Roche Virtuoso User manual

Ventana Medical Systems, Inc.

www.ventana.com

Part No.: PL-000092-UK Rev. K

2017 - 05

Virtuoso Reference Guide, Version 5.5

ii Virtuoso Reference Guide

Virtuoso Reference Guide

Copyright

Trademarks

VIRTUOSO, ISCAN, VENTANA, COMPANION ALGORITHM, the VENTANA logo, and VANTAGE are trademarks of Roche. All

other trademarks are the property of their respective owners.

Open Source And Commercial Software

Virtuoso software might contain components or modules that are Open Source or Commercial Software programs. For copyright and

other notices and licensing information regarding such Software programs included with the Virtuoso software please see Appendix A

of the reference guide and the product on-line help pages included with the product.

The product and Virtuoso software as a whole may form a regulated device in accordance with the applicable laws – please refer to the

reference guide and the labeling for details. Please note that the respective authorization in accordance with the applicable laws lapse in

case of any unauthorized changes to the Virtuoso software.

Contact Information

Ventana Medical Systems, Inc.

1910 E. Innovation Park Drive

Tucson, AZ 85755

USA

+1 520 887 2155

+1 800 227 2155 (USA)

www.ventana.com

Ventana Medical Systems, Inc.

203 Ravendale Drive

Mountain View, CA 94043

USA

Roche Diagnostics GmbH

Sandhofer Strasse 116

D-68305 Mannheim

Germany

+49 621 7590

Part No.: PL-000092-UK Rev. K iii

Table of Contents

About the Virtuoso Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Who Should Read this Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Intended Use for Virtuoso Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Related Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Virtuoso Software with VANTAGE Integration Software . . . . . . . . . . . . . . . . . . . . . . . . 1

Technical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Connection Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

User Roles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Administrator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Histotechnician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Pathologist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Coordinator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Cyber Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

User Authorization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Securing Networks and Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Protecting Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

1: SLIS Software Basic Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Opening the SLIS Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Home Page Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Reset Password Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Logout Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

About the SLIS Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

SLIS Software Operating Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Manage Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

SLIS Hot Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Adding a New Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Update Case Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Delete a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Manage Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Adding a New Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Update Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Delete a Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Manage Clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Adding a New Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Update Client Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Delete a Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Manage Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Adding a New Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Update Physician Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Delete a Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Manage Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Adding a New User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Update User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

iv Ventana Medical Systems, Inc.

Table of Contents Virtuoso Reference Guide

Delete a User . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Admin Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Creating a New Tissue Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Retrieving and Editing an Existing Tissue Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Retrieving and Editing a Test Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Global Tissue Type Parameter Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Virtuoso Software and LIS Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

When Not All Required Data is Sent by the LIS to the Virtuoso Software . . . . . . . . . . 53

Example of Missing Required Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Order from LIS not in SLIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

2: Virtuoso Software Operating Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Opening the Virtuoso Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Logging into the Virtuoso Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Home Page Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

User Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Collaborating with Remote Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Joining a Collaboration Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Logout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Search Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Job Queue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Request Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Obtain Information About the Virtuoso Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

3: Virtuoso Software for Administrators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

Role Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Creating New Roles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

Assigning Users to New or Existing Roles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

General Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Setting Up Real Time Collaboration with WebEx . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Report Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Report Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

DNA Ploidy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Report Template . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

Reference Ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Input Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Output Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Case Sharing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Stain Set-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

VANTAGE Integration Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Audit Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Audit Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Usage Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

4: Virtuoso Software for Histotechnicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

Find Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

Filter Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

Rearrange Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

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Part No.: PL-000092-UK Rev. K v

Work List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

Rearrange Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

View Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Tracking History Slide View with VANTAGE Integration Software . . . . . . . . . . . . . . 121

Thumbnail Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

Dock or Undock the Thumbnail Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124

Thumbnail Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

Image Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

Stain Set-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

Accept or Reject a Slide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Create a Field of View or Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134

Specimen List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Release a Specimen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Upload a Gross Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Upload a Radiology Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

Upload Miscellaneous Case Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

5: Virtuoso Software for Pathologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147

Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148

Find Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

Filter Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

Rearrange Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

Rearrange Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

Slide Pending Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154

View Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157

Thumbnail Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Dock or Undock the Thumbnail Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166

