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Implementation of a Network Digital Image Repository in aMulti-User Pathology Department
J. Mark Tuthill (mtuthil1@hfhs.org), Paul Tranchida, Adrian Ormsby, Barbara Basberg, Richard Zarbo, David Chen, Department of Pathology, Henry Ford Medical Center, Detroit, MI
Content: Digital imaging has become an accepted method of capturing images for gross and microscopic specimens. In this project our department attempted to create a repository for all the digital images captured during the workday, and have these images be immediately accessible to all users anywhere within the department at the point of capture. A single interface was utilized for all image capture devices for this repository.
Technology: Imaging server consisting of a personal computer running Windows 2003 Server, and Microsoft SQL. Each imaging station had the software application ThumbsPlus (Cerious Software, Charlotte, NC) installed with an ODBC connection to the SQL database. TWAIN interfaces for all compliant cameras and scanners already attached to each imaging station were installed. This allowed ThumbsPlus to be the single user interface to multiple input devices.
Design: The imaging server is located in the office of the department's informatics division. The image repository is organized into two main sections: one is for the staff's personal images, and the other is for images pertaining to the cases of our anatomic pathology laboratory information system. The latter section is organized by the year in which the specimen was accessioned, with each case having its own folder named after its unique bar-code generated accession number.
Each grossing station is equipped with a Canon Powershot G6 camera positioned on a flexible mechanical arm, and it has access to the imaging server's storage space as well as the ThumbsPlus database through a network connection. Other imaging stations throughout the department are equipped with either slide scanners, flatbed scanners, or a microscope fitted with an Olympus DP-70 digital camera; images are captured and immediately stored in the desired directory within ThumbsPlus using the instrument's TWAIN interface. Images were named according to the case number. The batch processing features available within ThumbsPlus facilitated the performance of format conversion, resizing, and other processes commonly encountered when working with digital images. Pathologists may retrieve any folder and its associated images by browsing to the appropriate root directory and scanning the bar-code slide label of the case.
Results: The above setup made it easy for residents and pathologists to capture gross and microscopic images and immediately deposit them in the appropriate folder. As of this writing the repository contains approximately 40,000 images. Pathologists have expressed appreciation for being able to rapidly retrieve the images associated with cases, especially during multi-departmental tumor boards. ThumbsPlus is a flexible, powerful program for easy location, processing, and organization of image files, and is an adequate interface for the repository. The amount of user training involved in capturing and storing images within ThumbsPlus was minimal. Training was eased due to the single ThumbsPlus interface used by all devices. In addition to image capture and the ease of organizing images, ThumbsPlus allows the automatic generation of user-defined keywords for images. This feature can assist with the creation of a comprehensive directory of images based on many parameters (organ, diagnosis, image type, etc.) allowing users to easily search for images of interest.
Conclusion: Having a digital image repository distributed over a computer network is a relatively affordable and convenient way of sharing images in a pathology department. By utilizing a single interface we were able to bypass some of the difficulties encountered in digital imaging where different steps in the capture and viewing process are performed by different applications and their interfaces. This repository is convenient not just with tumor boards, but also for educational purposes. Finally, it allows the pathologist to easily locate and attach images to their cases through MiSys CoPathPlus, allowing for more detailed and clinically useful pathology reports.