Digital Pathology An Introduction From glass slides to

Digital Pathology, An Introduction From glass slides to digital files and there after

process l Scanning of glass slides by a scanner--convert information to a digital format l Navigate the digital slide using a software, from any power, on any area of interest, just like a glass slide l Data analysis

Applications Remote access of slides: • Frozen Sections (night calls and remote sites) • Telepathology for 2 nd opinion Secondslide. com pathxchange. com • Multi-institution collaborative studies • Retrospective and prospective collections of cases for TMA, case series studies, etc

Real time consultation Bioimagene

Clinical applications l Archival & viewing of data: Tumor Boards Quality Assurance (2 nd read on QA cases) Publications (? digital slide access as a part of case reports and case series in the future? ) – Scan in key diagnostic slides for outside review cases, to avoid having to borrow back slides for clinical or academic needs. – Access old cases for comparison for frozen sections and current cases – Teaching sets for rare cases. – – –

Extract region

Image Management

Digital IHC From Aperio tutorial,

Bioimagene companion algorithm Breast: ER, PR, Her 2 neu, ki 67, p 53 quantitation l Prostate: PIN-4 and Ki-67 l Brain: Ki 67 l Heme: quantitation of CD 138 labeled plasma cells in bone marrow samples. l Carcinoid: Bio. Imagene’s Ki-67 carcinoid algorithm is an aid to pathologists and researchers in the detection and quantitation of stained cells in carcinoid tumors derived from gastrointestinal tissues. l

Practical issues l Cost (machine, software, storage & personal) l Time for scan: 15 x 15 mm tissue – 20 x < 1 min; 40 x 6 -7 min l Memory: 20 X scan: 250 MB; 40 X scan: 800 MB – 1 TB can hold 2, 070 slides (assuming 500 MB/slide), or 4000 slides for 20 x (250 MB)

vendors l Aperio l Bioimagene l Olympus (nanozoomer) l Omnyx (UPMC+GE) l 3 DHistech l Leica

Issues for evaluation l Scanned image quality l Image management software (interface with LIS system if intend for clinical use) l Image analysis software l Technical support l Stability of vendor in the market l Good fit between your need and vendor’s strong points