Thumbnail Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

Image Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

Stain Set-Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

Create a Field of View or Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

Perform an FOV Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177

Accept or Reject an FOV for an Aggregate Score . . . . . . . . . . . . . . . . . . . . . . . . . . . 180

Mark an FOV for a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181

Export an Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

Manual Override of Aggregated Slide Score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184

Draw an Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185

Add Comments for a Slide and FOVs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

Viewing and Synchronizing Multiple Slides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

Specimen List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195

Reject a Slide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195

Reassign a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197

Share a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199

Cancel a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200

Display Case Revisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201

Upload a Gross Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203

Upload a Radiology Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204

Upload Miscellaneous Case Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206

Report and Sign-Out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209

Sign-Out a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209

Generate a Case Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

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Generate a Specimen Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214

Post Sign-Out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

Reopen a Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

Make a Case Addendum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218

Make a Case Amendment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220

Make a Case Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222

6: Virtuoso Software for Coordinators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225

Topics Covered in this Chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226

All Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226

Find Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227

Filter Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228

Rearrange Case List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229

Reassign Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230

A: Virtuoso Software Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233

Virtuoso Open Source and Commercial Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233

Open Source Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233

Licensing Information for Open Source Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234

Commercial Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

Licensing Information for Commercial Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

B: Virtuoso Server and Client Workstation Requirements . . . . . . . . . . . . . . . . . . . . . . . . . 265

Server Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265

Client Workstation Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

Part No.: PL-000092-UK Rev. K 1

About the Virtuoso Software

Welcome to the VENTANA Virtuoso software, a comprehensive web-based pathology solution for viewing, managing, and

sharing digitized glass slides.

Topics Covered in this Chapter

• Who Should Read this Guide (page 1)

• Intended Use (page 1)

• Related Software (page 1)

• Technical Support (page 2)

• Connection Requirements (page 2)

• User Roles (page 2)

• Terminology (page 3)

• Cyber Security (page 5)

Who Should Read this Guide

Histotechnicians, Pathologists, Coordinators, and Administrators should read this reference guide and use it for reference while

using the Virtuoso software.

Intended Use for Virtuoso Software

The Virtuoso software is a web based pathology solution for viewing, managing and sharing digital glass slides. Virtuoso software

is an accessory to iScan systems and allows interfacing with stain scoring and interpretation software algorithms.

NOTE: Images in the Virtuoso Reference Guide are illustrative only and are shown for general training purposes. Please

see the individual User Guides for performance characteristics for staining systems that are available for clinical

use.

Related Software

When operating the Virtuoso software without an interface to a laboratory information system, there is an optional module to

manage cases, patients, clients, physicians, and users that appear and are used within the Virtuoso software. This module is the

Virtuoso Simple Laboratory Information System, or SLIS. If using the Virtuoso SLIS module, see “1: SLIS Software Basic

Procedures” on page 7 for more information.

Virtuoso Software with VANTAGE Integration Software

The VENTANA VANTAGE software and Digital Pathology Integration provides a set of functionality within VANTAGE and

Virtuoso software. Event information about a slide, specimen, or case generated from the Virtuoso software is captured, tracked,

and consolidated with the rest of the information generated by the VANTAGE software and the other VENTANA stainers and

instruments. Whenever a user needs this information, the Virtuoso software can request this information from the VANTAGE

software and display this data directly in the Virtuoso software. Another user can also request and view the same set of data from

within the VANTAGE software. This level of interoperability gives labs consistent information across these two platforms.

If VANTAGE Integration software is installed with the Virtuoso software, the following features are implemented:

• View the current status of a pending slide: In the Virtuoso software, check the status of a case or slide order to view where it is in

the histology or scanning process.

2 Ventana Medical Systems, Inc.

About the Virtuoso Software Virtuoso Reference Guide

• Tracking history in the Virtuoso software: View a comprehensive history of cases and slides in the Virtuoso software – includes

all histology and DP events, from microtomy to slide scanning to case signout.

