Virtual Microscopy: The UCL experience. Marco Novelli
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1 Virtual Microscopy: The UCL experience Marco Novelli
2 Virtual microscope Hamamatsu Nanozoomer
3 Research. Overview Scanning - image quality, reliability etc. Use of virtual microscopy in routine histopathological reporting. Current areas of clinical interest. Remote reporting UK EQA schemes Teaching Areas of difficulty.
4 Research Overview Scanning - image quality, reliability etc. Use of virtual microscopy in routine histopathological reporting. Current areas of clinical interest Remote reporting UK EQA schemes Teaching Areas of difficulty
5 Scanning - image quality, reliability etc.
6 Dahmane Oukrif Research Fellow
7 Scanning Simple. Reliable. Relatively quick. High quality images. Simple effective viewer (NDP.view)
8 Use of virtual microscopy in routine clinical histopathology
9 Radiologists have PACS. How about virtual microscopy for pathologists?
10 Use of virtual microscopy in routine clinical histopathology Current UK situation: Capacity Cost Reporting speed Pathologist compliance
11 Capacity UCLH Medium sized UK teaching hospital. 21,000 cases per annum 120,000 slides per annum 500MB per slide
12 Capacity UCLH Medium sized UK teaching hospital. 21,000 cases per annum 120,000 slides per annum 500MB per slide 60,000 GB / 60 Terabytes
13 Capacity UCLH Medium sized UK teaching hospital. 21,000 cases per annum 120,000 slides per annum 250 working days 480 slides/day
14 Capacity UCLH Medium sized UK teaching hospital. 21,000 cases per annum 120,000 slides per annum 250 working days 480 slides/day Scanning 5mins/slide 2400 minutes = 40 hours/day.
15 Capacity UCLH Medium sized UK teaching hospital. 20,000 cases per annum 100,000 slides per annum 250 working days 400 slides/day Scanning 5mins/slide 2400 minutes = 40 hours. 3+ Nanozoomers
16 Cost Technician(s) to scan slides -? /pa Virtual microscope(s) -? 100,000+ each Computer, monitor and network upgrades -?? Unlike radiology (PACS) Unlikely for clinicians to want to see images. ALL ON COSTS (no change in processing etc). Little (if any) saving.
17 Reporting speed and pathologist compliance Over local network reporting speed very fast. Pathologists will have to learn how to use systems (inherently conservative!). Benefits of virtual images need to be emphasised Measurements (e.g. Breslow thickness). Counts (e.g. Proliferation index assessment). Remote reporting flexible working.
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19
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21 Use of virtual microscopy in routine clinical histopathology Current UK situation: Capacity Cost X Reporting speed Pathologist compliance?
22 Current areas of clinical interest
23 Remote reporting Is remote reporting feasible? Why would you want remote reporting? Where and how should we start?
24 Remote reporting Is remote reporting feasible?
25 Remote reporting Is remote reporting feasible?
26 Remote reporting Is remote reporting feasible? Schistosomiasis
27 Remote reporting Is remote reporting feasible? YES
28 Remote reporting Why would you want remote reporting?
29 Remote reporting Why would you want remote reporting? Lack of local histopathologist/expertise Frozen sections at remote/satellite hospital Expert/specialist opinion
30 Remote reporting Why would you want remote reporting? Lack of local histopathologist/expertise Use of time zones
31 Remote reporting Why would you want remote reporting? Lack of local histopathologist/expertise Use of time zones Delhi - London 5.5 hours Heidelberg New York 6 hours
32 Remote reporting Why would you want remote reporting? Lack of local histopathologist/expertise Use of time zones Lifestyle (histopathologists)
33
34 Remote reporting Where and how should we start? Peripheral hospitals (e.g frozen sections). Gulf + developing world.? Joint venture with Western private health care providers (e.g HCA, Capio etc).
35 UK EQA Schemes External Quality Control Schemes Sets of slides circulated to histopathologists. Histopathologists report cases. Scored anonymously (candidate numbers). Repeated poor performance. Re-train
36 Virtual Microscopy EQA schemes Many advantages: 1 set of slides. Cost Can use small biopsies Cost (No postage). Uniform sections. UCL: Leeds University: y.leeds.ac.uk Disadvantages: Variable computer access/connections. Pathologist compliance.
37 Teaching Extremely useful here. Slide access pre-courses. Image libraries. E-learning (
38 Areas of difficulty
39 Areas of difficulty Variable web access + computer types (PC/Mac) Hospital firewalls Choice of software + cost Image analysis Image databases/websites
40 Areas of difficulty Variable web access + computer types (PC/Mac) Hospital firewalls Choice of software + cost Image analysis Image databases/websites
41 Areas of difficulty Variable web access + computer types (PC/Mac) Hospital firewalls Choice of software + cost Image analysis Image databases/websites
42
43
44 Areas of difficulty Variable web access + computer types (PC/Mac) Hospital firewalls Choice of software + cost Image analysis Image databases/websites
45 UCL server web interface
46 Leeds University server web interface
47 Where does all this leave me?
48 Beautiful machine
49 Beautiful machine, but I am still learning to drive and I cannot afford a chauffeur!
50
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