124: Slide-free Digital Pathology | Deep Dive into Muse Microscopy

Transforming Pathology: A Deep Dive into the Muse System

This episode is sponsored by Muse Microscopy. 

In this episode, we explore the primary challenge of implementing digital pathology globally—digitizing the analog. 

A potential solution is direct-to-digital pathology, exemplified by the MUSE system by Muse Microscopy. This technology eliminates the need for glass slides and manual staining, offering rapid, non-destructive imaging of intact tissue samples. 

You will learn about the advantages of Muse, including faster diagnostics, improved data fidelity, and broader accessibility, particularly in remote areas.

 Detailed insights into the Muse workflow, imaging techniques, and potential applications in human and veterinary medicine are provided. 

Challenges like adoption barriers and regulatory hurdles are also addressed. Join us as we explore how the Muse system is redefining diagnostic workflows and enhancing patient outcomes.

00:00 Introduction to Digital Pathology
00:18 The Hurdle of Digitizing Analog Pathology
00:26 Direct to Digital Pathology: A Game Changer
01:46 Introduction to Muse Microscopy
02:32 How Direct to Digital Pathology Works
03:10 Advantages of Direct to Digital Pathology
04:13 Understanding Muse Technology
05:26 The Digital Pathology Workflow with Muse
14:15 Challenges and Misconceptions
15:38 The Future of Pathology
16:31 Frequently Asked Questions
18:07 Conclusion and Additional Resources
18:54 Behind the Scenes and Final Thoughts

Links and Resources:

• Original blog post on Digital Pathology Place  Website and LinkedIn
• YouTube playlist with more information about MUSE
• SmartPath Product presentation from CAP 2024
• Video showing the SmartPath device at the conference booth
• USCAP in Boston - Muse Microscopy booth #528

Transcript

Introduction to Digital Pathology 

Welcome, my digital pathology trailblazers. So what is the number one obstacle, number one hurdle in implementing digital pathology? Everywhere? Everywhere across the globe?

The Hurdle of Digitizing Analog Pathology

It's the fact that we still have to digitize the analog. So  as long.

Direct to Digital Pathology: A Game Changer

As this is the case, the return on investment is not gonna be immediate, but there is something, , that can overcome this hurdle and it's called direct to digital pathology.

I have recently been working with a company that does that muse microscopy,  and I collaborated with them on an article in LinkedIn that had quite some traction. So I wanted to give you this article as a podcast episode as well.

I'm just gonna read it to you, so let's dive into it.


Pathology is undergoing a seismic shift moving away from the traditional methods that have been standard for over a century.  Histopathology, which traditionally relied on thinly sliced tissue sections mounted on glass slides is evolving with advancements In slide three optical microscopy, this novel approach eliminates many bottlenecks associated with conventional workflows, such as time consuming sample preparation and staining processes  by imaging intact tissue samples directly. Slide three techniques enable faster diagnostics, better data fidelity, and broader access to pathology services, especially in the remote or resource limited areas.

Introduction to Muse Microscopy

To help you learn more about these cutting edge advancements in slide three technology, this episode is sponsored by Muse microscopy.

Let's introduce slide three, pathology among the various emerging technologies. In slide three, pathology the Muse system Microscopy with UV light surface Excitation stands out as the first mature solution. Muse offers a novel direct to digital workflow that bypasses that traditional reliance on glass slides and manual staining

in this episode, we'll explore muses workings, advantages and potential to change the pathology workflow as we know it.

How Direct to Digital Pathology Works

So what is direct to digital Pathology? Direct to digital pathology replaces and or compliments the conventional histopathology workflow by capturing diagnostic quality images of fresh or minimally processed tissues directly from the sample.  Unlike traditional processes that rely on embedding tissues in paraffin, slicing them into thin sections and staining them on glass slides, this innovative approach employs advanced optical and computational methods to analyze intact specimens.


Advantages of Direct to Digital Pathology

The advantages of direct to digital pathology include faster turnaround because by eliminating steps like microtone slicing and staining, results can be delivered in minutes versus hours or days in the classical workflow.  Then we have the non-destructive imaging tissue remains intact, preserving it for further analysis if needed.

Another advantage is accessibility. Digital images can be shared instantly facilitating remote consultations.

So, as I told you, this episode is based on a blog post we wrote together, and in the blog post there are graphics. So I'm gonna include the link to the original blog post. You can also find it on digital pathology place.com or muse microscopy.com, and you can see the detailed graphic that will help you.

Understand the muse technology, but let me give it a try with just words.

Understanding Muse Technology

So the Muse system is a pioneering tool in the slide three pathology space. By using UV light surface excitation, it produces high resolution fluorescent images of tissues without requiring traditional glass slides or chemical staining.

The core features of Muse include, as we said, the UV surface excitation, and the system uses short wavelength, UV light to ex excite tissue generating autofluorescent  signals that can be captured digitally.  Then integrated workflow. The tissue samples are placed in a cassette image directly and digitally converted into an H and e equivalent format inside the device.

