Transmission Electron Microscopy: The Transition From Photography to Digital Images

Background: The Mount Sinai Hospital (Toronto, Ontario) uses transmission electron microscopy (TEM) for the diagnosis of soft tissue and poorly differentiated tumors, examining approximately 350 cases/y. To cut material costs, it was decided to move from photographic TEM to digital-image TEM. Design: In November 1996, a Philips-CM100 TEM (Philips Electron Optics, Eindhoven, The Netherlands) was fitted with a Kodak Megaplus Digital Camera (Model 1.6i, Eastman Kodak Company, San Diego, Calif) connected to a PC-based system. AnalySIS software (version 2.1, SIS Soft-Imaging Software GmbH, Golden, Colo) was used for image management. Results: Digital imaging reduced photographic material cost from $5000/y to $800/y. In addition, staff was no longer needed for photograph development, and electron microscopy staffing decreased from 2.0 full-time equivalents (FTEs) to 1.2 FTEs. The quality of the digital image was roughly equivalent to that provided by photography, producing images suitable for publication. A slight decrease in quality was noted at extremely high magnification. This difference did not lead to any diagnostic difficulty. Diagnosis was made from on-screen images. The move to a digital-based system provided additional benefits. Turnaround time was reduced from 5 days to 3 days. As cost was no longer related to the number of pictures, the number of pictures per case increased from 5.7 to 9.1. The software allowed on-screen measurement of cellular structures. Digital archiving improved case storage and retrieval. Image viewing could be done from a number of networked workstations. Digital images allowed image analysis and manipulation and image transfer by e-mail. The digital images facilitated the creation of an electron microscopy teaching set for residents and technologists. The digital format also supports the goal to allow remote database access through the Internet. Conclusions: Despite the relatively small needs of our facility, the move to digital image-based diagnostic TEM produced a significant savings in material and personnel costs. In larger labs with greater material and personnel costs, the savings from moving to a digital system could be even greater. The move to a digital format produced additional benefits for education, image transfer, and image manipulation, which were not possible with a photograph-based system.
Aaron Pollett, MD (APollett@mtsinai.on.ca); Jacqueline Pittman, MLT; Yvan Bedard, MD, PhD. Mount Sinai Hospital, Department of Pathology and Laboratory Medicine, Toronto, [...]