Whole Slide Imaging Development of a Consultative Practice at UCD

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Whole Slide Imaging Development of a Consultative
Practice at UCD

• Or 6 years of Digital Pathology

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Disclaimer

• Conflict of interest statement
• I do not receive any compensation from any of the
  companies represented in this presentation

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Outline

• When did we first start using WSI for digital
  pathology
• Why did we start practicing digital pathology
• What is digital pathology and Whole slide imaging
  
• How did we use
• What did we build
• Why did we build it

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When

• 2000-2001
• Began looking into the viability of creating high
  resolution whole slide images of microscope
  slides
• Very few venders in this space at this time
• Manually taking tile images and manually
  stitching them together.
• Stitched together a few hundred images to form a
  single composite image

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When
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Pten Nkx knockout
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When

• An entire slide using only a manual technique
  would take about 24 hours to complete
• Tim Marshal introduced us to Aperio

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Aperio
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When

• Hardware limited software

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Why

• Mouse Models of Human Cancer Consortium (MMHCC)
• NCI consortium of cancer researchers who were
  using the mouse to model all known human cancers
• UCD was contracted to create an images set of all
  the know (most important) mouse models of human
  cancer

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Why

• WSI was decided as the best mechanism to fully
  illustrate the pathology

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Why

• The Mutant Mouse Pathology Lab
• Collaborate closely with the MMHCC researchers
• Principally mouse geneticists
• Pathology education
• WSI Digital pathology was a good fit to support
  our collaborations

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Digital pathology requirements

• Display WSI
• Provide destruction-less annotations
• Cross platform
• PC, Mac (XP, OS9)
• Cost neutral for our collaborators
• Viewable via the internet
• Simple to operate
• Researchers do not have time to learn new software

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WWW

• Web application
• Browsers more-or-less platform independent
• Cost neutral
• Viewable via the internet
• WSI viewers
• Mr.Sid
• Almost went out of business
• Dropped Mac support
• Limited annotations

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WWW

• WSI viewers
• Zoomify
• Supported all platforms
• ActiveX
• Java
• Quicktime
• Flash
• Pixels-on-demand (copywrited by someone used
  without permission)
• PFF byte handler

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Limitations of WSI

• Venders were concentrating on image acquisition.
• Viewers did not work well over the internet
• Limited (i.e. none) support of Mac

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PrivateAnnotator

• Private password protected pathology image
  website
• Resources were limited by user
• Asynchronous viewing / annotation of WSI

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PrivateAnnotator
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PrivateAnnotator
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PrivateAnnotator
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PrivateAnnotator
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PrivateAnnotator
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PrivateAnnotator
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PrivateAnnotator

• Strengths
• User friendly simple web-based application
• No overhead on users
• Firewall friendly (only port 80 needed)
• Asynchronous
• Issues
• Asynchronous
• Occasionally more then annotations are needed to
  illustrate learning points

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What did our users want

• Users responded very positively to WSI
• Complained that the speed is not fast enough
• User wanted a multiheaded microscope like
  experience
• They wanted to discuss pathology
• Use WSI to discuss their genetic manipulations
• VoIP

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Requirements

• Simple to use
• Preferably similar user interface as the
  Annotator
• Allow multiple users to see the same image at the
  same time

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PrivateCommunicator

• Zoomify
• Built on flash
• Contracted with Zoomify to expand the viewer
• Macromedia Communication server

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PrivateCommunicator
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PrivateCommunicator
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PrivateCommunicator
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PrivateCommunicator
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PrivateCommunicator

• Features
• Synchronous viewing
• Baton passing
• Superuser mode
• Sync-view
• VoIP

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PrivateCommunicator

• Issues
• Synchronous viewing
• Bandwidth
• Macromedia Comm server licensing
• Will it continue to work now that Adobe owns
  macromedia?

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Comm Server
WSI Viewer
WSI Viewer
WSI Viewer
Comm Server
Image Server
WSI Viewer
WSI Viewer
WSI Viewer
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PrivateCommunicator

• Users responded very positively however
• All communication is WSI based
• Users want more
• Virtual conference room, with a multiheaded
  microscope
• Share Powerpoint, Word, image analysis

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Breeze

• University had invested in Adobe Acrobat Connect
  Pro.
• Conduct virtual conferences
• Allow user to share anything on their desktop

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What have we learned?

• Users do not know how to use their computers
• System must be simple to use
• Open ports must be kept at a minimum
• Digital pathology works very well
• Consultation
• Collaboration

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What is needed

• Image analysis
• Now that images are digitized users are starting
  to realize that we should be able to bin lesions
  into more then 3 bins (well, moderate, poorly
  differentiated)
• Image interoperability
• All current venders have their own format with
  their own image server
• Keep an eye on DICOM Working group 26

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Questions?