Aleks: [00:00:00] I was always thinking, how cool would it be to do it right there and then without any prep, just sit down at a table, grab a guest with all the conference noise behind me, clip the microphones and record a podcast and that’s what happened at the last digital pathology and AI congress in New York together with Giovanni Lujan, whom I already knew from our crossover podcast with the Digital Pathology Association podcast, Beyond the Scope.
He was at the conference and we just decided to record this episode for you and we are commenting on our impressions and the new trends in digital pathology that were communicated at the Congress. So let’s dive into it.
Giovanni, so cool to meet you in person finally, we’ve talked how many times, at least two podcasts together.
Giovanni: Yeah and I’ve been a devoted follower of your podcast and all your activities online. I think you are a very inspiring person if you don’t know she’s my [00:01:00] professional profs. I’m inspired by her passion and how she’s really into digital pathology.
Aleks: Thank you so much. You’re really into digital pathology as well. That’s why we like probably are all over the place talking about it, but here we are at the digital pathology and AI Congress organized by Global Engage and Giovanni was chair yesterday and today, and he gave a talk. I’m still waiting for my turn to speak at [2:30] about the GLP validation of digital pathology and drug development.
But so far your impression, is you travel to conferences all the time. What’s the what do you think is different about this one? Then I can tell you what I think is.
Giovanni: It’s smaller, it feels that you get to know more people because of how small it is and the breaks are bigger. So they on purpose leave a lot of time for people to interact with each other.
And with the vendors. So I think that’s a great advantage or different point from the other ones that focus more on the academics and just mini conference [00:02:00] back to back. I think this has a lot of the social aspect to it that I think is very good too. So for networking, I think this is a pretty good company.
Aleks: Yeah, that was my goal also to come here and you get, so they have those ninja tricks. They have long breaks and they have one on one meetings with the vendors. And you mentioned in your talk that in Europe because Global Engage organizes those conferences across the globe in Asia, in Europe and they say that their European conference is the biggest.
This one is not the biggest, we have 350 people here and at the beginning, when I was talking to different companies, they were like, just 350 people? And it pays off to be a sponsor here? Do you get good connections? And they say yes, because it’s a very quality audience and then I was like, why is this audience more quality?
Because they are already doing digital pathology. And you mentioned that in Europe, they’re even like more ahead. They are already troubleshooting what they have been doing for a couple of years. But here, everybody who’s here is either super [00:03:00] close and looking for solutions or already doing and presenting workflows, which is different than just going to a scientific conference and reading about the research. So that’s what I think distinguishes this one for networking perfectly.
Giovanni: Yeah. I had the opportunity to go to both and I think that’s the main difference between here and the European, which will be in London in December I will be there.
Aleks: I don’t know, but I will be here for next year as well, but you’re going to probably go to pathology vision as well.
Giovanni: Yes.
Aleks: Yeah. I thought I would be going, but I’m going to a veterinary pathology conference. I’m going to be the chair and I’m like, Oh, okay. I’m the chair. So I don’t think I can.
Giovanni: No, you must go to that one.
Aleks: I should show up, right?
Giovanni: I, you should give me some tips to be so organized about traveling with your equipment. See, here we are. She has a microphone. We have the lightning device. We have the laptop, and we have the camera.[00:04:00]
Aleks: Tripods, we have tripods.
Giovanni: The only thing missing is hair and makeup, which I told her next time.
Aleks: Yes, I’m gonna tell you next time to be prepared at the circuit.
Giovanni: But it’s just incredible how well prepared she is, and how much she delivers for the, for your followers, for your audience. Yeah, kudos to you.
Aleks: Thank you so much. It’s nice to hear. You know what I wanted also to touch on that like in digital pathology, because it’s, I would still consider it cutting edge and like developing discipline where people are working through the kinks of the workflow. New devices are coming up.
Sometimes you’re still limited by your device. So you come here and that there are new options and there is this artificial separation of science and the industry and in this area, it mingles very much. And also yesterday, there were several vendor presentations. And the level of science that those vendors have to demonstrate to go and sell it in the healthcare space is [00:05:00] incredible.
