User attitudes in analyzing digital slides in a quality control test bed: a preliminary study

The pathologist examines suitably stained glass slides through a bright field microscope in order to render histopathological or cytological diagnosis by looking at tissues and cells. Glass slides serve as a permanent record of the patient disease. Over the course of a patient's treatment slides may need to be reviewed at other institutions before treatment can commence. Due to their fragile nature a transportable permanent digital facsimile of the glass slide would be ideal. A digital slide is a set of digital images representing the whole slide normally used by the pathologist, or a significant part of it; it is usually made by a large amount of images, up to thousands, which makes its management difficult. The present paper provides a description of the requirements needed to reproduce glass slides and of the available technological equipment, then the features of the two systems we implemented on different hardware are described, together with those of the digital slide viewer. The viewer was evaluated in two experimental test phases, during which user behaviour and diagnostic reports were measured. Digital slides used in the two experiments were acquired with either system. Possible applications of digital slides are then discussed, including undergraduate and professional education, quality control, and image analysis on full samples as well as on tissue microarrays.