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. 2024 Aug;116(4):232-241.
doi: 10.32074/1591-951X-1004.

Digital transition in pathology lab: a survey from the Lombardy region

Elisa Belloni #  1 , Emanuela Bonoldi  2 , Giorgio Bovo  3 , Sabrina Buoro  4 , Michele Cerati  5 , Fulvia Milena Cribiú  6 , Emanuele Dainese  7   8 , Alessandro Del Gobbo  9 , Mattia Facchetti  10 , Andrea Gianatti  11 , Umberto Gianelli  12 , Paolo Giunta  13 , Vincenzo L'Imperio  1 , Massimo Milione  14 , Manuela Nebuloni  15 , Fabio Pagni  1 , Marco Paulli  16 , Antonella Piga  17 , Fabio Pasotti #  4
Affiliations

Digital transition in pathology lab: a survey from the Lombardy region

Elisa Belloni et al. Pathologica. 2024 Aug.

Abstract

Objective: Digital pathology is an opportunity to revise the routine and old artisanal workflow, moving to standard operating procedures, quality control and reproducibility. Here the results of a survey promoted by the Coordinamento della Medicina di Laboratorio (CRC Med Lab) of the Lombardy region in Italy are reported to shed light on the current situation of digital adoption in the country.

Methods: The survey composed of 58 questions was sent to 60 pathology laboratories. The results were collected and most significant answers were reported and discussed.

Results: Answers were received from 57 (95%) laboratories, a minority organized in spoke-hub networks (16%) with a centralized processing phase (11%). Hybrid manual/computer-assisted traceability was prevalent (36%), with QR/barcode labeling starting within the pathology lab (23%). Different laboratory information systems (LIS) were employed, mostly with alert functions and/or multimedial file attachments (56% and 46%, respectively). The majority opted for a semi-automated tracking management (44, 77%) and 18 centers (32%) were partly digitizing the routine (¾ scanning < 25% of slides). Whole slide images were retained for 3.7 years in average; in-house blocks/slides archiving was still preferred (30, 53%), with 1838 (±1551) and 1798 (±1950) days (5 years) internal permanence for blocks and slides that are stored in out-source (mean turnaround time for return on-demand 3.7±2.1, range 1-10 days).

Conclusions: The advantages of digital pathology must be balanced against the challenges faced in the structural revision of the pathology workflow. This regional scouting can represent the foundation to build an efficient and connected digital pathology system in the territory.

Keywords: archives; digital pathology; pre-analytic; traceability; whole slide images.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Laboratory Information System (LIS) software houses used in pathology laboratories as the Lombardy region survey with relative usage %. *property software (e.g. FileMaker, MadLad, Archigest, KAIROS, Xpath).
Figure 2.
Figure 2.
Distribution of the different tracking systems used (manual, partially or completely automated) for single workflow steps in the different laboratories that participated in the survey. IHC, immunohistochemistry.
Figure 3.
Figure 3.
Distribution of the digitized slide percentage among laboratories. The majority declared to scan ≤ 5% of the routine (about 13 centers, as reported in the curve on the left), with three/fourth of the responding centers scanning < 25% of slides (see box plot on the right).
Figure 4.
Figure 4.
Possible operative solutions to face the criticalities unveiled by the survey.
See this image and copyright information in PMC

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