• Quality analysis with DP events: When slide images are rejected in the Virtuoso software, the image quality issue and

subsequent action taken to resolve the issue are reported to the VANTAGE software, allowing the VANTAGE software to

include DP when reporting quality issues encountered in the lab.

For additional information on the VANTAGE product, see the VENTANA VANTAGE User Guide 2.0 or later.

Technical Support

For Virtuoso Technical Support, contact Ventana Medical Systems, Inc.

Connection Requirements

In order to connect to the Virtuoso software, your web browser and workstation must meet the minimum requirements listed in the

following table:

Refer to “B: Virtuoso Server and Client Workstation Requirements” on page 265 for additional requirement information.

User Roles

The Virtuoso software is a role-based system that mirrors the typical anatomical pathology workflow with roles for pathologists,

histotechnicians, coordinators, and lab administrators. A user can be assigned a single role or multiple roles depending on the needs

of the lab. For convenience, tasks in this reference guide are documented by role. As some tasks are applicable to multiple roles,

those common instructions are repeated.

Administrator

Administrators in the Virtuoso software can set reference ranges, input and output parameters, and general configuration.

Administrators manage user roles and configure case and specimen reports. Administrators also configure audit reports to track

usage. Refer to “3: Virtuoso Software for Administrators” on page 69 for more information. To create and manage users within the

Virtuoso software, Administrators can use the Virtuoso Simple Laboratory Information System. See “1: SLIS Software Basic

Procedures” on page 7 for additional information.

Histotechnician

Histotechnicians in the Virtuoso software can examine slides, annotate images, evaluate the quality of images (QC), accept or

reject slides, release cases, and many other tasks that support the pathology workflow. Refer to “4: Virtuoso Software for

Histotechnicians” on page 103 for more information. To input and manage cases, patients, clients, and physicians that appear and

are used within the Virtuoso software, Histotechnicians can use the Virtuoso Simple Laboratory Information System when an

Ventana Medical Systems, Inc.

1910 E. Innovation Park Drive

Tucson, AZ 85755

USA

Tel (USA): +1 800 227 2155; for Technical Support, press 1

Tel: +1 520 887 2155; for Technical Support, press 1

Recommended Minimum

Operating System Windows 7 Professional Windows 7 Enterprise

Supported Browsers

Mozilla Firefox 24 ESR, 17 ESR, and

Internet Explorer 9.0

Internet Explorer 8.0

Workstation RAM 4 GB 4 GB

Network Connectivity 1 Gbps Ethernet Network Card 10/100 Mbps Ethernet Network Card

PDF Reader (for generating reports) Adobe Acrobat Reader 11.0.06

Virtuoso Reference Guide About the Virtuoso Software

Part No.: PL-000092-UK Rev. K 3

interface to an independent laboratory information system is not available. See “1: SLIS Software Basic Procedures” on page 7 for

additional information.

Pathologist

Pathologists in the Virtuoso software can manage case lists, view slides, annotate and analyze images, reassign cases from the

specimen view or case list, generate specimen reports, sign-out cases, make an addendum and amendment on a case, and many

other tasks. Refer to “5: Virtuoso Software for Pathologists” on page 145 for more information.

Coordinator

VENTANA Virtuoso software enables a Coordinator to reassign a specimen from one pathologist to another pathologist.

Reassignment is sometimes necessary when a pathologist is unavailable to work on a specimen. Refer to “6: Virtuoso Software for

Coordinators” on page 225 for more information.

Terminology

Term Definition

Admin View The Administrator Home page.

Analysis View Whole slide image view of a slide for analysis.

AOI Area of Interest.

Biopsy History History of tissue samples that have been taken from the patient.

Case Folder in which a group of slides scanned by the iScan Coreo and VENTANA

iScan HT scanners is located.

Case List The list of cases appearing within the Virtuoso software that includes the

current case status.

Case Status

One of six status types that describe the current status of the case:

Pending - A case has been created but some case information is still

pending upload into the Virtuoso software.

Unreleased - All case information has been uploaded to the Virtuoso

software but is pending a quality review by the histotechnician.

Released - The histotechnician has performed a quality review of the case

information and has released the case to the assigned pathologist for

review.