There are publications in nature in JAMA, whatever your highest impact factor journals are, and not only that, then they have to increase the size of the cohorts. To be able to present it to the FDA and I think this is undervalued or not perceived that much when you come from the perspective.
Oh, this is the science and this is commercial here it mingles very much and that’s why I think it’s cool that we have a super cool venue. I don’t know if you can appreciate the camera. Showing it’s an old bank.
So we have columns and we have a super cool setup there for the stages We have the stage in the center and the vendors are around the public So it’s not disruptive to go and quietly talk to them also during the talks, which I don’t know if I recommend or not It doesn’t matter because you don’t disturb anybody and who’s interested in the talk is just going to listen to the talk.
So you implemented at Ohio [00:06:00] State’s digital pathology. Everybody is digital now and that was also the topic of your talk.
Giovanni: Yeah most everybody still.
Aleks: We have some rebellious people.
Giovanni: No not really. We have some, a few specialties that are lagging just for the nature of the.
Aleks: Their specialties.
Giovanni: Yeah, like hematopathology, cytopathology, renal because of fluorescence, those are not fully digital. They see some of their slides digitally, like him, look at the narrow biopsies and the lymph tunnel biopsies digitally, but then they have all the smears, and marrows. And those are still in the original glass format. So that’s how we’re doing now, or what we’re trying to implement to catch up with this.
So the specialties, because back in the day, there was no technology available for them. So they naturally step aside and have been not enjoying the full benefits of being digital. But now with a lot of AI coming in both directions, cytology and hematology in Reno, now it’s time for [00:07:00] them to be incorporated and we are working very diligently now to try to get the best possible tools for them as well.
Aleks: So one, one point that I have to mention here is because it’s still young, we are still limited by the tools that we have. All the specialties that you mentioned, if there were tools, would probably go digital at the same time as well. But the other thing that I wanted to ask what was your interaction in the hospital with the vendors.
In general, like with the vendors that supplied you with your hardware, with your everything, like all the support.
Giovanni: I, because all of this was initiated by Dr. Anil Parwan I, who’s the vice chair. He has this concept of this modus operandi that is very welcoming to everybody. All the institutions that want to collaborate and any vendors that have any products that they want to demonstrate to us, or are seeking any type of collaboration. So over the years, we’ve interacted with most vendors out there. And so we keep a very good [00:08:00] relationship, not only with the ones that we use, but actually with everybody else as well. The ones that we don’t use at all or the ones that we’ve established some sort of project on the side or sometimes ongoing projects with other vendors.
So I think that gives us a very unique privilege to be able to get exposed early on to what each vendor is coming up with. And I think that is just a great thing to do because when you realize like in the case of Dr. Pawani is a very busy person, he’s the vice chair. He leads over the informatics entirely, pretty much.
He’s also the signing-out pathologist. So when you get all these phone calls from different vendors that they want to show you something or bring you something for you to evaluate or whatever. You will see how most people will decline those invitations and maybe just ignore them. But he always replies, he always says, yeah, welcome, come in, plan the next meeting.
So I think that’s how we keep that relationship [00:09:00] constantly increasing, which I. I think this is a very good idea.
Aleks: By the way, if you don’t know Dr. Anil Parwani, Google Wikipedia digital pathology. And his picture is on the Wikipedia page of digital pathology. He’s a doctor of digital pathology.
And I’m going to have him on the podcast soon. But yeah, so I think this attitude at this conference, when people start announcing their partnerships, I think that was not present a couple of years ago. I think people were more like everybody developing their stuff in their bubble and here at this conference, I see them coming together.
Obviously, some are in competition with each other, but mostly they’re like seeking who would be a good partner to partner and do more together. So that the one vendor can keep their core competence and the other one provides their core competence and together they, they build a tool that was, for example, evidence in yesterday’s pages presentation where they developed algorithms, they like achieved the [00:10:00] milestones of having an FDA cleared computer-aided diagnostic test.
And so they like heavily are heavily invested in image analysis and they have it in a regulated environment. And now they collaborated with.
Giovanni: Mindpix, yeah,
Aleks: Mindpix. I hope this is correct, yeah that’s it. But I know they are bringing more image analysis capabilities that are from different stains, with everything, part of the diagnostic workflow, but they don’t want, they don’t want to split their focus from their core competence of developing things on H and E.
