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At ICGI one of our key areas of research is Heterogeneity. Cancers are heterogeneous and can follow multiple paths. Some will progress to metastases and death while others will remain indolent.
A single tumour can contain multiple regions of different genetic or epigenetic aberrations that are not distributed evenly throughout the tumor.
Sampling for most markers is generally performed on a small fraction of a single block of tissue. Using prostate cancer as an example, the sample examined is a mere 1:1000 of the tumor. This small sample size means there is a greater risk of missing the cells that actually go on to kill the patient.
Grading the sample and giving a correct diagnosis depends heavily on the pathologist’s expertise; pathologists assessing the same sample can arrive at vastly different conclusions.
Furthermore, the manual laboratory procedures needed to render a diagnosis are time-consuming, and the shortage of pathologists only adds to the increasing difficulty to keep up with patient demand.
The need for automation and assistive digital tools in pathology has never been greater.