In Progress - The case is under review by the pathologist.

Signed-Out - The pathologist has completed their review of the case.

Cancelled - The case has been cancelled by the histotechnician or the

pathologist.

Case View Thumbnail view of each slide in a case.

Clinical Indication Something that points to or suggests the proper treatment of a disease, as that

demanded by its cause or symptoms.

Control Slide Contains known control tissue that is run with a patient slide to compare results.

Coordinator View Coordinator Home Page, Case List View, Search Case, Reassign Cases.

4 Ventana Medical Systems, Inc.

About the Virtuoso Software Virtuoso Reference Guide

DNA Deoxyribonucleic Acid.

FOV Field of view.

Gross Description Macroscopic description of tissue samples.

Histotech View Histotechnician Home page, Case List View, Case View, Analysis View.

Home Page Web site or page personalized for a user.

Image Server Web server that delivers images; dynamically adjusts size of images according

to user browser settings; allows users to share large number of high-resolution

images directly from their own computers.

LIS Laboratory Information System.

Pathologist View Pathologist Home page, Case List View, Specimen View, Analysis View,

Collaboration (Collab) View.

Patient History Collection of vital patient data including gender, age, biopsy history, etc.

Procedure Code

One of four workflow procedure types indicated for slide preparation and

diagnosis:

Integrated View (Treating MD) - Indicates that the lab performs both slide

preparation and diagnosis of the specimen submitted by the treating

physician.

Integrated View (Client) - Indicates that the lab performs both slide

preparation and diagnosis of the specimen submitted by the pathologist

from an external lab.

TechView361 - Indicates that the lab performs the slide preparation only of

the specimen submitted by a pathologist from an external lab. The

pathologist performs the diagnosis with the aid of computer-assisted

quantitative image analysis.

TechView342 - Indicates that the lab performs the slide preparation only of

the specimen submitted by a pathologist from an external lab. The

pathologist performs the diagnosis and gives a manual score of the slide.

Progress Bar A component in a graphical user interface used to convey the progress of a

task.

QC Quality Control.

QC Progress Bar Shows percentage of slides evaluated against set QC (quality control)

threshold. The bar is located in the Case View screen.

QC View Whole slide image view of a slide for evaluation.

Slide Thumbnail Image of entire glass slide, including label.

SLIS Simple Laboratory Information System.

SLIS View SLIS User Home page.

Specimen Tissue sample that has been taken from the patient and then processed and

placed onto slides.

Specimen View Thumbnail view of each slide in a specimen.

Term Definition

Virtuoso Reference Guide About the Virtuoso Software

Part No.: PL-000092-UK Rev. K 5

Cyber Security

Any device that is connected to a network (internally or externally) has the potential to be compromised by unauthorized access or

viruses. As with most devices, the Virtuoso software is designed to run on a computer utilizing Microsoft Windows and virus

protection software which requires the validation and implementation of the appropriate patches.

Some of the potential cyber security hazards are:

• Malicious software that alters the device software (such as viruses)

• Unauthorized access to the system that could compromise data safety

• Security of data transmitted over the Internet

Cyber security involves protecting data by preventing, detecting, and responding to malicious cyber attacks. Cyber attacks could

involve computer viruses which can completely erase data or hackers who alter files or even use the device as a host to attack other

devices. As serious as these hazards are, steps can be taken to maximize cyber security.

User Authorization

All Virtuoso software users must login with a valid username and password. The username and password are securely transmitted

in encrypted form over the Internet or Intranet. Once a user has logged in, the user remains active in the application until the user

explicitly logs out, closes the browser, or because the application closes after a period of inactivity.

Securing Networks and Servers

Network security consists of the provisions made in the computer network infrastructure, policies adopted by the network

administrator to protect the network, and the network resources that prevent unauthorized access.

