Context.—

Pathologists may encounter extraneous pieces of tissue (tissue floaters) on glass slides because of specimen cross-contamination. Troubleshooting this problem, including performing molecular tests for tissue identification if available, is time consuming and often does not satisfactorily resolve the problem.

Objective.—

To demonstrate the feasibility of using an image search tool to resolve the tissue floater conundrum.

Design.—

A glass slide was produced containing 2 separate hematoxylin and eosin (H&E)-stained tissue floaters. This fabricated slide was digitized along with the 2 slides containing the original tumors used to create these floaters. These slides were then embedded into a dataset of 2325 whole slide images comprising a wide variety of H&E stained diagnostic entities. Digital slides were broken up into patches and the patch features converted into barcodes for indexing and easy retrieval. A deep learning-based image search tool was employed to extract features from patches via barcodes, hence enabling image matching to each tissue floater.

Results.—

There was a very high likelihood of finding a correct tumor match for the queried tissue floater when searching the digital database. Search results repeatedly yielded a correct match within the top 3 retrieved images. The retrieval accuracy improved when greater proportions of the floater were selected. The time to run a search was completed within several milliseconds.

Conclusions.—

Using an image search tool offers pathologists an additional method to rapidly resolve the tissue floater conundrum, especially for those laboratories that have transitioned to going fully digital for primary diagnosis.

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Author notes

Dr Pantanowitz is on the medical advisory board for Leica, Ibex, and Hologic and consults for Hamamatsu. Dr Tizhoosh is on the advisory board for Huron Digital Pathology. Dr Kalra has an industrial internship at Huron Digital Pathology. The other authors have no relevant financial interest in the products or companies described in this article.