Context.-Digital whole slide imaging is the anticipated future of anatomic pathology, where sign-out of glass slides will be replaced by scanned images. Whole slide imaging has been successfully used in surgical pathology, but its usefulness and clinical application have been limited in cytology for several reasons, including lack of availability of z-axis depth focusing and large file size. Recently, several systems have become available in the United States for whole slide imaging with z-axis technology.Objective.-To determine the accuracy and efficiency of whole slide imaging, as compared with traditional glass slides, for use in cervicovaginal diagnostic cytology.Design.-Eleven cervicovaginal cytology cases (ThinPrep and SurePath) scanned at 320, 340, and 340 z-stack magnifications using the BioImagene iScan Coreo Au 3.0 scanner were evaluated by 4 cytotechnologists and 3 pathologists in a blinded study. Different magnification scans were recorded as separate cases and presented in a randomized sequence. Corresponding glass slides were also reviewed. For each case, the diagnoses and total time to reach each diagnosis were recorded.Results.-Diagnostic accuracy was higher and average time per case was lower with glass slides as compared with all digital images. Among the digital images, the 340 or 340 z-stack had the highest diagnostic accuracy and lowest interpretation time.Conclusions.-Whole slide imaging is a viable option for the purposes of teaching and consultations, and as a means of archiving cases. However, considering the large file size and total time to reach diagnosis on digital images, whole slide imaging is not yet ready for daily cervicovaginal diagnostic cytology screening use.(Arch Pathol Lab Med. 2013;137:618-624; doi: 10.5858/ arpa.2012-0430-OA) D igital imaging is the creation, storage, and transmission of an image file using a computer and is considered by many to be the future of anatomic pathology. Most pathologists currently use some form of digital imaging, such as static images obtained by microscope-mounted optical cameras. Within the field of cytology, digital images are routinely being used for automated computer-assisted screening of Papanicolaou test slides, as well as for training and education. Proficiency testing is currently performed on glass slides, though the future use of digital slides is anticipated. The development of greater image quality and resolution within digital pathology has promoted the use of telepathology, including telecytology, which has been shown to be acceptable for both adequacy checks and rapid cytology diagnoses. [1][2][3][4] Other uses of digital imaging in pathology include image-enhanced reports, live imaging through robotic microscopy, 5 remote surgical frozen section review, 6,7 quality assurance testing, 3 and image cytometry/ analysis.Whole slide imaging (WSI), a subset of digital imaging, is the process of scanning an entire glass slide and converting the data into a high-resolution digital image that is viewed and manipulated on a computer....

Rapid genome sequence analysis permitted us to genetically define this strain, rule out the likelihood of bioterrorism, and contribute effectively to the institutional response to this event. Our experience strongly reinforced the critical value of deploying a well-integrated, anatomic, clinical, and genomic strategy to respond rapidly to a potential emerging, infectious threat to public health.

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