The following are critical steps for securing a network server:

• Physical security (servers and network infrastructure behind locked doors)

• Use of robust passwords

• System and data backups (at regular intervals)

• Data protection

• Terminating unused services

• Restricting access to used services

The following are critical steps and methodologies used to secure network and servers:

• Data protection

• Data backups (at regular intervals)

• Refusal of automatic updates from off-the-shelf software

• Antivirus software for computers and servers

Time Stamp A sequence of characters denoting the date and/or time at which a certain

event occurred. This data is usually presented in a consistent format, allowing

for easy comparison of two different records and tracking progress over time.

URL Uniform Resource Locator. Protocol for specifying an address (file) on the

Internet. Usually consists of an access protocol (http), a domain name

(www.ventana.com), and the path to a file or resource on the domain (Virtuoso).

Example: http://www.ventana.com/virtuoso.html.

Web Portal Web interface presenting information from diverse sources in a unified way.

Allows Virtuoso software users to view patient and case data, along with

reports.

Term Definition

6 Ventana Medical Systems, Inc.

About the Virtuoso Software Virtuoso Reference Guide

Protecting Data

Establishment of a network firewall and protection of the network against viruses using anti-virus software are effective methods to

protect data. Virus definitions should be kept up to date and regular scans of computers for spyware should be performed using a

legitimate anti-spyware application. If viruses or spyware are found, remove them immediately.

Evaluate Your Software Settings

The default settings of most software enable all available functionality. However, hackers may be able to take advantage of this

functionality to access devices. It is especially important to check the settings for software that connects to the Internet (browsers,

email clients, etc.). Apply the highest level of security available that still provides needed functionality.

Backup and Recovery

In order to develop a successful backup and recovery plan, comprehension of data accessibility needs and the potential impact of

data loss is essential. Automatic backup procedures need to be adopted using a data backup utility.

Part No.: PL-000092-UK Rev. K 7

1: SLIS Software Basic Procedures

The Simple Laboratory Information System, or SLIS, is a functional module to manage cases, patients, clients, physicians, and

users that appear and are used within the VENTANA Virtuoso software. The SLIS software is used to manage the Virtuoso

software when there is no interface with a laboratory information system.

Topics Covered in this Chapter

• Opening the SLIS Software (page 7)

• Logging into the SLIS Software (page 7)

• Home Page Features (page 8)

− Reset Password Button (page 9)

− Logout Button (page 9)

− The About SLIS Button (page 9)

• Manage Cases (page 10)

• Manage Patients (page 23)

• Manage Clients (page 29)

• Manage Physicians (page 34)

• Manage Users (page 40)

• Admin Rules (page 46)

• Virtuoso Software and LIS Integration (page 53)

Opening the SLIS Software

1. Open a supported Internet browser.

2. Type your SLIS URL (uniform resource locator, or web address) in the Address Bar.

For example: https://<host name>/:8080/slis. Where <host name> is the name of the machine on which the SLIS application

server is installed.

3. Press Enter.

The SLIS software is opened in your browser.

Logging into SLIS

4. In the SLIS Login Screen (Figure 1-1): Enter your User ID and Password.

Figure 1-1. The SLIS Login Screen

5. Click the Login button. The SLIS home page is opened (Figure 1-2).

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Home Page Features

The following buttons are available on the SLIS home page

Figure 1-2. The SLIS Home Page

NOTE: By default, the SLIS Home Page opens on the Cases tab.

After logging into the SLIS software, do not use the browser Back button or the

Backspace key to navigate between windows or views.

Reset Password, Logout, Help, and About Buttons

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Part No.: PL-000092-UK Rev. K 9

Reset Password Button

The Reset Password button allows you to change your SLIS password at any time.

1. Click the Reset Password button. The Reset Password window appears (Figure 1-3).

Figure 1-3. Reset Password Window

2. Enter in your old password and new password and then confirm your new password.

3. Select the Save button to activate the new password. You are required to use the new password at your next login.

Logout Button

Select this button to terminate your SLIS session.

Help

Click the Help button to display the on-line help for VENTANA Virtuoso software.

About the SLIS Software

Select this button to view the SLIS version number and legal and copyright notifications

SLIS Software Operating Procedures

The SLIS workflow includes creating, updating, and deleting of these same Virtuoso items and users (Figure 1-4).

