1. The Introduction and Implementation of new Scanning Systems Susannah Tandy 20/11/14

2. Introduction Why do we scan our slides? – Microscope V Scanning Why did we need a new scanning system? Implementation – iso15189:2012, Validation and Verification – Scanner installation plan – Verification Results Positive results and the future

3. Microscope V Scanner Historically analysed using microscope However, this can be a lengthy analysis Needed to move into 21 st century

4. Microscope V Scanner Purchased the Metasystems metafer slide scanning platform – White paper funding Manipulation – Line up chromosomes – Enhancement Storage – Digital copy Time and motion studies showed a 30% increase in efficiency

5. Original Metafer Scanning System Comprised of 1 st Generation slide feeder and Zeiss Axioplan Z microscope Although increased efficiency, there were frustrations:

6. Original Metafer Scanning System Frame Check – Time consuming Temperamental Sensors – Frame loading problems – Delays Auto-Oiling System – Messy – Can contribute to breakdowns Limited capacity – Max of 70 slides

7. Original Metafer Scanning System Had reached end of life: – Zeiss no longer supporting the microscope – Used old IT technology Windows 7 capability not guaranteed Looked towards getting an upgrade

8. New Metafer Scanning System Purchased Metafer 2 nd Generation slide feeder accompanied by Zeiss Axio imager Z2 microscope – Includes a barcode reader No need for frame check More efficient use of staff time

9. New Metafer Scanning System Better frame loading system – Less likely to drop a frame – No aborted runs – Less delay on cases being scanned More advanced Auto-oiler – Controls the amount of oil – Better focusing – No drips – Less mess and potential breakdowns

10. New Metafer Scanning System Only 5 slides per frame BUT – Each stack can take 16 frames – 80 slides per stack Up to 5 stacks each scanner – Increase number of slides per run

11. Why Metasystems? Compatible with systems already in place (Ikaros and Isis) Avoided having to move to an alternate provider – transfer of images

12. Implementation Purchased using Capital replacement budget with support from the trust Reduced number of constitutional scanners – Reduction of conventional cytogenetic analysis due to move to Arrays service Maintained Haemato-Oncology capabilities – Increasing service

13. iso15189:2012 Validation and Verification of equipment is an important requirement of iso15189:2012 WMRGL is accredited to iso15189:2012 Validation – carried out by company Verification – carried out by laboratory Scanners implemented before assessment – Needed to make sure we met the criteria – Opportunity to ensure correct procedure in place – First large piece of new equipment

14. Installation Sequential – Maintain capability with minimal downtime – Ensure appropriate testing Constitutional scanner installation – December 2013 3rd scanner not upgraded – Verified for Haemato-oncology preparations Haemato-Oncology scanner installation – January 2014

15. Verification Both scanners found to be acceptable for the scanning of slides appropriate for that scanner ConstitutionalHaemato-Oncology Postnatal casesPrenatal cases Total number of Metaphases Captured The Test Scanner picked up more metaphases than the Control scanner Amount of rescanning needed The Test scanner did not need to rescan any high power images while the Control scanner did The Test scanner needed to rescan less high power images than the Control scanner Quality of imagesImages from the Test scanner were of a comparable quality to the images captured on the Control scanner Images from the Test scanner were of a better quality than the images captured on the Control scanner Images from the Test scanner were of a comparable quality to the images captured on the Control scanner

16. Moving Forwards SOPs written and agreed – SOP for the use of new scanning systems – SOP for Guidelines for Validation and Verification– abide by iso15189;2012 standard Since been used to implement new hardware – Luminex – Helped ensure protocols are correct WMRGL moving onto windows 7 in future – 2 nd generation scanners already us this – Remaining original scanner not compatible Verify Constitutional scanner for Haemato- Oncology slides

18. Acknowledgements I would like to say thank you to the following people: Claire Gleave Donna Woodman Graham Fews Michelle Fenlon Michelle Owen The Karyohub Team Any Questions?