And they brought in a partner, which I think is, I don’t know, I cannot even give a perspective because this is the only industry I’ve been so involved in. So I don’t know if it’s. is a natural thing that’s happening, but I like it. I like that people are starting to like, look for partners.
Giovanni: No, I think it’s an evolution because as you said, it started as, Oh, let’s do this, and let’s do it ourselves and let’s do it well.
Now, I think it’s very well known that you cannot do everything. So you should keep [00:11:00] doing something. And of course, we have software.
Aleks: Go figure, you cannot do everything yourself. No. It’s when we first started, I think that was the goal. I want to take you digitally from beginning to end.
Giovanni: Yes, one-stop shop. People like that. And so that’s what we were trying to do or they were trying to do, but it was obvious that this is going to be an exploding field where it is an exploding field and you have to, rather than trying to do everything more or less, like maybe not, fail here, fail there, better to focus on something, do it good and then Partner with another.
Aleks: With another competence and then bring in where you want to expand. Yeah. I think on the one hand, it’s not surprising because like, whenever you like come up with the idea, I want to protect this idea and you want to go for it and capture the market with it. But on the other hand, we are working in the healthcare system and the hospital lab, how many systems do you have that need to be interoperable?
And this interoperability concept only started taking off two years ago, [00:12:00] three years ago in this space. Still, there are, like, some people who don’t want to have an open API, don’t want to export results in a, I’m coming from the image analysis background, but the results are only usable in this very system and that’s for any software, but on the other hand, in the lab, you have to now interact in the era of digital healthcare with so many other systems that this is not an option anymore and digital pathology is catching up, so.
Giovanni: It’s going to become more crucial as more of the other sub-specialties within pathology and the other specialties in medicine also become digital.
There is a lot of opportunities there for digitizing not only glass slides but all sort of images that come from different sources and then interconnecting those images with the original data, with the medical data, with research data. So in the end, I think this is going to be a global action, a global set of data from health care [00:13:00] within a hospital that eventually to make it even more productive will probably be interconnected with another hospital with networks of hospitals with countries with the world.
Aleks: We to accelerate drug development.
Giovanni: Which we, which brings before we get criticized for that because it brings the HIPAA regulatory into concerns. Yeah. That’s a scenario like, the, we mentioned science versus vendors and then there is like healthcare and pharma industry. Like pharma is working on drugs that are being used in healthcare.
How about making it faster? I think this will be a great opportunity for when we are more interconnected. With more Intel operable systems that will be crucial and to alleviate the concerns for private medical information and all that. I think that there is a whole workflow coming that way to where you can have the data that you need and have the data that is private and be able to separate it and use what can be usable and protect all the patient information at the same time. Of [00:14:00] course that requires a lot of trust and right now, because it’s new.
Aleks: Firewalls or the concept of federated layer learning is being popularized where you like to train your models on one set of data. And then you don’t take the data and pull it with other data. You take the model and put it on different data.
So it gets the information, but there is no breach of the informational system.
Giovanni: Yes, that’s I haven’t heard anybody talk about it. All those are to explore. All these are developing tools. Not developing tools. Some tools have been available in data science for a while. There is nothing new on that, but now it’s new in health care.
And all these concepts to be for healthcare to be able to accept them and open up, they have to make sure that the information is truly protected because you don’t want to find out after being in one of these communities of learners, where you combine information that some of your private information will be.
Aleks: Leaked out.
Giovanni: Yeah, and so I think that’s the reason why it’s not that great because I [00:15:00] think everybody bringing up that topic will immediately be confronted with the regulatory aspects of that type of sharing and I don’t think we have at this point a good way to.
Aleks: Explain and prove, Yeah I think so because like I said, like whenever you get for the tools, for the devices, whenever you get clearance, you already have so much data you can go and confidently present it and people will ask you questions, but you can defend your work. Whereas when it’s still a work in progress.
Giovanni: Yeah, you don’t have that result but.
Aleks: Exactly.
Giovanni: That we determine that. Oh, yeah, it’s successful. There were no bridges. There was nothing unexpected.
