Recent health trends have triggered an increased demand for frozen sections (FS) biopsies, also known as cryosections. These are a type of tissue sample that are ‘flash’ frozen using a specially developed cryostat machine so that they can be immediately examined by pathologists during ER or surgical room procedures. This makes them ideal for urgent cases that require a rapid diagnosis, including organ procurement and oncology diagnoses.
As demand in these areas continues to grow, so too does the need for fast, highly accurate frozen section interpretations. In fact, the number of new cancer cases will increase to over 18 million globally in 2018, up from 14 million in 2012. In addition, nearly 120,000 Americans are now on the Transplant Waiting List, with 95% of these patients awaiting new kidneys and livers.
Because of this great need, more potential donors who are considered ‘marginal’ are being tested to try to keep up with the increased demand. Organ Procurement Organizations (OPOs) utilize frozen section (FS) biopsy results to help glean baseline information that establishes whether a viable match is present.
Digital Pathology, Frozen Section Turnaround Time, and Cost Savings
Telepathology technology is helping OPOs and cancer surgical teams to keep up with the increased demand for FS services. In one recent study, frozen sections were used to diagnose cancer malignancy, margins, and metastasis as well as kidney and liver histopathology interpretations. It was found that pathologists’ diagnostic reporting time was cut in half (from 6 to 3 minutes) using remote digital slide analysis, versus traditional glass slide evaluation.
In addition, a recent study published in The Journal of Oncology Practice shows that health care providers have the potential to save nearly $2 million each year just by expanding their utilization of frozen sections for one type of cancer care alone. Using a digital pathology service helps with this expansion through streamlined processes that provides fast results, increased accuracy rates, state-of-the-art technology, and greater long-term insights.
The great news is that telepathology is also addressing some of the traditional limitations that come with using frozen section tissue sampling so that it can be optimally utilized to meet the growing demands placed upon surgeons, pathologists, OPOs, and medical care providers.
How Telepathology Helps Make Frozen Sections a More Viable Option
Frozen Section Advantages
It’s no secret that FS biopsies bring many advantages to the table. Quick interpretations means that OPOs can find out organ viability in time to save lives and create the best success rates for their transplant patients. With frozen sections, intraoperative teams can also collaborate in real-time to determine a diagnosis, ensure correct margins, and obtain any additional samples that may be needed, without putting their patients through an exacting second surgery.
In addition, the cryopreservation method is considered one of the best for conserving antigen and enzyme expressions. It is also recommended for studying post-translationally modified protein, DNA, or RNA to determine if certain biomarkers are present, such as those indicating disease-inducing oxidative stress.
Frozen Section Growth with Digital Pathology
Despite their many advantages, FS tissue samples do have a few drawbacks. One of the main concerns that pathologists have expressed in the past is that, compared to paraffin-embedded samples, the tissues are thicker. This reduces image resolution and the ability to see as many structural details.
Digital pathology brings with it advanced pixel data technology that allows for clearer analysis of this tissue morphology. The College of American Pathologists recently released a review of digital whole slide imaging (WSI), and it reveals how rapid advances in the field have led to high resolution images and continuous automatic refocusing, both of which are aiding in increasing diagnostic sensitivity. In fact, in a recent study, pathologists reported that the high quality of the WSI Frozen Section images was one of the best features of their digital experience.
Telepathology also opens up the ability to engage in fast and efficient consults with industry peers in order to cross-check FS image interpretations. Additionally, built-in AI technology picks up morphology patterns in order to help establish a more detailed, highly accurate diagnosis even when thicker tissue samples are present.
Another traditional disadvantage to FS biopsies is that their storage capacity is considered short-term compared to formalin-fixed slides. FS slides typically start to disintegrate after a year, but with Whole Slide Imaging this issue is overcome through secure digital storage platforms. This allows the images to be preserved when they’re fresh, and then used for future diagnostic purposes and learning opportunities, whether in an educational setting or by pathologist searching the database for data relevant to their line of inquiry.
This type of long-term slide preservation provides specialists with access to more in-depth patient histories because they don’t have to rely solely on past pathological reports. They can then use this information to gain a broader perspective that helps them more objectively diagnose their patient’s future health conditions.
The Future of Frozen Sections and Telepathology
A recent long-term study conducted over a 2.5-year period that ended in 2017 analyzed the telepathology results and experiences from over 5,000 frozen section cases. Among the most promising findings were trends indicating that a move towards remote FS diagnoses can help improve patient care and increase equity in medical resource distribution.
With the demands for frozen biopsies increasing, these positive results mean that hospitals, organ procurement organizations, and medical facilities that utilize digital pathology services can become leaders in serving their patients even in the face of growing caseloads. Our U.S., Board Certified pathologists and subspecialists work 24/7, 365 days a year to provide you with expert-level frozen section interpretations that help you accurately and efficiently handle all of your interpretation needs. We even have a special collaboration with Washington University School of Medicine in St. Louis to provide cutting-edge, cloud-based analysis for OPO donor placement.
Contact us today to learn how our FS services can assist you and your patients to grow in health, wealth, and innovation.