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9 Creation of a large collection of frozen sections using an online database; a novel application of virtual pathology
  1. K McDonald1,
  2. W Ng2,
  3. S Brandner3,
  4. SMH Rizvi1
  1. 1UCL & Partners, London, UK
  2. 2St Thomas’ Hospital, UK
  3. 3UCL Institute of Neurology, London, UK


Background/context Frozen sections are histological sections undertaken intra-operatively while a patient remains anaesthetised, and are reported within a very short time frame. They can optimise patient management. Snap freezing creates tissue artefacts that are difficult to interpret, and even in our large teaching hospital less than 150 frozen sections are performed per year. Thus trainees gain minimal experience in frozen section interpretation. Virtual (digital) pathology is increasingly used for diagnostic and training purposes,1–3 but to our knowledge there is no virtual frozen section database available for education.

Description of innovation Previous teaching sets have comprised small numbers of physical slides, which can only be viewed in one place, and may become lost or broken. Moreover, only two published books describe their interpretation. We have scanned slides from 350 cases and created an online database and an Adobe Captivate based e-learning module which describes how to interpret frozen sections. We used a Hamamatsu NanoZoomer 2.0 HT scanner and PathXL® ( as a web-based host. This collection is equivalent to 3–4 years’ worth of specimens and covers the entire breadth of specimens a pathology trainee should encounter.

Improvements/outcomes (anticipated or recorded) The learning module and database will be launched in the next few weeks and it will be available to all London School of Pathology trainees. We intend to survey trainees before launch to determine their previous exposure to live cases and teaching sets, then re-survey later to determine the usefulness of the module. Given the lack of any other resources of this kind, physical or digital, we expect the results to be favourable.

Take home message Virtual pathology is increasingly used for diagnostic and training purposes, but not specifically for frozen sections. We have created the first online database of frozen sections, complete with an e-learning module on their interpretation.


  1. Pantanowitz L, Valenstein PN, Evans AJ, et al. Review of the current state of whole slide imaging in pathology. J Pathol Inform 2011;2:36.

  2. Pantanowitz L, Szymas J, Yagi Y, Wilbur D. Whole slide imaging for educational purposes. J Pathol Inform. 2012;3:46.

  3. Boyce BF. Whole slide imaging: uses and limitations for surgical pathology and teaching. Biotech Histochem. 2015;90(5):321–330.

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