It's a very compact device. I'm gonna link to a post where I'm actually picking it up from the conference booth.

And because of this compact design, the system has a small footprint that allows deployment in labs, clinics, or other near patient settings.

Depending on the size and complexity of the tissue sample, muse can create images in just two to 15 minutes.

The Digital Pathology Workflow with Muse

The digital pathology workflow with Muse Technology consists of the sample preparation phase, digital imaging phase and image processing phase, and then the review phase. For the pathologist, so in the sample preparation phase,  we need to start with tissue collection. So fresh tissue is collected from the procedure and transferred to the gross room for initial processing.

Initial processing means the tissue is received as sessioned and preferred in the gross room according to standard protocols. Then tissue sectioning.  The specimen is sectioned grasp to appropriate specifications,

and the next step is non-destructive. Staining the tissue undergoes a non-destructive dying method. Preserving the sample integrity with superior RNA, retention to traditional FFPE samples. In the digital imaging phase, first we load the sample. Sample loading consists of, , tissue being loaded into the smart path.

Dx, cassette Smart Path is the name of the device, so we load it into the cassette and instrument for processing. 

Once we load it, macro imaging happens. A secondary camera captures a macro tissue image and records tissue coordinates and sample  identification information.  Then.  Region selection happens. So through the user interface, UI technicians review the macro tissue image and select the whole slide imaging or regions of interest so you can pick where you want the image to be generated.

You don't have to do the whole thing. If not, the whole tissue is relevant.  Then the high resolution imaging happens. So the device utilizes a primary camera with a 10 x objective under uuv, LED illumination,  and this camera features also autofocus capability.

Once the imaging is done, we have the image processing phase.  What happens first?  Is the multilayer capture. So the AI driven image capture happens in seven distinct layers.

Those distinct layers are. The different depths so you can go deeper into the tissue.

This happens tile by tile, and then all the tiles are being merged so that we obtain one. Single merge tile of the best focus. Then there is the tile processing. The process repeats for every tile in a serpentine fashion, and  a slight image overlap is maintained in the x and Y axis.

Next, there is a mosaic generation.

Mosaic are the muse images. So what happens is that we are stitching and merging all the tiles, and we are creating a native UV mosaic image. So the native image is an ultraviolet image, and then we have virtual H and e conversion. So the system converts native UV mosaic image to a virtual hemat, toin, and eoin format, and it produces final tissue image for pathologist review. In the review phase, images are typically available within 30 minutes of initial processing. Images are automatically uploaded to cloud storage or.

The lab's LIS system and pathologists can perform online reviews of the digitized images.  So does this mean  we are facing the elimination of glass slides? Well, that would be a game changer and it actually will be.

Traditional histopathology relies heavily on glass slides, which are prone to breakage, mislabeling, and degradation over time. And Muse removes this dependency offering a glass free slide free approach that retains all the diagnostic details while minimizing logistical challenges. The key benefits include durability.

It eliminates the risk of physical damage to specimens during handling or transport.

We can have significant cost savings because it reduces material and labor costs associated with slide preparation. Then we have improved image quality because it avoids artifact commonly introduced during slicing and staining, which is super important for image analysis and downstream ai if we wish to do it because AI is not too good with dealing with artifacts.

So we're looking for.  Potential. Tremendous increase in speeded efficiency for diagnostics. In healthcare, time is critical, especially for diagnosing life-threatening conditions such as cancer and traditional pathology.

Workflows often take days to weeks, but muse accelerates this process to deliver actionable insights within minutes. For example, during a breast biopsy, muse can provide preliminary information in a near patient setting. Assisting with fast treatment decisions while the patient is still in the facility, right?

So this is a stark contrast to the current workflow where patients may wait days or weeks for results.

The advanced imaging capabilities should not be underestimated as well because one of the standout features of Muse is the ability to provide deeper tissue imaging giving potential to 3D imaging. We have deeper sections like Zack.  By stacking multiple Z layers, the system produces topographical images that offer depth and detail far exceeding traditional methods.  So regarding the imaging depth, muse penetrates up to 50 microns into the tissue. Uh, whereas traditional glass slides, it's limited to five microns, offering only a 2D perspective.

This capability is invaluable for applications like stereo, where understanding the 3D structure of tissue is crucial for scientific studies and for example, for drug development.  Regarding the fluorescent and virtual staining, muse employs UV excitation to generate fluorescent images, which are then digitally converted into an H and e equivalent format.

This virtual staining process eliminates the need for chemical dyes, offering a safer and more sustainable alternative. How it works. UV light excites tissue to produce natural fluorescence. Then digital processing converts fluorescence into diagnostic quality h and e. Like images,  there are optional dyes for enhanced imaging. Non-toxic dyes like daik can be used, and this approach ensures consistent and reproducible results, making it ideal for both clinical and research applications. So what are the applications of Muse and Pathology?

