Case of the Month and the Virtual Slidebox Implementation
V Brodsky, A Louissaint, J Gilbertson, Y Yagi. Massachusetts General Hospital, Boston, MA
Background: Currently, a large volume of surgical pathology cases deemed interesting and often received from different countries are reviewed during the daily Outs conference with the residents and fellows of the Massachusetts General Hospital's Pathology department. These slides are subsequently filed for storage or returned to sender and are not necessarily easily retrievable for later review. We have built a searchable database driven collection of whole slide images of the slides presented at these conferences, accessible via a web interface. Additionally, selected surgical pathology cases with the associated added clinical history are submitted into a queue by the residents, with one case picked and published monthly on the Case of the Month website.
Design: The development platform corresponding with the Massachusetts General Hospital website includes Microsoft Windows Server 2008 and Microsoft SQL Server Developer Edition. The Case of the Month website is built on the open source ASP-based Blogengine 1.4 with modifications allowing for submission queuing prior to final approval. The slides are scanned with 0.33um/pixel sampling period using Mirax Scan device (3DHISTECH Ltd, Carl Zeiss Microimaging GmbH) and are put on a dedicated storage server, each linked from the 3DHISTECH's Mirax Server database software, which provides its own Virtual Slidebox web interface as well as allowing for links from the Case of the Month website to target individual slides. Clicking on the link to the whole slide image in the browser opens the Mirax Viewer which lets the user navigate the whole slide image streaming from the server.
Results: The interactions with the scanner and the website are currently agreed to be valuable additions to the resident education. The 0.33um/pixel sampling period of the scanned slides appears sufficient for surgical cases and is considerably higher than the resolution of printed histological atlases, however the possibility of scanning cytology slides at higher resolution is being considered.
Conclusions: Providing the searchable and easily navigable web database of whole slide images is definitely appreciated by the residents as an educational resource. We are collecting the usage data and will be investigating the possibility of opening access to the Harvard medical students and the outside world. The latter may prove to be a challenging task considering the bandwidth necessary to serve whole slide images. Eventual tracking of viewing patterns within the image will help identify high-yield areas important for diagnosis.
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 212, Wednesday Morning