microscope manufacturers are pressing ahead to meet the growing demand for digital solutions. “Leica’s big push is toward digital, as is the whole market’s,” says Giszczynski. But Edward Lachica, PhD, director of product marketing for Olympus Corp. of the Americas, says most lab techs still prefer using traditional microscopes: “Pathologists are now pressing us for digital solutions.” As with other physicians, pathologists are increasingly entering the digital world because of convenience and the ability to get results faster, he says. More and more pathologists are specializing or becoming resources for multiple locations and, therefore, want to be able to access the images of specimen slides that are stored on a secure server, Giszczynski says. As with radiological images, digital slides can be uploaded to a patient’s electronic health record where they become a permanent part of that record.

Storage of slides is also an issue, says Stan Schwartz, vice president of global education in the Biological Microscopes Division of Nikon. Glass slides are required to be stored for seven to 10 years, he says. Not only are these slides breakable, but boxes of glass slides are heavy and take up a lot of space. Digitizing slides can be as simple as mounting a digital camera to a conventional microscope, and most vendors offer such cameras. What has slowed acceptance of these digital images has been the quality of the monitors on which they are viewed, says Giszczynski. Now, however, high-resolution monitors are more affordable and readily available to even the smallest lab. While Phillip Walker, national account manager for the Medical Laboratory Division of LW Scientific, agrees that the evolution of high-definition has helped define digital pathology, he notes, “Nothing will take away from the clear eye peering into the scope.”

Microscope manufacturers have been launching new products or adapting existing instruments for new uses. The move toward digital imaging has made slide scanners popular. Giszczynski says his company recently launched a slide scanner which, he claims, currently provides for remote scanning in research labs; but this solution is awaiting clearance from the U.S. Food and Drug Administration for use in medical labs.

Lachica reports that Olympus now offers a slide scanner that allows users to load up to five separate slides in order to create a whole-slide image. He also says another new slide-imaging system uses time digital integration, which allows users to scan a whole-tissue slide at various levels to create a virtual slide that can be viewed at different focal planes. It can be equipped with an optional fluorescence illumination unit for scanning fluorescently labeled samples. The company also offers a laser scan confocal microscope which, he says, automatically rejects the out-of-focus blur often seen in a fluorescent image.

Walker reports that LW Scientific has launched a multipurpose microscope with integrated LED technology for both brightfield and epi-fluorescence microscopy, and also offers an epi-module that can be fitted on many existing infinity microscopes to provide affordable fluorescent technology. Use of LED illumination is growing, but Schwartz says that while Nikon offers the ability to turn all of its scopes into fluorescent scopes, it currently uses a standard mercury lamp housed in an external box. The wavelength of a mercury bulb can be changed by using filters but a filter on an LED cuts down on the amount of light produced.

All of these are not the only innovations changing the way microscopes look and operate. Heston Singh, business development and sales manager at Accu-Scope, says his company has developed a microscope with a built-in 8.4-inch computer touch screen. Network-ready, this unique instrument lets users e-mail images directly from the microscope, he says. In a similar push to computerize scopes, Nikon has developed a microscope with a digital camera but no eyepieces. Using a graphical user interface and a standard mouse, laboratorians view images on a high-resolution monitor. Since the digital camera has its own IP address, “Others can log on and view the same image,” Flem says.

Richard R. Rogoski ([email protected]) is a freelance journalist based in Durham, NC.

Photo 115879330 © Karenr |
Photo 124723736 © Steveheap |
Photo 129549884 © Katarzyna Bialasiewicz |
Photo 159136554 © Alberto Masnovo |