In human medicine, we will obtain rapid diagnostic quality images, which is ideal for intraoperative consultations where surgeons need. Immediate feedback. Then we can leverage it for remote pathology, which enables specialists to analyze images from distant locations, improving accessibility in underserved areas.

Then for cancer detection, it provides precise imaging for evaluating tumor margins and cellular abnormalities  in veterinary medicine.  The portability and ease of use make muse a perfect fit for veterinary clinics and even mobile units. Pathologists can quickly diagnose conditions in animals from biopsies to organ evaluations without the need for specialized lab infrastructure.

The implications for remote and resource limited areas are huge because in regions lacking histology, labs, or trained pathologists, muse could revolutionize access to pathology expertise by providing a self-contained solution for tissue analysis equipped with wifi or cellular connectivity.

The device can transmit images to specialists anywhere in the world enabling super fast consultations. Additionally, its portability opens possibilities for deployment in field hospitals, community, near patient settings, and even disaster zones where traditional pathology resources are unavailable. 

Challenges and Misconceptions

Do we have any challenges and what are the misconceptions?

Well, yes, despite its advantages, transitioning to a slide, free workflow may face initial resistance, and this is due to adoption barriers. Medical professionals accustomed to traditional methods may need time to adapt.  There are training requirements while SmartPath.  Muse technology is very user friendly and less complex than preparing FFPE, formal and fixed paren embedded tissues and on glass slides.

Training is necessary for optimal use, so we need to train people. There are regulatory hurdles, FDA, approvals and reimbursement models, as well as new clinical protocols need to evolve to accommodate these technologies. So addressing these challenges will require collaboration between manufacturers, clinicians, and regulatory bodies.

Regarding the reimbursement and cost effectiveness, muse could potentially leverage existing CPT codes for pathology evaluation and.

Or apply for new codes if necessary, simplifying its adoption in clinical settings by reducing labor and material costs while improving efficiency, it offers a financially compelling alternative to traditional workflows. 

The Future of Pathology

So you'll know that I think the future of pathology is digital, and Muse represents just the beginning of a broader shift towards digitization and pathology.

So as these technologies become more widespread, we can anticipate increased use of AI because automated tools will be able to assist in diagnosis and image analysis. Broader accessibility. , we will be able to deploy it in underserved and remote regions. Enhanced patient outcomes, faster decisions based on the diagnostic quality images leading to timely treatment.

And as Matthew Nunez, the CEO of Muse, aply said, the future is here. This technology has the potential to redefine how pathology is practiced, bringing it closer to the patient, and enabling faster, more effective care.

Frequently Asked Questions

So just to recap with a few frequently asked questions, what is Muse? Muse is a slide free tissue imaging device for a pathology that uses UV light excitation to generate digital images of tissue samples without the need for glass slides.  How fast is Muse? The system creates images within two to 15 minutes, depending on the sample size.

Then, you know that's image creation. Then there is a little bit of processing, a little bit for upload, but the image creation, two to 15 minutes.  Then can muse replace traditional pathology methods  while it complements existing workflows? Muse is particularly valuable for rapid image acquisition and non-destructive analysis.

So I anticipate this being super complimentary and in instances where there is no. Option for classical workflows. This could be the option.  Is muse suitable for veterinary medicine? Yes, its portability and ease of use make it ideal for veterinary applications.

What are the cost implication of adopting Muse?  Muse reduces overall cost by eliminating slide preparation and associated logistics with the potential of leveraging existing reimbursement codes in the future,  what is the imaging depth of Muse? Muse can image up to 50 microns offering a 3D perspective  that traditional slides cannot.

Conclusion and Additional Resources

So in conclusion, the Muse system is at transformative innovation. Pushing the boundaries of pathology and redefining diagnostic workflows By eliminating traditional bottlenecks, it paves the way for faster, more efficient, and more accessible pathology services across the globe.

And if you wanna see it, learn more about it. There is a whole YouTube playlist and a few YouTube videos that I will link in the description of this episode as well. Um, where I talk to the team, where there is a product presentation given by the Muse team at CAP 2024, we have a video from that, so definitely dive deeper.

And let me know what you think.

Behind the Scenes and Final Thoughts

Before I say bye, just a quick, , behind the scenes. So I wanted to, there is an option, , to have an AI generated voice like my voice generated with ai. And I tried to leverage this for reading this article, but then I played it and it sounded like a robot, reading a scientific publication.

So. I didn't wanna do this to you. I hope you appreciate, , me trying to read it in an engaging way. Let me know what you think. Reach out on LinkedIn, watch the videos, reach out on LinkedIn, watch the videos, and if you are coming to USCAP in Boston later this month, I'm gonna be there at the Muse microscopy booth. The booth number 5 2 8. So you can visit me, visit the team, check the devices, and see if this is something you would like to learn more about.  I'm gonna be there, 
and I talk to you in the next episode.