What Digital Slides Promise to

the Education Community

S. Joseph Sirintrapun, MD

Clinical Fellow – Pathology Informatics

University of Pittsburgh Medical Center

Overview

• Briefly define what is a digital slide and

virtual microscope

• Digital slide educational applications

developed at the UPMC

– VirtuPath

– Clinicopathologic and Radiologic Correlation

Application

– PathEd

What is a digital slide?

• Image file

• Entire glass slide scanned at high magnification

• Field by field creating “tiles”

• “Knitting tiles” together to form a seamless high resolution montage

What is a virtual

microscope?

• Often used synonymously with digital slides,

even in pathology informatics circles

• Distinct entities

• Virtual microscope

– Software that allows the user to “pan and zoom”

across the digital slide as if one were examining a

physical slide under a physical microscope

– “Digital viewer”

– Client server application

• Takes advantage that the digital slide is “binned”.

Educational Advantages to

Digital Slides• Entire slide captured digitally

• Great for archiving and distribution of classic, rare, scarce or interesting cases

• Simulates reality of evaluating a glass slide

• Skills can be practiced over the internet such as:– screening

– finding the essential areas of interest

– knowing how to navigate through a slide

• Static images, because the area of interests are immediately shown– key intangible skills are lost in the learning process

Pathology Centers of Excellence (COEs) at

UPMC

UPMC PresbyterianENT/Thyroid Pathology

Gastrointestinal Pathology

Hematopathology

Neuropathology

Thoracic/Mediastinal

Pathology

Transplant Pathology

UPMC ShadysideBreast Pathology

Dermatopathology

Genitourinary Pathology

Bone/Soft

Tissue/Melanoma

Pathology Informatics

Magee-Womens Hospital,

UPMCHSBreast Pathology

Gynecologic Cytopathology

Obstetric/Gynecologic Pathology

Centers of Excellence

(COE) Teaching Sets

• Since early 2004

– Over 5000 digital slide images have been

scanned and collected

– Bone, Soft Tissue, and Melanoma Pathology

Genitourinary Pathology

– Thoracic Pathology

– Neuropathology

VirtuPath

• Web based portal providing centralized access to the 5000 digital slides

• Teaching collections and conference materials– COE Teaching Sets

– Unknown Conference Slides

• Establishment of a solid contact point for COEs and individual faculty who wish to create or expand digital slide resources

• Medical students, residents, fellows, or attendings no longer need to go to specific physical locations to obtain glass slides

• Training is facilitated with the web-based viewers “virtual microscopes”

(link to this sheet)

Image

http://residents.pathology.pitt.edu/Unknown Slide Conference/USC_06.02.07_slides.htmhttp://image.upmc.edu/http://residents.pathology.pitt.edu/Unknown Slide Conference/USC_06.02.07_slides.htmhttp://residents.pathology.pitt.edu/Unknown Slide Conference/USC_06.02.07_slides.htm

Trestle

“Interscope”

Digital Slide

Maker (DSM)

UPMC Users

Standard PC

Intranet

Connection

Aperio

ScanScope

System

Virtual

Microscope

Interfaces

Aperio

ImageScope

Stored Area

Network (SAN)

Server - Pulls

images from the

robotic scanners,

serves for both

UPMC intranet and

internet access

UP

MC

FIR

EW

ALL VirtuPath

INTERNET

HOME

UPMC

INTRANET

VirtuPath

Centralized Web

Portal

Context database

- Microsoft SQL

Server

Web based portal

- SUNONE platform

Trestle

Java

Viewer

Home Users

Standard PC

Internet

Connection

UPMC Citrix

Access

Clinicopathologic and Radiologic

Correlation Application

• Web based portal simulating case work-up incorporating all information including history, lab tests, and radiology

• Currently used by the thoracic COE– 600 cases

• Clinical information can be taken from the electronic patient record

• Radiology information and static images can be taken from Stentor

• Pathology information and gross images can be taken from CoPath

• Training is facilitated with the web-based viewers “virtual microscopes”

• Question and answer capability

PathED: IMITS Online Digital Slide Repository

for USAF and UPMC Pathologists

Search Capability

Interface Management

Management & Maintenance

• Maintenance for groups/users– add, change, delete

• Group• User (Administrator/Instructor/Student)• Usernames/Passwords

• Preview questions

• Annotations management– capacity to search notes or bookmarks for text

– i.e. aspergillus, lymphoid follicle, hyperlinks

• Grading capability with statistical summary evaluation/manipulation

• Quality assurance and validation

Disclosures

• This work was supported by funding from the U.S. Air Force administered by the U.S. Army Medical Research Acquisition Activity (USAMRAA), 820 Chandler Street, Fort Detrick MD 21702-5014, Contract No. DAMD17-03-2-0017. The content of the information does not necessarily reflect the position or policy of the U.S. Government and no official endorsement should be inferred.

• No Financial Relationships with Commercial Interests

– S. Joseph Sirintrapun, MD