The Use of Scanning Virtual Microscopy for Pathologist Education

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The Use of Scanning Virtual Microscopy for
Pathologist Education

• Peter M. Banks, M.D.
• Director of Hematopathology
• Carolinas Medical Center
• Charlotte, North Carolina
• Adjunct Professor of Pathology
• UNC-Chapel Hill

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First CME Course Based onVirtual Microscopy for
CasesLessons Learned

• Historical outline
• Course organization
• First presentation
• Conclusions, recommendations

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Historical Timeline

• ASCP over 40 years education courses
• 2002 2 of 4 mainstay courses in hemepath
  retired
• Fall 2002 proposal for new course from
  Banks/Dunphy comprehensive, based on virtual
  microscopy for cases
• November 2003 case scans due
• January 2004 faculty weekend scan
  cropping, rehearsal
• February 2004 debut presentation

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Course ConceptComprehensive Review of
Hematopathology by WHO ClassificationHemic and
Lymphoid
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Logistical Challenges with HemicProcesses for
CME Courses Small Cellular Smear/imprint
Preparations - Nonreproducible
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Marketing
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Case Scan Gathering

• Faculty given 6 month deadline to submit slides
  for scanning, review for QC.
• 70 total cases
• Cellular smear preparations (marrow, blood)
  required 60x oil scans
• Tissue sections required 40x scans
• Trade-off large enough scans to be
  representative, small enough for packages

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Case Scan Gathering

• File format for registrants take-home sets CDs
  (700 MB). How many too many?
• Faculty meeting 2nd weekend January - 4 weeks
  prior to course debut(!) - cropping scans and
  rehearsing presentations.
• Last-minute rescans required for 3
  cases critical areas out of focus
• Annotations/coordinates for hard-to-find foci in
  scans
• Master scans submitted for duplication and
  packaging

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Selection of Field to be Scanned
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Uncompressed 4.1 GB Compressed 169 MB
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Uncompressed 508 MB Compressed 28 MB
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Packaging
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February 9th 2004
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Course Debut

• Course oversold (85 for 80 capacity)
• Introductory explanation of system (20 min)
• Demo laptop set-up at back of room
• Simultaneous (2-screen) presentations -
  PowerPoints by lecturer Virtual by assisting
  colleague
• Only 10 of 80 brought laptops
• Evaluations 75 favored virtual over glass
  slides for cases
• Many complained that 2-screen presentation too
  much, hard to follow

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Conclusions - Recommendations

• Great advantage realized any cases can be used
  no matter how small the sampling
• Savings in time, cost for producing glass slide
  sets scans more durable
• Requires one-time extra effort in selecting field
  for scan, proofing master scans in detail prior
  to duplication
• Needs faculty rehearsal for facile presentation

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Postlude

• Subsequent courses based on scanning virtual
  microscopy cases
• PMB AAOMP (San Antonio 2006 - through
  2009)
• ASCP Pulmonary Pathology (A. Churg) (first
  offering 2006)
• USCAP Specialty conferences and some short
  courses beginning 2006