An accurate, timely cancer diagnosis is the critical first step in every cancer patient&rsquo;s treatment. When the world shifted in response to the global COVID-19 pandemic, the digital pathology team at the OSUCCC &ndash; James rapidly mobilized and continued to provide quick and precise diagnoses to ensure that potentially life-saving treatment decisions could still be made. Traditional pathology services are performed using tumor cells placed on glass slides viewed under a microscope. The diagnosis is subjective, however, relying on the expertise and experience of the reviewing pathologist. It is also a difficult and slow process to share pathologic images if a second opinion is needed. Digital pathology &mdash; also known as &ldquo;whole-slide imaging&rdquo; &mdash; is the process of scanning conventional glass slides and then digitally knitting consecutive images into a single, whole image that replicates the information on the glass slide. This virtual image is paired with associated clinical information to give pathologists an integrated picture of the person&rsquo;s unique cancer. Pathologists can then perform additional diagnostics, including image analysis tests that are not possible on traditional glass slides. Unlike images on glass slides, these enhanced images can be viewed, manipulated and interpreted on a computer with the combined benefit of the pathologist&rsquo;s trained eye and predictive computer algorithms. &ldquo;Digital pathology has truly revolutionized how pathology is used to diagnose cancer and has opened up new opportunities for research. We are honored to be at the forefront of implementing this technology for patient care, research and education,&rdquo; says Anil Parwani, MD, PhD, MBA, director of digital pathology and vice chair/director of anatomic pathology at the OSUCCC &ndash; James and The Ohio State University College of Medicine. Since March 2020, when the COVID-19 pandemic forced hospitals to shift operations temporarily, the team has seen a 15% increase in digital pathology service usage. &ldquo;This technology has been even more critical for continuity of care during the ongoing COVID-19 pandemic, when access to health care can be challenging due to necessary safety precautions and limitations on services. This tool helps us get patients to the right providers in a timely manner,&rdquo; adds Dr. Parwani. &ldquo;Our team frequently consults with other experts in real-time about cases to confirm a diagnosis. Getting a precise diagnosis the first time is critical for patient treatment success.&rdquo; Bringing Digital Pathology Services Into Clinical Care at Ohio State In April 2017, digital pathology was approved by the U.S. Food and Drug Administration for use in primary cancer diagnosis, opening the door for clinical pathology services to undergo important changes that made it easier for experts to review and utilize sophisticated quantitative algorithms to accurately stage and grade cancer. In March 2018, the OSUCCC &ndash; James team became the first hospital in the United States to make a clinical diagnosis based on digital pathology alone. Since that time, 25 members of the OSUCCC &ndash; James pathology team have transitioned to using digital pathology for first pathology reads and have confirmed hundreds of cancer diagnoses based on this technology alone. In December 2019, the digital pathology lab expanded into a freestanding space equipped with six scanners and an adjacent histology lab. Staffed every weekday from 5:30 a.m. to 7 p.m., the team was able to rapidly increase clinical digital pathology sample processing. In addition, the OSUCCC &ndash; James team has established partnerships with affiliated hospitals, including Highland Health in Cincinnati and Adena Regional Medical Center, to provide digital pathology services. Services at other James Cancer Network affiliate hospitals are expected to be implemented in the coming year, along with several out-of-state collaborations with other university-based health systems. Beyond patient care, Parwani says digital pathology has also allowed Ohio State to continue educating the next generation of pathologists with minimal disruption. During the pandemic, some postdoctoral trainees were able to use digital pathology information to begin research to develop grading and algorithms for predictive diagnostics. To date, the digital pathology team has scanned 1.78 million slides &mdash; which includes 10 years of patients treated or followed by OSUCCC &ndash; James physicians, as well as current patients starting in March 2018 &mdash; and 41 members of the pathology faculty are approved to use digital pathology for clinical diagnosis. Parwani says he is excited about the momentum and potential for further growth of the digital pathology program, including potential international collaborations for education and research through The Ohio State University Telepathology Network. &ldquo;We are well on our way to making the OSUCCC &ndash; James a global leader in advanced image-based diagnostics and technologies that will continue to make a big impact in cancer diagnostics, research and therapeutic design. Our team is excited and hopeful for the future,&rdquo; says Parwani. Learn more about digital pathology services at the OSUCCC &ndash; James. Initial implementation of the digital pathology program was supported in part by Pelotonia funds.