Tumor boards were created with worthy objectives in mind – to share knowledge, improve current patient care, and prepare/educate residents & fellows for their future practices. Tumor boards are also a requirement for cancer center accreditation, hence a necessary cost of doing business.
Preparing for tumor boards, however, is too often an onerous task fraught with time delays, rework, and cumbersome, inflexible presentation methods. After your support staff pulls reports, retrieves slides, and brings them to you, do you spend hours photographing and taking notes of the key points you then load into a PowerPoint to present for each case? Do you ever get to your tumor boards and find that another view of the slide might better answer the clinician’s question?
A new approach that uses a robust digital image platform now offers the opportunity to reduce wasted time in the process, improve the quality and effectiveness of your tumor board presentations and as such, provide the best data possible for a cancer patient's treatment plan.
Consider the current practice:
Pathologists typically receive a list of cases to be reviewed at upcoming tumor boards from the oncology service. After reviewing the list for the relevant pathology, the pathologist provides their support person with a second list of a subset of these cases. The support person prints out each patient’s report and then retrieves the slides associated with the case.
Once the material has been assembled, the support staff will put the reports and slides together in a slide folder and return the material to the pathologist. He or she will review the material, take digital photos of critical fields of the slides to illustrate key points, and bring the material to the tumor board for discussion.
Furthermore, the pathologist must then perform rework by reviewing the slides, capturing the important images with a digital camera, and then putting the material into a coherent package for presentation. Slides from other facilities that may have been reviewed at the time of the original diagnosis may no longer be available, potentially resulting in an incomplete representation of the patient’s case.
If whole slide images are utilized instead of glass slides, the digital slide images must be retrieved from the server and manually matched to the case annotations. At times, depending upon the complexity of the case, the patient’s material may also include archival material from previous biopsies or associated specimens. Again, if those slides were digitized, there is a strong probability that the technologies are incompatible and additional time is required to compile material for your presentation.
How can you improve the quality of your tumor board presentation while removing the waste from your workflow?
Setting up a workflow that engages a digital pathology platform can streamline the preparation and presentation process for your tumor boards. By having whole slide images scanned of the diagnostic material within each case and accessioned into Corista’s Digital Pathology Processing Platform (DP3TM), you will have your case ready for review as soon as you receive notification from the oncology service as to what cases are to be presented. The digital pathology platform combines and integrates all the patient and case data with the images in real time. You can then use the tumor board feature in the platform to assemble and manage the cases you will present.
When interpreting a case, the pathologist notes which slides are critical to the diagnostic decision. When you have signed out the case, it can then be sent to the lab where the key slides are scanned and the case accessioned into Corista’s DP3 to include the key elements of the patient’s final report.
When it is time to prepare the case for tumor boards, you can access the case through the DP3 and immediately review the key slides along with the report. You can then annotate the fields of interest on each slide using the tools in the DP3 system allowing for both linear and area measurement of defined fields. Your image quality will be more consistent using your scanned images than with a digital microscope camera. After review of each case, you can then add the case to the “tumor board” for presentation with your other cases. A couple of clicks replace what used to take hours spread across days.
At the tumor board, you will also have the opportunity to review the entire slide or key areas of interest at different magnifications rather than rely on just your prepared material. The platform accepts images from any whole slide scanner so you can include scanned slide images sent from other facilities into your presentation as well. When your tumor board is complete, you can then archive it for future reference.
Using Corista’s DP3 to manage your tumor boards allows for better use of resources, improved effectiveness of your presentation, and greater flexibility. It can be used with any whole slide scanner. As you develop your digital pathology workflows, you may want to change your scanning system. Using a digital pathology platform that integrates with any scanner also allows you to maintain all of your archival material for review at any time.
Ready to learn more on how Corista's DP3 can help improve effectiveness of your tumor board presentations? Contact us to learn more.