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Digital Pathology

18 Goodbye to the microscope? Not yet! Carol-Immanuel Geppert MD, from the Institute for Pathology at Erlangen University Hospital, Friedrich Alexander University Erlangen-Nuremberg, debates the impact of digitisation on pathology. Digital Pathology (DP) is the fastest growing area of pathology, along with molecular pathology. However, the use of digital tools such as scanners and analysis software, as mentioned in a previous article, is mainly limited to academia (volume 24. issue 6/15). Aca- demic medicine benefits most in teaching and research where larger investments can be applied for without the pressure of daily clinical routine, or the economic pressures of the health system. In Erlangen, DP has been an established part of teaching in hu- man, molecular, and dental medicine. Using an online-microscope, students from Würzburg, Regensburg and Erlangen (Co­ope­ra­tion partners: the universities and university hospitals as well as the Fraun­hofer Institute Erlangen) can access digital slides from their respective courses browser-based via the internet, from anywhere and can study with superimposed texts and annotations (image 2). In addition, in recent research some projects have also been driven with the help of DP within the Comprehensive Cancer Centre Erlan- gen–Nuremberg, addressing problems from different clinical fields. DP already plays an important part in nati- onal and international cooperation projects. Naturally, new and fast-paced technology also has its limitations, which need to be clearly stated. The error rate of the scanners with slides or low contrast, or errors in digi- tal image analysis (DIA) caused by artefacts can negatively impact on trust in this new technology. Therefore, there is also some criticism and scepticism amongst patholo- gists. Furthermore, next to the many advantages of DP there are also clear disadvantages, such as high initial investment costs for scanners and data storage, as well as the on-going costs for maintenance and sup- port. Pathology will be confronted with si- Digital patholo- gy is already an important part of teaching at the Institute for Pathology, Erlangen University Hospital. Via the internet, students can access all course contents, browser-based with annotations and texts, as well as for monitoring achie- vements (online microscope based on development in cooperation with Fraunhofer IIS Erlan- gen, www.patho- skopieren.de) DP reveals new horizons for diagnostics, research and teaching

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