Game-changing technology opens door to faster, more accurate cancer diagnoses
”Canada is really good at funding fundamental research, it’s the commercialization that’s really tough. That’s where OBIO® has done a good job. They’ve been incredibly supportive.Patrick MylesCEO, Huron Digital Pathology
”Being part of the Network gives us access to exciting innovative companies that can enhance the economic interest of Ontario. It helps to create a culture of innovation and asking questions. And it provides opportunities to provide better to care our patients in the future. When you put all that together, it becomes a very powerful value proposition.Dr. Ted ScottVP Research and Chief Innovation Officer, Hamilton Health Sciences
”Innovation developed by researchers within our healthcare system and leading academic institutions has the potential to impact healthcare globally. Developing, performing clinical trials and procuring these innovations within our health system will help to enable our innovative companies to develop these technologies to export products globally, create jobs and become leaders on the world stage for the next generation of technologies that impact the lives of patients.Jacki JenuthPartner, Lumira Capital
Behind every cancer diagnosis, lies a pathology report—an expert assessment of cells or tissues that helps determine the type and extent of a cancer and the best treatment plan.
With most hospitals generating thousands of pathology slides each month, these slides and reports represent an immense body of knowledge that could lead to faster, more accurate diagnoses for patients. An Ontario company, Huron Digital Pathology, is poised to unlock that knowledge with the world’s first commercial image search engine for pathology.
The company’s software (Lagotto™) indexes archives of digitized biopsy slides, representing each as a series of distinctive barcodes that capture the key features of the cell or tissue sample. A pathologist reviewing a new slide can perform a search, and a sophisticated algorithm—a form of artificial intelligence (AI)— quickly compares barcodes to find similar images and the associated pathology reports and diagnoses.
This ability to immediately access the expertise of colleagues when reviewing images is significant; pathologists, particularly those with sub-specialty expertise, are often in short supply and older pathologists are retiring. Cancer cases are also increasing as Canada’s population ages. Requesting a consultation with a colleague to assess a difficult case could delay a diagnosis by weeks. Reviewing multiple similar cases also helps pathologists improve the accuracy of their own diagnoses.
Key to the technology’s success is its ability to search a large database quickly. Scanned pathology images are typically very large—one image can be a gigabyte of data—making it difficult to search images quickly. By using barcodes, the software can convert these images into just 10 to 15 kilobytes of data. As a result, Lagotto™ can search up to 100,000 images a second.
”With digital pathology, and more specifically this image search, we’re trying to break down the barriers to accessing diagnostic data and knowledge from subject experts.Patrick MylesCEO, Huron Digital Pathology
”In many cases, different pathologists will look at a tissue and say essentially the same thing, but there’s a subjective interpretation. These tools are a way to standardize that. If you see the reports of 10 other pathologists, you’re likely to be more diagnostically accurate.Dr. Clinton CampbellHematopathologist, Hamilton Health Sciences
EAHN™ project offers opportunity to validate technology
Not surprisingly, the value of the search technology depends entirely on its accuracy in finding similar images. By 2020, the company had validated its search algorithms using a publicly available data set of 30,000 images from the US National Health Institute/National Cancer Institute. The next step was applying the technology in a clinical environment. EAHN™ provided that opportunity.
Through EAHN™, companies with innovative health technologies are matched with health organizations to develop, test, refine, adopt, promote, and disseminate novel technologies. In this case, Huron Digital Pathology was matched with Hamilton Health Sciences. Working with the hospital’s IT support and a lead pathologist, the company installed a high-quality scanner and scanned and indexed 1000 pathology slides. The search engine was then used to conduct searches and several hematopathologists (specialists in blood and bone marrow) provided feedback on the accuracy of its matches.
”None of us can do this alone. We need strong partners— private/public partnerships. OBIO® does that really well.Patrick MylesCEO, Huron Digital Pathology
”Being a member of a mature and supportive network like OBIO® is really critical because it gives us access to pre-vetted mature or rapidly maturing companies with really exciting products.Dr. Ted ScottVP Research and Chief Innovation Officer, Hamilton Health Sciences
”Pathologists, machine learning scientists and industry need to work as an interdisciplinary team to engineer these technologies from the ground up. You can’t do it alone as a pathologist and you can’t do it alone as a scientist. You have to have good relationships.Dr. Clinton CampbellHematopathologist, Hamilton Health Sciences
Study provides important feedback to enhance search algorithms
The results were not as expected, and the team soon realized the reason. The search algorithm assumes large data sets of 10,000 images or more; the 1000 images scanned for the project were insufficient to generate accurate results. It was valuable learning, and Huron Digital Pathology is modifying its algorithms to obtain higher accuracy with fewer images. The project also helped the company consider how to implement the technology on a much larger scale.
For Huron Digital Pathology, the experience demonstrates the value of EAHN’s program. The development and refinement of innovative technology depends on working with collaborative partners who are open to and engaged in the problem-solving process. Hamilton Health Sciences was that kind of partner.
The hospital is also positive about the experience. EAHN™ projects provide the opportunity for the hospital to access high potential technology from companies that have been pre-vetted and without going through a traditional procurement process. EAHN’s contract and project management addressed privacy, security and other issues that routinely require significant staff time. And the funding provided by EAHN™ removed any financial barrier that might deter the hospital from taking on this kind of project.
”We were learning in real time through the EAHN™ project, and that’s really helped to form some of our thinking about how we implement this on a much larger scale.Patrick MylesCEO, Huron Digital Pathology
”This project allowed us to get hands-on, frontline experience not only with establishing a small digital pathology workflow, but also to test in a real clinical setting, how this artificial intelligence-based technology can work.Dr. Clinton CampbellHematopathologist, Hamilton Health Sciences
Leading the shift to digital pathology
Digital pathology is relatively new, and the shift from microscope to reviewing digitized slides on a computer screen will take some time. Radiology digitized in the 1980s and it was a decade before many hospitals had a fully digital workflow in place. Pathology has its own challenges. One cancer diagnosis can involve ten to 200 slides, and some hospitals would need to digitally scan up to 500,000 slides a year.
Currently, digital pathology is more common in the US and some parts of Europe. In Canada, Quebec is moving in that direction and Huron Digital Pathology expects larger hospitals in other provinces to follow. The efficiencies of a digital workflow make the change inevitable and the Lagotto™ platform and other AI applications point to the possibilities that digitization brings. The company estimates the diagnostic imaging market to be $10+ billion.
For now, Huron Digital Pathology will continue to validate and evolve its algorithms to improve accuracy, particularly as it scales up to larger data sets. A contract with the US Joint Pathology Centre will help them in this process. The Centre is the pathology tissue repository for the US Department of Defense and Department of Veterans Affairs, and Huron Digital Pathology is scanning and indexing their 55 million slides as the Centre moves to digitize its holdings. The Centre will use the company’s image search technology to enable data sharing with researchers, clinicians and educators, providing access to 100 years of medical and scientific knowledge.
”The field of pathology is undergoing a revolution right now.Dr. Clinton CampbellHematopathologist, Hamilton Health Sciences
”The experience that we gained from the EAHN project translated into the implementation we are doing at the Joint Pathology Centre.Savvas DamaskinosChief Technology Officer, Huron Digital Pathology
”OBIO® EAHN™ has been effective at partnering innovative health technology companies like ours with local customers. Our senior management team has the opportunity to work with world-leading health organizations and experts right here in Ontario, which not only supports the growth of Huron’s commercial operations in Canada, but enables us to attract and retain top talent.Patrick MylesCEO, Huron Digital Pathology