Viewer

Image Viewer Options

Once the case is launched from the main dashboard or the laboratory information system (LIS), users will arrive to the clinical viewer. This viewer consists of a primary whole slide viewer with menus present on the top, left and right side to guide navigation of the slide and case.

Top Menu Selection (from left to right)

The top bar or header of the viewer prominently and consistently displays essential patient information, such as the name, date of birth, gender, and Medical Record Number (MRN), ensuring clear visibility. 

Case Information:

• Ability for users to easily retrieve all information associated with the case. Fields include:

  • • Patient Personal Information and Priority: First Name, Middle Name/Initial, Last Name, Gender, Date of birth, Internal Accession Number, MRN Number, Priority, Country, State, City, Address, Clinical History

    • Hospital Details: Referring Hospital Name, Referring Physician Name, Comments

    • Case level details: Accession IDs, Total Slides per Accession, Uploaded Date and Specimen Collection Date 

    • Case and Insurance Documents

Notifications:

• Ability for users to be notified for cases created, case assigned, case reported, updates pre sign-out, updates post sign-out, ordered stains and report Issues.

• During in-app notifications, new entries will add a "dot" once over this icon when notification is available.

• By clicking on the link for the notification, event is recorded and auto-removed from the list. 

• Under settings users can select which of the above events they would like to be notified about, as well as the notification mechanism (email, in-app or both).

Full screen:

• Allows the User to launch the whole slide viewer in full screen format.

Bookmark:

• Easily add a case to the bookmarked dashboard, where users can navigate through saved cases to add tags (e.g., Tumor Board Week 8) or send cases for de-identification for research or educational purposes. 

Keyboard Shortcuts:

• Provides a list of all keyboard shortcuts available to the User.

Product information:

• This is the medical device label for the whole slide viewer along with the product, the current version and associated unique device identifier (UDI).

Collapse/Expand Side Bar:

• Option to expand/collapse right hand side bar. 

Slide Label and Accession Details

Slide Thumbnail:

• Provides a view of the slide label and hovering over the label with the mouse provides a macro view of the entire slide and label.

Accession Details:

• Accession number

• Part number

• Block number

• Site

• Stain/Study

Options Menu:

Slide Tray

• • Allows the User to view the entire slide tray including clinic and gross images if included in the case.  The slide tray displays the part or specimen number and thumbnails of all whole slide images.

  • When launched, the slide tray appears at the bottom of the viewer however, if the User prefers, the arrow located on the top right of the slide tray can be clicked and the slides will move to the left of the toggle navigator window. The annotation tool bar then moves to the right of the micro image.

  • The slides can also be filtered to display all slides, slides from previous cases, rescans, clinical slides, deprecated slides, QC/Control Slides and gross images. Selection becomes available as these image categories are generated.

  • The user can add QC slides to the case from a list of available Control Slides.

Report an Issue 

• • Allows the User to report an issue, for example a blurry whole slide image, to the laboratory for review and rescan.  

Order Stain

• • Allows the user to order stains within the platform. 

Case Report

• • The User can view and edit the Case Report as well as view AI results.

Macro Report

• A user can use the Macro Reporting Flow to populate a report using standard Macro and ICD codes.

AI

• • Based on the AI algorithms integrated into the PathPresenter platform, this tab enables users to view previously applied algorithms or apply new AI algorithms to specific slides or regions of interest. 

Download Slides

• Allows a user with required permissions to download single or multiple slides from the case.

Annotation:

• The User can view all saved annotations.

• Hovering over the information icon displays the description of the annotation and count, if applicable, who created the annotation and the date and time and the date and time of any modifications made to the annotation.

• Saved annotations can be edited or deleted and marked as Private or Public.

• The User can search for specific annotations by pathologist.

Case Chat

• Users can send messages and discuss cases with colleagues, with the required credentials, to collaborate on a case in real time.

Tool Bar: (Top to bottom)

Home: 

• • The home key restores the image to its original resolution and position and no longer displays annotations. Any annotations applied to the image can be viewed in the annotation tab in the right hand menu.

Toggle Navigator:

• • Opens a small window in the top left corner of the screen that displays a macro view of the slide enabling the user to navigate to any specific area on the image.  

  • The User can activate tracking capability whereby color is applied to the area that has been viewed to ensure the entire slide has been reviewed.  

  • The navigator window also allows the user to utilize 5x or 20x magnification.

Magnifier:

• • Opens a small window in the bottom right corner that displays a magnified view of the slide around the region of the pointer.

  • The magnifier is set to 2x the Zoom level

Snapshot (Image Capture):

• This option allows the user to take a snapshot of the image/slide on screen. 

• The image can be saved in png, jpeg or tiff formats.

• By default, the snapshot will be labeled with the stain details however the User can change the label within the pop up window.

• If required the snapshot can be downloaded.  

Annotation: 

• • • Several annotations are available for the User and are listed below in the order they appear in the tool bar: 

      • Elliptical 

      • Rectangle

      • Looped

      • Linear Ruler 

      • Contour Ruler

    • Once an annotation is placed, the User can add comments, adjust the height and width, modify the border and fill colors, change the transparency, and alter the border thickness. 

    • The User selects an annotation tool and begins placing it on the image by clicking and dragging the mouse to the desired location. As they create the annotation, the height and width are displayed in real time, providing instant feedback on the dimensions. 

    • All annotations can be saved and accessed through the "Annotation" tab located in the right-hand menu. 

    • Saved annotations can be edited or deleted. All details of who added an annotation and when can be looked in the information icon.

    • Counter

    • This option allows the user to place small dots on the image, which can be saved and viewed under the "Annotations" tab. It is particularly useful for counting tumor cells on the slide. The total number of counters placed on the image is also displayed in the saved annotations. 

Filters for Contrast and Brightness:

• • • The User can adjust the contrast and brightness of an image, as well as invert the colors or convert the image to grayscale. 

    • The User can also reset the entire selection

Hide Annotations:

• • • The user has the option to hide all annotations for a clear view of the image. All annotations are saved and can be found listed under the "Annotations" tab. 

Side-by-Side View:

• • • • This option allows the User to compare two or four slides.

      • When selected, a dropdown will appear and the User can select 2 slides or 4 slides for comparison

      • The slide on the screen when the option is selected will become the primary slide and the User can select other slides for comparison by selecting "Add Slide"

• Synchronize:

• When viewing multiple slides, the "Synchronize or Sync" tab will appear. Toggling it on links the slides, allowing synchronized movement across them, while toggling it off lets you move and view each slide independently. 

• Actions like zoom, pan, rotate on the primary slide are synchronized to the other slides.

Flip: 

• • • The image can be flipped to a mirror image using the flip option.

Rotate:

• • • Allows the User to rotate the image to any degree using the slider bar.

Zoom: 

• • • The User can easily zoom in on an image by selecting the desired magnification of 1x, 2x, 5x, 10x, 20x, 40x, 60x, 80x,100x.

    • A scroll bar can also be used and allows the User to select a custom magnification level.

    • Alternately the User can also zoom by scrolling using a mouse.

    • If the image is zoomed in beyond its original scanned magnification, a yellow warning bar will appear with the message, "Zoom exceeds scanned magnification."