The digital pathology archive: the UMC Utrecht initiative Paul van Diest, MD, PhD Professor and Head Department of Pathology University Medical Center Utrecht p.j.vandiest@umcutrecht.nl

The problem I 100.000 new slides per year archive of 7.000.000 slides total weight 60.000 kg weight increase 100 kg per year

The problem II slides often have to be retrieved: clinicopathological conferences compare with new material teaching research

The problem III slide retrieval takes time (0.5 fte) many circulating slides slides may get lost/misplaced slide quality deteriorates in time faded colors loose cover glasses broken

The solution? technically feasible to digitize all slides store images on SAN view slides digitally

Advantages of the digital archive all slides are digitally available instantaneously simultaneously to multiple users no slide retrieval from the archive no searching for circulating slides constant image quality no slides get lost/damaged

Advantages of the digital archive quicker preparation of CP conferences CP can be held outside the pathology laboratory close colleagues can be consulted quicker remote colleagues (at home, at conferences, on vacation) can be consulted quicker external consultations can be done quicker images can be made available in EPF (ZIS, Mirador)

Advantages of digital “microscopy” teaching all students view the same “best slide” slide images can be integrated with annotations questions macroscopic images sound clips links etc

Advantages of the digital archive more efficient CP conferences higher speed, dynamics and flexibility of consultation higher quality and more dynamic teaching but…… Can it be done?

The digital pathology archive: the UMC Utrecht solution acquisition workstation scanning macro imager order form scanner database RVC mirador Sun SAN DPS HSM storage 6 TB fast access hard disk array pathology users clinical users 120 TB tape library

Digital slide demo

PALGA link

Pitfalls of the digital archive I huge storage management 200 MB – 1 GB per slide (20x) 80 TB per year backup back archive speed of image retrieval logistics of scanning 500 slides per day no delay in having slides scanned flexible scanning slots image compression

Pitfalls of the digital archive II costs (vs. savings/quality improvement)

Scanning logistics scanners are loaded twice daily at different moments organize other work around this 7 hours per run bar code recognition in scanners extra set of slide boxes mark slides to be scanned (double slides) do not write on slides install alarm system when scanner crashes

Future perspectives I nationwide digital archive (EPF) quicker revision quicker consultation lab A lab B lab C lab D lab E lab I lab H lab G lab F lab A lab B lab C lab D lab E lab I lab H lab G lab F central storage or…

Future perspectives II digital diagnostics remote diagnostics diagnostic networks

from …….. to …….. pathology cockpit

The digital pathology archive: desirable and feasible!