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. 2017 Dec 19:8:51.
doi: 10.4103/jpi.jpi_58_17. eCollection 2017.

Routine Digital Pathology Workflow: The Catania Experience

Filippo Fraggetta  1 , Salvatore Garozzo  1 , Gian Franco Zannoni  2 , Liron Pantanowitz  3 , Esther Diana Rossi  2
Affiliations

Routine Digital Pathology Workflow: The Catania Experience

Filippo Fraggetta et al. J Pathol Inform. .

Abstract

Introduction: Successful implementation of whole slide imaging (WSI) for routine clinical practice has been accomplished in only a few pathology laboratories worldwide. We report the transition to an effective and complete digital surgical pathology workflow in the pathology laboratory at Cannizzaro Hospital in Catania, Italy.

Methods: All (100%) permanent histopathology glass slides were digitized at ×20 using Aperio AT2 scanners. Compatible stain and scanning slide racks were employed to streamline operations. eSlide Manager software was bidirectionally interfaced with the anatomic pathology laboratory information system. Virtual slide trays connected to the two-dimensional (2D) barcode tracking system allowed pathologists to confirm that they were correctly assigned slides and that all tissues on these glass slides were scanned.

Results: Over 115,000 glass slides were digitized with a scan fail rate of around 1%. Drying glass slides before scanning minimized them sticking to scanner racks. Implementation required introduction of a 2D barcode tracking system and modification of histology workflow processes.

Conclusion: Our experience indicates that effective adoption of WSI for primary diagnostic use was more dependent on optimizing preimaging variables and integration with the laboratory information system than on information technology infrastructure and ensuring pathologist buy-in. Implementation of digital pathology for routine practice not only leveraged the benefits of digital imaging but also creates an opportunity for establishing standardization of workflow processes in the pathology laboratory.

Keywords: Digital pathology; informatics; pathology; whole slide imaging; workflow.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Image of a virtual slide tray created and incorporated within the anatomical pathology laboratory information system
Figure 2
Figure 2
The creation of a single slide tray within the anatomic pathology laboratory information system Pathox is shown that displays the macroimage (thumbnail) of several slides which permits incorporation of digital slides acquired from different scanners
Figure 3
Figure 3
(a) Compatible scanner and staining slide racks (b) allow slides to be easily loaded for scanning with minimal laborious human intervention
Figure 4
Figure 4
Screenshot of the virtual slide tray incorporated within the anatomic pathology laboratory information system showing how whole slide images are connected with the tracking system. The virtual slide tray displays macroimages of scanned slides that allow pathologists to check whether tissue present on the glass slide was correctly recognized by the “tissue finder” tool of the scanning system. (a) Two slides of a case are shown that were missing, due to a failure to read the barcode during scanning. (b) In this case, the tissue finder tool was unable to recognize the entire tissue sample
See this image and copyright information in PMC

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