Digital Cytopathology and Whole Slide Imaging – Exploring Its Application in Cytology Education and Proficiency Testing Programs in Ontario, Canada
Golnar Rasty, Andrea V Park, Sharon E Crafter, David J Kuni, Michele M Wier, Allan L Wolfshon, Janet L Yawney, Jane Gun-Munro, Greg Flynn. University Health Network, Toronto, ON, Canada; Quality Management Program-Laboratory Services, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; William Osler Health System, Brampton, ON, Canada; London Health Sciences Centre, London, ON, Canada; Gamma-Dynacare Medical Laboratories, Ottawa, ON, Canada
Background: The Quality Management Program-Laboratory Services (QMPLS) plays a key role in the health-care system through its focus on quality assurance and analysis of proficiency testing (PT) performance by licensed laboratories in Ontario, Canada. Digital Morphology (DM) utilizes computers to review and interpret digitized images of microscopic preparations along with data management, web accessibility, annotations, and automated image analysis. This technology allows pathologists and cytotechnologists to review images from any computer and enables consultation within and among different facilities. The purpose of our survey was to test digital images for use in PT.
Design: A pilot survey was conducted by QMPLS in 2010. The participants were asked to download the viewing software Image Scope provided by Aperio. QMP-LS distributed the software to 51 participants within Ontario. The participants were asked to view and analyze eight digital images obtained from various preparation techniques and body sites.
Results: Over 85% of participant responses matched the assigned value, except for one case of a respiratory bronchial washing conventional smear, where the thickness of the sample interfered with visualization of the malignant cells. The results showed that LB preparation slides are better suited for DM since they have smaller areas to scan. The image quality and the ability to focus on the image and cells were the two most important factors for successful application of DM in PT. One of the main hurdles was downloading the Image Scope software because of hospitals' and community laboratories' firewalls, though after reconfiguring firewall and proxy settings all participants were able to proceed with the survey.
Conclusions: By using digital images, External Quality Assessment (EQA) programs can provide the means for participants to view and interpret microscopic preparations of small volume, unique or difficult to obtain patient material for assessment and/or education. The benefits of this technology are conducive to revolutionizing traditional cytology surveys.
The pilot survey identified optimal sample types for future DM surveys and the the feedback will help guide QMP-LS in using DM in future surveys.
Category: Quality Assurance
Monday, March 19, 2012 1:00 PM
Poster Session II # 282, Monday Afternoon