Streamlining Tumor Board Reviews

Streamlining Tumor Board Reviews

By Sherri Heffner

The increasing complexity of cancer therapy, particularly with respect to the intricacy between laboratory/pathology discovery and clinical treatment, benefits from a multidisciplinary team approach to patient care. Hospital Tumor Boards are a means for providing an ongoing and integrated treatment planning approach in which a number of doctors who are experts in different specialties (disciplines) review the medical condition and treatment options of cancer patients.

Hospital Tumor Boards meet routinely for multi-disciplinary case presentations and review of various types of cancer cases. The goal is to discuss treatment options for the patient and reach a consensus on how to best manage the patient's care.

Pathology Challenges

Pathological findings are a significant component of Tumor Board case presentations, yet assembling the pathological information for a given case presentation can be a time-consuming and tedious process, consuming hours of both an administrative technician and pathologist's time. Multiple case reports and slides have to be identified and pulled. For a given case, this might include up to 50 independent slides, some of which may be offsite in a warehouse or at another facility.

The pathologist must also review and choose the best slide(s) to present the case and organize and prepare photos of the slide for the Tumor Board presentation. Ways to prepare photos include use of a 35mm camera, a digital camera on a microscope to produce a jpg photo for insertion into Power Point, or use of a microscope with an analog TV camera and monitor. Photo quality can be highly variable.

Another challenge is that during the presentation, questions may arise about part of the tissue sample that was not captured in the photo (i.e., a margin), or the pathologist may find he didn't bring a photo of the right slide to respond to a question from the team.

Data Collection, Collaboration

Digital pathology is a computerized, image-based environment for managing and interpreting information enabled by a digital slide. Digital pathology systems provide digital slides (digital images corresponding to entire glass slides) with image quality equivalent to a microscope; a consolidated view of relevant case information; and clinical and workflow tools that include remote viewing, digital slide conferencing, image analysis and intelligent archival and retrieval.

Through use of digital pathology information management software, pathologists are able to manage and analyze vast amounts of digital slides and other data in project-specific, context-based configurations. Intelligent data retrieval tools enable users to efficiently search and access information based on multiple criteria within the pathology database.

With a digital pathology system, pathologists preparing for Tumor Board no longer have to locate, pull and transport glass slides, saving hours of prep time. Pathologists can easily store cases by date for easy access during presentations or for search of previous cases. Search criteria to locate slides can be based on multiple levels of information, such as by case, specimen, digital slide or image and by numerous sub-categories within those levels such as stain type, result or scan date.

Another benefit is that more in-depth information can be presented in a fluid manner. All of the disparate sources of information needed by the pathologist to present a complete picture of a case—digital slide, gross images and case history—are available in one consolidated view. Digital pathology provides the highest quality image possible, with greater educational value for clinicians and a more accurate reflection of the specimen. During the presentation, a pathologist can identify and display digital slide images in multiple ways, or present with multiple slide images along with the gross specimen. The digital technology allows images from a pathology slide to be presented at precise levels of detail, resolution and clarity not possible with standard definition. Pathologists have the ability to zoom and annotate the slide during preparation and presentation, and to speak to any region of the slide to answer specific questions that may arise.

Digital pathology also facilitates the ability to share images with remote attendees to collaboratively discuss cases and educate via special cases during reviews. With an Internet connection and the appropriate software, several pathologists across the country can access and confer on a case at the same time and review detailed pathology slides from any remote location.

Sherri Heffner is a senior marketing manager at Aperio Technologies.