Web-based oil immersion whole slide imaging increases efficiency and clinical team satisfaction in hematopathology tumor board.
BACKGROUND
Whole slide imaging (WSI) is widely used for education and research, but is increasingly being used to streamline clinical workflow. We present our experience with regard to satisfaction and time utilization using oil immersion WSI for presentation of blood/marrow aspirate smears, core biopsies, and tissue sections in hematology/oncology tumor board/treatment planning conferences (TPC).


METHODS
Lymph nodes and bone marrow core biopsies were scanned at ×20 magnification and blood/marrow smears at 83X under oil immersion and uploaded to an online library with areas of interest to be displayed annotated digitally via web browser. Pathologist time required to prepare slides for scanning was compared to that required to prepare for microscope projection (MP). Time required to present cases during TPC was also compared. A 10-point evaluation survey was used to assess clinician satisfaction with each presentation method.


RESULTS
There was no significant difference in hematopathologist preparation time between WSI and MP. However, presentation time was significantly less for WSI compared to MP as selection and annotation of slides was done prior to TPC with WSI, enabling more efficient use of TPC presentation time. Survey results showed a significant increase in satisfaction by clinical attendees with regard to image quality, efficiency of presentation of pertinent findings, aid in clinical decision-making, and overall satisfaction regarding pathology presentation. A majority of respondents also noted decreased motion sickness with WSI.


CONCLUSIONS
Whole slide imaging, particularly with the ability to use oil scanning, provides higher quality images compared to MP and significantly increases clinician satisfaction. WSI streamlines preparation for TPC by permitting prior slide selection, resulting in greater efficiency during TPC presentation.
Division of Hematopathology, Department of Pathology, ARUP Laboratories, University of Utah, Salt Lake City, Utah, US.
Zhongchuan Will
ZW
Chen
Division of Hematopathology, Department of Pathology, ARUP Laboratories, University of Utah, Salt Lake City, Utah, US.
Jessica
J
Kohan
Division of Hematopathology, Department of Pathology, ARUP Laboratories, University of Utah, Salt Lake City, Utah, US.
Sherrie L
SL
Perkins
Division of Hematopathology, Department of Pathology, ARUP Laboratories, University of Utah, Salt Lake City, Utah, US.
Jerry W
JW
Hussong
Division of Hematopathology, Department of Pathology, ARUP Laboratories, University of Utah, Salt Lake City, Utah, US.
Mohamed E
ME
Salama
Hematopathology; microscope projection; oil immersion; tumor board; whole slide imaging