Reader Suggests Substitutes for the Term "Soft Copy Read" in Digital Pathology

In a blog note posted yesterday, I suggested that the term soft copy read could be used by pathologists to describe the process whereby a scanned image of a tissue lesion is reviewed using a terminal rather than a microscope (see: Digital Pathology, Pathologists, and the "Soft Copy Read"). I am not completely satisfied with this phrase, borrowed from the radiologists, but think that its use, or a similar phrase, could be useful in the digital pathology dialogue. In response, Lance submitted the following comment:

Perhaps a more applicable term would center around the [term]: 'digital diagnosis' or 'z-view diagnosis'. Note, in both terms, inclusion of the term 'diagnosis' implies that the final decision/diagnosis rendered was made using the preceding word's methodology. For the two (off the cuff) terms - 'digital diagnosis' would imply/mean that the diagnosis was made using a digital display, and the latter incorporates the fact that the digital scanner incorporates a z-plane. Granted, with the latter term, a 'z-plane' is technically a component of glass slides as well, though we often don't think of it in such terms. Moreover, this renders an interesting question regarding terminology and nomenclature. One factor not fleshed out in this post is the permanent inclusion of a term (such as 'glass diagnosis' or 'glass review') that details/parallels the 'hard copy', e.g. glass in the world of pathology. Perhaps the term 'tissue diagnosis' remains correct, but it greatly generalizes things and may become akin to saying a clinical diagnosis was made...a term that, in actuality, fails to convey any methodology used, but rather is a generalized 'waste basket' term.

First of all, I agree with Lance that the inclusion of the term diagnosis in the phrase could be misleading. Frequently, there is no lesion present so no diagnosis can be rendered. The use of the term z-view is also misleading because most paraffin sections, but not necessarily cytopathology smears, will be scanned only in one plane. The terms glass view or glass review suggested by Todd above have much to recommend them. I will also suggest the phrase glass read that is quite similar to soft copy read and has a clarity and directness that appeals to me. Given that tissue sections mounted on glass will not disappear in the foreseeable future, any term including the word glass should have a long life.

So, to recap the discussion, we are considering at several terms to describe the review of a scanned image on a terminal screen by a pathologists. The current candidates are the following:

• Soft copy read
• Soft copy review
• Glass read
• Glass review
• Glass view

Among these, I personally favor glass read or glass view because they are short, descriptive, and to the point. What do you think?

Comments

[Jared Schwartz MD PhD]

Pathologists examine an image of tissue or cells and provide a consultative interpretation. This may or may not result in a specific diagnosis. The manner in which the image is obtained is technology. Film or digital camera, optics using a light microscope, a florescent scope or an image using digital technology. The reality is the pathologist must interpret the image and render an opinion. This has been already been done for years using a variety of technologies. Testing examinations, education, research and clinical studies all today use both light microscopes and digital images. The real issue is not a name
for the technology but whether the image to be examined is of higher quality and which method provides one with more options to manipulate than using another technology. The name of the Specialty is the same Pathology, such has been the case for Radiology/Surgery/etc despite the technology they use constantly changing. In my opinion it is not a soft or a hard read, it is an interpretation of an image that one is provided for possible diagnosis.

[Ole Eichhorn]

I like "digital read".

The problem with "glass" is that it could refer to the physical slide as easily as the computer screen, in fact, I've heard "going to the glass" used as a synonym for using a microscope.

I believe "soft copy" was used more often in Radiology when X-rays were scanned to make a digital copy; now with digital X-rays and MRIs and CTs, I think "digital read" is used more often.

Using the term "diagnosis" feels slightly off; the act of reading can result in a diagnosis, but I think the diagnosis is the determination made by the pathologist, not the act of viewing a slide.

This is a very interesting question; I'm going to pose it to the members of the Digital Pathology Association's Industry Council, which was formed specifically to opine on such things...

[Anon]

Why not use Digital Read?

[Lance Needham]

I agree and understand the sentiments expressed here and by others regarding this issue...and it is one that I haven't seen raised in other forums but will undoubtedly come into play in the very near future.

Perhaps I'm off-base or biased, but I fear that inclusion of the term 'glass' in the verbiage may be misleading ~ as most other fields associate glass with the typical fashion of glass slide and a microscope.

Is there a necessary downside in the inclusion/ utilization of 'digital' in the terminology? 'Digital view' or 'Digital read' would be both short, accurate, and similar to the terminology already employed by our radiology counterparts...