This is Lab Medicine Rounds, a curated podcast
for physicians, laboratory professionals, and students.
I'm your host, Justin Krueter, the Bow Tie Bandit of Blood,
a Transfusion Medicine pathologist at Mayo Clinic.
Today we are rounding with Shane Ferraro,
a Pathologists' Assistant, Assistant Supervisor
in the Division of Anatomic Pathology
at Mayo Clinic in Rochester, Minnesota,
to talk about the important innovation of 3D scanning.
Thanks for joining us today, Shane.
Yeah, my pleasure.
Thanks for having me.
Very exciting.
Yeah. So 3D scanning is something that I think a lot
of us are starting to kind of hear about.
Some of us are probably getting a chance to see
about this innovation.
I'm curious, from your perspective
why is 3D scanning an an important innovation in pathology?
Yeah, it's a, it's a very exciting question
and a very exciting topic.
So from all of my experiences
with our 3D scanning system so far
I think the most important impact is on education.
And for instance, so
with our pathologist assistant team,
we're heavily invested in resident and PA student education.
So the applications of this technology really allow
for like a versatile and kind of conducive approach
to how people in anatomic pathology learn.
So we're very visual learners,
we're very hands-on, and that's an extension
from our experience in like cadaver labs.
And, you know,
as we were to the frozen section lab here,
surgical pathology labs in general.
So the the applications of the technologies here,
can really be fostered in a way to,
create environments that are more conducive to learning.
So for instance, with this technology, we can create things
like QR codes, which you can bring to a presentation
and you can have the audience kind of scan
that with your phone, and then they could look
at a 3D model that you created on their phone.
So they get a really interactive experience with that.
In addition to that
we also have the ability to create actual tangible 3D models
from the specimens that we have scanned.
So when we do that
we can actually have those models shared
in an environment that's, that's not a
an actual like pathology lab.
So you don't have to worry about safety precautions.
You don't have to worry
about balancing clinical care with resident education.
So you can really hone in on some of those skills
and really foster a good environment for them to learn
in. So, very exciting from that angle for us.
Yeah, I mean, it sounds really almost transformative, right?
I think you mentioned a couple of things that you can do
that we haven't really been able to do before.
You mentioned, so with a 3D scan
that we're able to really take anatomic models
and we can kind of,
the audience can play with them on their phone.
And I'm curious, like when you talk about, you know
educational change that's happening
because you can get the audience do that
are there certain activities that you can do
with the audience that you weren't able to do before?
Are there certain insights that you're hearing
from the learners when you're doing that kind of approach?
It's hard to really know
because this is something that we just received
and as I mentioned, like, so all
all of our PA educators are, are really excited.
I've had several of them already asking
about the opportunities to actually get their own specimens
and their QR codes to share.
So the enthusiasm is there.
I can't quite comment on how it might transfer
into an audience kind of engagement, but just the fact
that somebody could get their phone, scan the QR code
and then just you can hear all the audible ooh's
and ah's as they go through a specimen.
It sounds like a very exciting thing.
And I look forward
to having those opportunities with people.
So
Yeah. Absolutely.
So what do you think is important
for our audience to understand about 3D scanning?
So two, two things come to mind.
You know, we talk
about 3D scanning as if it's like some kind of
really like futuristic abstract technology
when in reality it's, it's more simple than that.
So the machine is, you know,
it's this big cube and we would put the specimen
inside this chamber and it would have,
it's mounted on a rotating platform
and we could kind of choose like what kind of, you know
mount it's on, it could be a glass surface, it could be
like a pin mounted method, or we can do like,
it's a resting kind of mesh kind of screen.
So it's on this, this, this mount
and then it's in the chamber
and there's several cameras kind of lined along the edge.
So the specimen will rotate
and the cameras are just taking multiple photos
of it as it rotates.
So it's just a really fancy kind of camera setup.
So those photos actually act as the
the data for the 3D model to be rendered.
And these models are really like crisp and clean
and this is like, it's very simple and very scalable.
So it's something
that I think will be much more prevalent going forward.
The other
the other thing that I think is really interesting
about this is, I talk about the education side a lot
and that actually transfers over towards patients too.
So for instance, here
with our PA service and our pathology service,
we see a lot of heart and lung transplants.
So we actually have a service where patients
can request this upfront.
They can,
they can request to see a scan of their specimen.
So the, the patient could come
in after they've had their lungs, you know, removed.