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Figure 1-4. The SLIS Workflow

SLIS users are presented with the home page upon login (Figure 1-2). By default, the Cases tab is displayed on the home page.

Manage Cases

Adding new cases, updating case information, and deleting cases from the Virtuoso software are performed using the SLIS Cases

tab.

Figure 1-5. Cases Tab

1. Click the Cases tab (Figure 1-5). The Cases window appears (Figure 1-6).

Virtuoso Reference Guide 1: SLIS Software Basic Procedures

Part No.: PL-000092-UK Rev. K 11

Figure 1-6. Cases Window

SLIS Hot Keys

You can use the following hot key combinations in addition to using other defined procedures while creating or editing a case.

Ctrl-S

Press the Ctrl and S keys at the same time to save the currently opened case.

You can also click on the Save button.

Ctrl-N

Press the Ctrl and N keys at the same time, and a new case is opened.You can

also click on the New button.

Alt-P

Press the Alt and P keys at the same time to add a new specimen. You can

also click on the + tab.

Alt-L

Press the Alt and L keys at the same time to add another slide to the specimen.

You can also click the Add button.

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Adding a New Case

1. From within the Cases window, select the New button from the SLIS tool bar (Figure 1-7). The Case Information pane appears

(Figure 1-8).

NOTE: The following procedure assumes the use of a computer mouse when selecting items on drop-down menus but

the tab button and the up and down arrows on the keyboard can be used to perform the same actions.

Figure 1-7. The SLIS Tool Bar

Figure 1-8. Case Information Pane

Add New Case Button

Virtuoso Reference Guide 1: SLIS Software Basic Procedures

Part No.: PL-000092-UK Rev. K 13

2. Begin by entering the Accession number in the Case Information section (Figure 1-9). Field names ending with a red asterisk

(*) are required fields.

Figure 1-9. Case Information

3. Type information about the patient in the Patient Information section, (Figure 1-11).

IMPORTANT: You can create new patient information by clicking on the Create Patient button.

The Create Client Screen (Figure 1-10) is displayed where you can defined a new

patient for the case. See “Adding a New Patient” on page 24 for information on

how to add a patient.

Figure 1-10. Create Patient Screen

Accession #

Required field. Enter the accession number associated with the case.

Maximum 30 characters.

Lab Site

Required field. Type in the first letter of the lab. Select the lab site from the list

that appears.

Date Specimen

Collected

Enter a date in the MM/DD/YYYY format. For example, April 11, 1952 is

entered as 04/11/1952. Or, click on the Calendar button to the right of the field

to select a date from a calendar. Default is the current date or can be blank.

Time Specimen

Collected

Enter a time in the HH:MM AM/PM format. For example, 11:00 AM. Default is

the current date or can be blank.

Primary Tissue Type Required field. Select the tissue type from the drop-down menu.

Tissue Type

Description

This field becomes active based on the tissue type selected. If active, select a

tissue description from the drop-down menu.

External Case ID A unique case identifier.

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Figure 1-11. Patient Information

4. Enter the workflow for the case on the Workflow section (Figure 1-13). Field names ending with a red asterisk (*) are required

fields.

IMPORTANT: You can create a new client, referring and treating physician, and assigned pathologist by clicking on the

appropriate buttons. See the sections in this chapter referring to adding clients, physician, and users for

additional information.

Figure 1-12. Create buttons

Name

Required field. Type in the patient name. As you type, the system displays a likely

match from the list of existing patients in the system. If the correct patient name is

displayed, select the name from the list with a single mouse click.

To create a new patient, click the Create Patient button and refer to “Adding a New

Patient” on page 24.

Patient ID Enter the Patient ID associated with the patient.

Patient Sex This field will be auto populated from the patient record.

Patient DOB This field will be auto populated from the patient record.

Patient Age This field will be auto populated from the patient record.

Clinical

Indications

Enter the clinical indication(s) for the patient. Maximum 450 characters.

Create New

Patient Button

New

Patient

Button

Create Client

Create Referring Physician,

Physician, and User Buttons

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Roche Virtuoso User manual

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