Digital Histology

Histology – the study of the minute structure of cells, tissues and organs in relation to their function – is a vital component of early medical training.

James May, PhD, Chair of the Department of Anatomy in the College of Osteopathic Medicine of the Pacific (COMP) at Western University of Health Sciences, wasn’t satisfied with the time-consuming, traditional method of teaching histology. For many years, students were scheduled for two to three hours of histology lab time. They would borrow a box of slides, purchase a histology atlas and identify cell and tissue structures under a microscope.

“Five years ago, I decided this is not the way to go,” May said. “I created a Web site, digitized my collection of Kodachrome slides and created a Web-based histology atlas.”

Instead of coming to class and sitting in a laboratory, WesternU students can view the atlas at home or in the classroom using a Web browser. COMP did away with microscopes and students are no longer required to buy their own microscopes.

May subsequently turned to Aperio Technologies Inc., based in Vista, Calif., to have his collection of glass slides digitized. COMP subsequently purchased a dedicated server for storage of histology and pathology digital images. The virtual histology Web site developed by May currently has about 140 slides.

“I teach the same way as before, but it’s a lot easier for students to learn the material when they can do it on their own time,” May said. “They don’t spend two to three hours in a lab. Images viewed on a computer are easier for them to see.”

Digitizing the slides also eliminated the need to clean and organize slides and microscopes.

“We eliminated space needed to have laboratory and freed up faculty time,” May said.

May served as a beta tester for KickStart, a digital microscopy starter package that enables educators to share digital slides in an open, Web-based platform. The system was created by Aperio Technologies Inc.

“Having several years of software experience, we were happy to bring him on as a beta tester for the KickStart product, which launched in 2006,” said Chrystal Adams, Product Manager for Education for Aperio. “He tested the software’s functionality and suggested enhancements, many of which we have implemented into the software. We now offer a comprehensive educational package.”

Aperio has an install base of more than 400 systems in 27 countries, and has a track record of significant growth year to year, she said. The company has customers at academic medical centers, hospitals and biopharmaceutical companies.

“With this technology you can make digital slide teaching sets available 24-7, without providing 24-7 lab access,” Adams said. “Students log in from their homes to browse lesson slides at their leisure. This promotes self study among students, which is highly valued by educators.”

Students can look at the entire tissue and focus in on specific areas. A microscope has set magnifications – 4X, 10X, 40X, 100X – but the digital image can be viewed at any magnification within a wide range. The image is also clearer than looking through a microscope, May said.

The Web-based system is used by students in the osteopathic medicine, physical therapy and veterinary medicine programs, as well as by students from USC and the University of New England. Next year they will be used by dentistry, podiatry and optometry students in WesternU’s new colleges.

Other institutions utilize the Web site as a component of their histology lab, May said. They primarily provide feedback about how well the Web viewer is working.

Among May’s collaborators is Joel Schechter, PhD, USC Professor of Cell and Neurobiology and Assistant Dean of Student Affairs and of the Basic Science Curriculum, who was on the faculty when May was a USC graduate student.

USC’s histology program went fully digital eight years ago using static images. May borrowed some of USC’s glass slide sets to use in his program.

Schechter and a colleague created a virtual histology program, a three-disc program with light and electron microscope images. But USC’s images show preselected areas, while May’s images can be moved around on the computer screen.

“More and more schools are teaching microscopic anatomy and pathology on digitized images,” Schechter said.

WesternU students appreciate the change. Charlie Wray, DO ’11, said he used microscopes as an undergraduate.

“This is 100 times better,” he said. “You’re not blindly searching for something you know nothing about. I think it’s appreciated by everyone.”

The detailed slides remove any ambiguity about what you’re looking for, said Allan Belcher, DO ’11.

“Plus you can look at them at 2 a.m., and the quality and clarity is perfect,” he said. “The time is so important. As an undergrad, it would take three to four hours to clean slides and the microscope and adjust lighting. What took four hours takes 30 minutes now.”