They have a new set of lungs
they can come in with their family and they could,
they can talk to the actual pathologist who
reviewed the actual specimen, the, the patient's lungs.
They took sections to look at microscopically
and they could get a one-on-one interactive session to
kind of go over the specimen
and kind of really see
the cycle of care.
And then they can also go home with that specimen
so they can have a, a memento and a reminder of the service
and the care that they experience here at the clinic.
So there's some really cool things, you know
that are happening in addition to like
just the education that goes along with this.
So
You know, another thing that comes up in my mind is, I
I mean, you're a pathologist assistant, you know
are you taking this home to show your family
members what kind of stuff you deal with?
I'm excited to, I have to be careful.
I mean, I could tell my wife about some of these things
but she doesn't wanna hear it as much.
So I gotta, I have to make sure I pick the right
kind of specimen to bring home that might not
hit those kinds of buttons for some people.
Oh, I,
I understand that. That kind of gets us into, you know
what are some of the practicalities
for implementing 3D scanning and a pathology practice?
Right. You mentioned that you're seeing this as really a
a very scalable technology.
Yes. So going back to kind of how
I mentioned how it's, yeah, it is scalable
and it's a really simplified kind of setup.
So right now we're
launching this system in our frozen section lab
which is a rapid intraoperative diagnosis lab.
So it's a very clinical heavy setting.
We, provide intraoperative results to surgeons
so that they can know how to advance with their procedures.
So balancing that kind of aspect
of our work with getting some
of these educational requests, is a hurdle.
You know, so as we kind of learn how to, how to
balance our work and really accommodate these requests
because for the most part
this is primarily an educational kind of setup.
There are, you know, ideas to kind of expand this
into a more clinical kind of aspect, but right now it's
it's really finding that, that that sweet spot to get the
get our pathologist and the surgeons the answers they need
and really make sure that we can streamline our processes.
And, you know, that, that might be something as simple as,
as I mentioned earlier
there's different mounting techniques.
So for instance
if you have something that might be more soft, like a
like a fatty kind of tumor that's really squishy
and just kind of sits, you're
you're not going to be able to put that on like a
a pin mounted method.
You're going to have to put it on the glass surface.
If you have something like a bone, which might look weird
or it might stand at an awkward angle
using that glass might not work.
So kind of making sure that we can rapidly kind
of put together the mounting technique, get a good scan,
get the surgeon what they need,
get the consultant what they need,
and make sure all kind of parties are involved,
is probably the biggest hurdle in, in my mind.
And are there different teams that you are interacting with
like outside of pathology that is helping to kind
of bridge to make some bridges
between pathology and other clinical departments?
So, right, so the system that we use
the actual scanning system is called Med Creator.
We're supported by a thing, which is the company named
they're based out of Chicago
and they have other departments here that they
they collaborate with.
So we haven't really worked too much
outside of our department.
We work closely with the autopsy lab who really
pioneered a lot of this, these techniques
and kind of helping support this growth of the technology.
So we work closely with them
but otherwise outside of like surgical pathology and
you know, anatomic pathology
we haven't worked with too many other departments.
I'm excited for those opportunities.
I know in the past
as this kind of technology was more experimental
there were different opportunities we had with
I think it was radiology who did want to like
coordinate with certain specimens.
So we did have those opportunities in the past
which was a lot of fun.
I had a lot of fun with that.
So
Yeah. And you mentioned, you know, in pathology
it sounds like it kind of got its route started
with forensic pathologists
and then you're saying now it's kind of being brought
out to the surgical practice?
Yeah, so our, our autopsy lab, it, it functions as a
a medical or an in-house autopsy lab
in addition to the, the forensics pathology service.
So those, it was more or less those medical,
those kinds of autopsies, those educationally approved
for cases where we were kind of expanding
on some of this technology.
Their interfaces are a little bit more complex
and as I mentioned before
thing has been able to really condense
and simplify all the applications and, you know
for instance, the software that controls how the
the mounting station kind of rotates, stops
the cameras engage, all
of all that stuff was kind of worked together in autopsy
and they really like consolidated those applications.
Hmm. And, and how long does it take to scan some tissue?
Is this something that is relatively quick
or is this like a day long process?
It's actually, yeah, I didn't even think about how
I'm commenting on how interesting this is.
So it's really simple.
It's really quick actually.
So we would just need to go into the software
the software that they've made, this kiosk application
we would just need to basically adjust the
the camera settings and you could adjust
like the model quality, but it's not necessary.