Aleks: I think people are coming out for lunch so.
Giovanni: Yeah, we’re one last thing that I want to say because this is important.
Aleks: One more last thing as well.
Giovanni: That I hope that we talk more about that, that we talk about this type of learning and about the cloud too, which is another.
Aleks: Cloud was touched upon in the keynote [00:16:00] about cloud versus on-prem storage. And I posted it on LinkedIn and I was like, I didn’t expect this is going to generate any kind of discussion, a lot of controversy about that.
Giovanni: It is a controversial topic in the same, for the same reason is unknown to the health care environment.
Aleks: The risks are unknown.
Giovanni: You have all your posts like and you’re not concerned about, Oh, my somebody’s still there.
Aleks: Yeah. But that’s the thought I had. I’m okay. If somebody’s going to copy this, I have presentations. I’m like, good for them. Then they spread it to more people. It’s because it’s educational content and my goal is to give it to as many people as possible. So if somebody takes it, please go take it.
It’s not encouraging to steal my content but in general, as a risk, it’s a low-impact risk for me and the others.
Giovanni: The same as you post stuff on Facebook, some people are very careless. They post whatever, but they know that can be accessed and stolen, and posted somewhere else that they have no control over.
So that [00:17:00] is understood on the web environment if you post something there, it can appear at the other end of the world.
Aleks: Take out of context, remix, and.
Giovanni: Yeah, but that’s okay. We accept that risk but when we’re dealing with private medical information, we know that the hospitals are highly liable for those and so that concept won’t pick up as quickly as it needs to pick up because of the storage issues. But I think the more we discuss it, the more it gets out in the open. We learned to trust it.
Aleks: One last thing. So what’s your like nugget of wisdom that you picked from this conference that I have, I’m going to tell you in a second, what sentence I’m going to keep repeating to people, but that’s like the one thing that you’re taking out and we’ll tell other people and mine is, and also that was also from the keynote lecture was when there, there is no more ROI on digital pathology because this is the way pathology is going to be done.
In the same way, as nobody is calculating [00:18:00] ROI on having an MRI in a large hospital, it has to be there. There is no negotiation. You touched on this with Oh, if we would live in an ideal world, pathologists would go and say, we need this for our work because we do and when you’re like, I do a hundred percent digital sign up.
And that was also in the keynote lecture. I’m embarrassed to say that I don’t remember the name of the person who gave the keynote speech. He was from Ontario, Mackenzie Hill.
Giovanni: It’s Andy Evans. He’s my good friend.
Aleks: So thank you, Andy, because the words of wisdom from your presentations are now going to the world.
But yeah, so he said that the pathologists are no more asking for glass, but one of his pathologists said, if you take away this digital, I’m changing jobs. And I feel the same way. If they take away my digital pathology, I’m looking for an employer that can give it to me.
Giovanni: Mine has a lot to do with that too. I think it should echo not only in my head but with everybody’s that we should forget about digital [00:19:00] conference. This is a pathology conference and that’s the way that it’s done. Pathology is digital.
Aleks: You don’t have digital radiology conferences, do you?
Giovanni: We can maybe we can say computational pathology to incorporate all the AI into it but digital definitely, I think at this point it should start being redundant.
Aleks: This is fantastic because that’s where we want to go. Thank you so much Giovanni for joining me and yeah, thank you for listening.
Giovanni: Thank you, everybody.
Aleks: Thank you.
Giovanni: It was great.
Aleks: Thanks so much for listening to the end. If you were at the Congress, we might have already met, we might have seen each other, and we might have even talked. And I know that not everyone can go to all the conferences every year. So this is why at Digital Pathology Place, we launched the club, the Digital Pathology Club which has the course component where all our digital pathology place courses are hosted and the community component.
And in the community, we are [00:20:00] discussing the current topic and interacting. And we also started the daily digital pathology paper challenge. So if you’re interested in trying out the challenge for you next week, I have something special for you. I have a one-week free trial. of this membership. And the moment you join, you can access everything that we have in the courses as well as the challenge.
So go ahead, click on the link below and give it a try and I talk to you in the next episode.
