Process review and Web-based training
In this stage, 23 digital microscopic images of randomly selected
cases were taken by the histotechnologist in Ibadan from the study
histologic slides with appropriate positive and negative controls for ER,
PR, and HER2 markers using a digital camera, which was mounted on a
microscope. The images were then transmitted in JPEG format over the
Internet as e-mail attachments to the pathologist in Chicago. The
images were reviewed by the pathologists in Chicago for scoring, image
quality, and staining characteristics using free graphic software Picasa
from Google and ImageScope, Aperio Technologies (Vista, CA). The
images were then jointly reviewed by both pathologists during the Web
conferences. The purpose of this stage was to assess the quality of digital
images and staining techniques in Nigeria and further train the
attending pathologist at the Ibadanfield IHC laboratory on techniques
of assessment of staining quality and scoring.
Tissue microarray slides created at the University of Chicago were
also scanned using Automated Cellular Imaging System (Fig. 2).
Digital images of discordant cases were then jointly reviewed online
by pathologists using freely downloadable viewing software Image
Scope Viewer (Aperio Technologies) and WebEx, a virtual meeting
manager that enabled us to share desktops, presentations, and image