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Consideration on work items of IHE-pathology and DICOM for pathology image

Consideration on work items of IHE-pathology and DICOM for pathology image. Sep.25 2005 Ikuo Tofukuji IHE-Japan Pathology-WG. WF of Pathology with Optical Microscope. Physician Surgeon etc. Image archive Image display. Pathologist. Medical technologist. Preprocess. Take sample

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Consideration on work items of IHE-pathology and DICOM for pathology image

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  1. Consideration on work items ofIHE-pathology and DICOM for pathology image Sep.25 2005 Ikuo Tofukuji IHE-Japan Pathology-WG

  2. WF of Pathology with Optical Microscope Physician Surgeon etc. Image archive Image display Pathologist Medical technologist Preprocess Take sample Place order Receive order, patient data, clinical data Register patient Receive sample Take gross picture Make block Gross image Cutting drawing Process sample Make slide Diagnosis process Refer all data Observe slide Make report Key image Receivereport Decide care Attach

  3. WF of Pathology with Virtual Microscope Physician Surgeon etc. Image archive Image display Medical technologist Pathologist Take sample Place order Preprocess Receive order, patient data, clinical data Register patient Receive sample Take gross picture Make block Gross image Cutting drawing Process sample Make slide Scan Slide Whole slide image Diagnosis process Reconstruct observation view image Refer all data Observe slide Make report Key image Receivereport Decide care Annotate and attach

  4. Structure model of DICOM Objects in RadiologyPreprocess (Archive images) Study Patient Series: One report will be made corresponding to the series Image Transmitting X-ray Front shot Order Side shot Image CT Slice Slice Slice

  5. Structure model of objects in Preprocess of Pathology Service (Make slides and Scan*) Study: One report will be made corresponding to the order Series Patient Image Removed organ Biopsy specimen Gross Image Order Cutting Drawing Image Whole slide Image (Virtual slide only)* Block Glass slide Whole slide Image (Virtual slide only)* Glass slide *Note: In case of optical microscopy, no-whole slide image Block Removed organ Biopsy specimen

  6. Diagnosis process structure model in optical-microscopy(Independent from DICOM) Naked eyes observation (Make diagnosis strategy) Observation of microscopic view (Search characteristic findings) Make case report (Reply to order) Refer gross image Observe glass slide 2X 40X 2X 10X 10X 20X 4X Key images 2x Observe glass slide

  7. Diagnosis process structure model in virtual-microscopy(Independent from DICOM) Refer staring image (Make diagnosis strategy) Observation of reconstructed images (Search characteristic findings) Make case report (Reply to order) Refer gross image Refer whole slide image 2X 40X 2X 10X 10X 20X 4X Key images 2x Refer whole slide image

  8. Note on pathology observation process • Diagnosis process strategy is arranged by pathologist based on his experience and diagnosis purpose. • Diagnosis process is dynamically constructed according to findings in view fields. • Diagnosis process is not recorded. • Recording is desirable for QA or education • No another medical section records decision process • Key images include important findings, may be taken and attached to the report with annotation, usually not be stored in PACS.

  9. IHE-pathology work items to be discussed • Workflow profiles for routine diagnosis services • First step: pathology & cytology • Procedures & report, cytology includes screening procedure • Observation: optical-microscopy, virtual-microscopy (bright field) • Second step: frozen section, autopsy • Third step: telepathology (frozen, second opinion) • Technical framework: actors and transactions • Define actors’ functions • Define messages to be transferred among actors • Terminology and code?

  10. Pathology DICOM work items to be discussed • Image format • Object: gross picture, virtual slide • Subject: compression, reconstruction & display • Image attached information items • Patient • Specimen • Block • Slide • Structured report optimized for pathology diagnosis • Report structure and items to be included • Attaching key image with annotation

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