So you would just put in your settings, name your file
hit the button, and it takes about five minutes
for these pictures to be taken.
So once the pictures are taken, you can open up the chamber
and retrieve your specimen.
And then the, the actual rendering of the model
will take 20 minutes.
So you can, you can have a really quick turnaround, but
in the grand scheme of things, those five minutes are really
important for a patient who's on the operating table.
So you have to still balance making, you know
making sure you're getting those results back
to your surgeon and the consultant.
But it, it is very quick, relatively speaking, so
Oh wow.
It's interesting.
Yeah. You know, so quick to scan.
And then also it sounds like if everybody's able to get
on their cell phone and manipulate it, it's not like
the old kinda lag time of, you know
you have to make sure you're on good internet.
Correct. And yeah, so we can look
at the model real time on the system.
Once it's, we can
we can look at it on our screen as, as it's rendered
and we can kind of look at it and say, you know what
maybe maybe we should try to get a better angle or, no
this is great.
You know, we can
we can know real time if what we have is good.
Is the thought is this going to replace?
I know there's always been kind of surgical photography
or surgical pathology photography.
Is, is this thought to replace this
in the next five, 10 years?
In my mind, no.
I don't.
I think that there's too much value in photography itself.
3D models have their place and you know, they really
they really can fit into the picture.
Sorry for the pun,
but I don't think that photography is gonna go away.
There's just you, there's too much pop, there's too much pop
to photographs that you kind of lose in a 3D model.
And I, I enjoy taking photos of our specimens
and I take a lot of pride in it
so I don't want to see that go away anytime soon.
Yeah, no, I, I really appreciate your kind of nuance too.
You know, it's not
like the panacea that's gonna replace everything.
There's a time and a place these certain things.
So I guess that kind of brings me
to my final question of where do you see, you know
this innovation going over these next five, 10 years?
Yeah, it's, it's fun.
It's really fun to think about that.
And it's, I get a lot
of like insights from our PA team and
they have some plans, they have some concepts.
One of the really interesting things is
as I mentioned before, you know, we could
you can print 3D models, but what you
you can also do is you could change colors
of certain anatomic sites or structures on these models.
So we can create like unique
really unique models to show the relationships
of adjacent structures.
And that's, that's a significant
it's a really important skill to have
in anatomic pathology and gross anatomy.
So we can do that.
And I think another kind of step I would like to see
which really kind of takes that to like the enth
degree would potentially be the applications
for augmented or virtual reality options.
So what I'm thinking is, like,
you could take a specimen,
so you could take a kidney specimen,
so you could take an overall scan of the specimen,
and then you could do like a step-by-step scan
as you would grossly examine the specimen
and grossly examine like if there's a tumor present,
how it relates to adjacent structures.
And you can provide a step-by-step gross examination
of that for a learner.
And they could have, they could pop
on a VR set and kind of go through the whole, you know
the whole steps and the
the maneuvers of grossing in a, like a surgical specimen.
Or they can have some kind of a
some other kind of like goggle system that provides
like an augmented reality system so that they can see
out of their periphery of the side of their vision
like the actual step-by-step process of it
while they're going through an actual surgical specimen.
It's, it's a lot of fun to kind of think of these things.
I have no idea if they're 100% applicable
but it's a lot of fun to kind of get these ideas
and see if they're, they're possible.
Yeah, I'm really excited by that.
I think something that young learners in the field
of pathology struggle with is sometimes looking
at something that's 2D and having to kind of construct this
as a 3D and it, it sounds like there's some wonderful
that may not always be the case going forward.
Yeah, it's, I get, I'm excited.
I think this provides a unique opportunity
for people to learn because maybe
maybe they're really intimidated by an actual
like specimen when they first see it
so can provide a more controlled environment
for them to get that hands-on experience
and the visual kind of correlation between what they read
in the book, versus what it actually is.
So, very cool opportunities.
Brilliant. Hey, we've been rounding with Shane Ferraro.
Thank you for taking the time to talk
about 3D scanning with us today.
Yeah, my pleasure.
Thanks so much.
And if you'd like to hear more on this topic,
Shane will be presenting
at the 2023 Pathologist's Assistant Symposium in June.
Please visit mayocliniclabs.com/2023PAsymposium
for more information. To all of our listeners,
thank you for joining us today.
We invite you to share your thoughts
and suggestions via email.
Please direct any suggestions
to mcleducation@mayo.edu and reference this podcast.
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