technology meets pathology business process in...

FUTURE OF ISC: WORKFLOW INTEGRATION M.G. Rojo1, T. Schrader2, P. Hufnagl3 1Servicio de Anatomia Patologica, Hospital General de Ciudad Real, Spain 2University of Applied Sciences Brandenburg, Brandenburg, Germany 3Institute of Pathology, Charité – Universitätsmedizin Berlin, Berlin, Germany

technology meets pathology 2nd International Scanner Contest

technology meets pathology

2nd International Scanner Contest

BUSINESS PROCESS IN PATHOLOGY



INTERACTION: DATA, SLIDES, REQUESTS, REPORTS

IHC Antibody Request

Tele-consultation

Primary Diagnosis

Secundary Diagnosis

Labor Slide Request Staining

Diagnostic Process Dictation Report

Confirmation

Image Analysis Cell counting ROI

INTEGRATION VIRTUAL MICROSCOPY

Device

 Barcode Reader  DICOM worklist  Status reports

Viewing

 Patient ID  Patient information  Report management  Slide management

  Image analysis  Slide requests

SCANNER AS DEVICE: APPLICATION OF SLIDES



DIGITAL SLIDE SCANNERS AND PATHOLOGY WORKFLOW INTEGRATION

 What? Work lists. Slide selection (in a mixture environment where not every slide can be scanned)

 When? Status information (when is scanned, urgency)  Who? Users interaction (who is taking care of scanning, who is

validating)   For? Intention (slide reading, image analysis)   How? Selection of magnification, number of focusing points



SOFTWARE INCLUDED WITH SCANNERS

  Console: Control of the scanner. What to do and how to do it. In some cases, touch screens

  Image management (database): Collects information for the scanner and from user input

Is this enough?





A PROPOSAL FOR EVALUATING SCANNERS IN PATHOLOGY WORKFLOW INTEGRATION

  Standards compliance:   DICOM Suppl 122 and 145   IHE AP General Pathology workflow

  Integration with:   Pathology information system   PACS

  Functionalities   Bar code reading. 1-D, 2-D (datamatrix, QR)   User identification (login-password, smartcard, touch screens)   Continuous of batch mode workflow



DISCUSSION

  Selection of evaluation criteria   Development of evaluation strategy

  Check lists   Send & receive of IHE messages like connectatos

  Differentiation of scanner as device and as software solution   Differentiation Viewing-, analyzing software and Pathology-

Laboratory Information System

RESERVE To use in case of any questions

Over 25 available scanning systems:

 3DHistech Panoramic (4)  Aperio ScanScope (6)  Olympus VS (3)  Hamamatsu Nanozoomer (2)  Claro (2)  Leica SCN400 (2)  Menarini D.Sight(2)  Omnyx (2)  Philips (1)  Roche Ventana (2)

Aperio Scanscope AT / XT / CS

3D Histech

Hamamatsu Nanozoomer 2 Olympus

VS800, VS120, VS110 .slide Philips

Leica SCN400 Omnyx VL4

Menarini D.Signt

Ventana iscan HT



DIGITAL PATHOLOGY – DATA INTEGRATION

 Pathology Information system (data)  Global image management (gross, microscopy, digital

slide)  Automated image analysis  Automatons control (stainer, immunohistochemistry,

slide scanner)  Traceability (tracking systems)  Telepathology (primary and second opinion)  Education (e-learning & education data bases)  Quality assurance  Biobank and tumour hospital registry



IHE ANATOMIC PATHOLOGY

  The transaction Modality image stored (RAD-8) and Evidence document stored (RAD-43) al low an Acquisit ion modality or an Evidence creator to send acquired or generated images to the Image archive of the PACS.

  Thanks to the transaction Storage commitment (RAD-10) the Acquisit ion modality or Evidence creator is able to request that the Image manager confirm ownership for the specified DICOM objects ( images or evidence documents or any combination thereof) stored in the Image archive , thus allowing the sender to delete those objects.

  The transaction Query/retrieve images (RAD-14/16) al lows querying the Image manager/ image archive (of PACS) to retrieve and display the images.



DICOM SUPPLEMENT 122 COMPLIANCE

  Attributes for the identification and description of specimens:   (1) identify the specimen (within a given institution and across

institutions)   (2) identify and describe the container in which the specimen resides   (3) describe specimen collection, sampling, and processing   (4) describe the specimen or its ancestors when these descriptions

help with the interpretation of the image.



DICOM SUPPLEMENT 145 COMPLIANCE

  Information object definition applicable to Whole Slide Images   Image optimization for large size, remote consultation,

multiple “magnifications”   Image tiling for storage   JP2 file format (JPEG2000 support)   Support for multi-spectral images, multiple focal planes and

detailed descriptions of the optical components used to create the image

  Able to store digital slides directly on a PACS



TRACEABILITY AND SCANNERS

  Secure object identification  Worflow management (and adaptation)   Time management (LEAN application)   Analysis of bottle-necks and performance optimization   Being able to locate all objects in every moment



AVOID IDENTIFICATION ERRORS

SOS

50S

505

5O5

S05

1405

1705

1905

14OS

17OS 84

B4

89

B7

87

BY

Source: Dako, Leica





CONCLUSIONS

A proposal for evaluation of scanners for workflow integration could include the following:   Standards compliance (scanning, storage and retrieving)   Traceability integration   User friendliness

  Shall we include a section for viewers/slide reading?



Giovedì, 14 giugno 2012 21






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technology meets pathology business process in...

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