Approaches to Whole Slide Imaging for Surgical Pathology Consult Services
Constantin S Friedman, Liza Rivera, Yao-Tseng Chen, Victor Brodsky. New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY
Background: Whole-slide scanning is an effective method of overcoming logistical problems associated with consult services, such as slides being unavailable for review due to having been returned; but it also presents significant costs and storage requirements. As whole-slide scanning of consult cases was being implemented at NYP/Weill-Cornell, the question arose of whether all consult slides should be scanned, or only those selected by attending pathologists. The latter approach was adopted for five subspecialty consult services: General/Endocrine/Head & Neck/Thoracic (GEHNT), Gastrointestinal (GI), Gynecologic (GYN), Genitourinary (GU), and Neuropathology. The scanned cases were analyzed in order to evaluate usage patterns of a slide-scanning system under real-world conditions.
Design: Attending pathologists were instructed to submit representative slides for scanning at their discretion. During an 8-week period immediately following the initial launch of the whole slide scanning, representative slides from consult cases selected by pathologists for the GEHNT, GU, GI, GYN and Neuro services were scanned using the Aperio Scanscope AT (2012); Console version 184.108.40.2063.
Results: Out of 210 consult cases, 92 were scanned, representing a scan rate of 43% overall. The cases contained an average of 9.40 slides each; 1 to 12 slides were scanned per case, averaging 1.98 slides per case. For the 5 consult services surveyed, the percentage of scanned cases ranged from 64% (56/87) to 0% (0/17). Of 14 pathologists who had received consult cases during the 8-week period, 9 submitted slides to be scanned. The scan rates ranged from 77% to 0% among pathologists. 49% of cases with neoplastic diagnoses were scanned versus 17% of non-neoplastic cases. Based on our previous data, scan time at “20X” averages 5.18 minutes per slide, and average file size was 498 megabytes (MB). Thus the consult cases required a weekly average of 1.96 hours of scan time and 113 gigabytes (GB) of storage. Scanning only selected slides from each case yielded savings of 59 hours of scan time and 340 GB of storage over an 8-week period.
Conclusions: The study revealed wide variations in scan rates between consult services as well as individual pathologists. The reason is likely multifactorial, including the different disease spectra encountered, the individual familiarity with the scanning service, etc. Non-neoplastic cases were less frequently scanned. Scanning representative slides from all consult cases, at the current rate of 1.98 slides per case, would result in a total of 35 hours of scan time and 207 GB of storage.
Monday, March 4, 2013 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 248, Monday Morning