Whole-slide imaging in pathology: the potential impact on PACS

Abstract

Pathology, the medical specialty charged with the evaluation of macroscopic and microscopic aspects of disease, is increasingly turning to digital imaging. While the conventional tissue blocks and glass slides form an archive that pathology departments must maintain, digital images acquired from microscopes or digital slide scanners are increasingly used for telepathology, consultation, and intra-facility communication. Since many healthcare facilities are moving to with departments in addition to radiology using the infrastructure of such systems, some understanding of the potential of whole-slide digital images is important. Network and storage designers, in particular, are very likely to be impacted if a significant number of such images are to be moved on, or stored (even temporarily) in, enterprise PACS. As an example, a typical commercial whole-slide imaging system typically generates 15 gigabytes per slide scanned (per focal plane). Many of these whole-slide scanners have a throughput of 1000 slides per day. If that full capacity is used and all the resulting digital data is moved to the enterprise PACS, it amounts to 15 terabytes per day; the amount of data a large radiology department might generate in a year or two. This paper will review both the clinical scenarios of whole-slide imaging as well as the resulting data volumes. The author will emphasize the potential PACS infrastructure impact of such huge data volumes.