Leica Aperio ImageScope DX User manual

Aperio ImageScope DX
User’s Guide
MAN-0352, Revision A | 20 May 2019

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 20192
Aperio ImageScope DX User’s Guide
Copyright Notice
ÌÌCopyright © 2019 Leica Biosystems Imaging, Inc. All Rights Reserved. LEICA and the Leica logo are registered trademarks of Leica Microsystems
IR GmbH. Aperio is a trademark of the Leica Biosystems group of companies in the USA and optionally in other countries. Other logos, product
and/or company names might be trademarks of their respective owners.
ÌÌThis product is protected by registered patents. For a list of patents, contact Leica Biosystems.
Customer Resources
ÌÌFor the latest information on Leica Biosystems Aperio ePathology products and services, please visit www.LeicaBiosystems.com/Aperio.
Disclaimers
ÌÌUse normal care in maintaining and using your MDDS. Interrupting network connections or turning off the MDDS while it is processing data (such
as when it is analyzing eSlides or generating an audit report) can result in data loss.
ÌÌCaution: Federal (U.S.) law restricts this device to sale by or on the order of an appropriately licensed healthcare practitioner.
ÌÌThis manual is not a substitute for the detailed operator training provided by Leica Biosystems Imaging or for other advanced instruction. Leica
Biosystems Imaging Field Representatives should be contacted immediately for assistance in the event of any instrument malfunction. Installation
of hardware should only be performed by a certified Leica Biosystems Imaging Service Engineer.
Optional Components
ÌÌ3D input device development tools and related technology are provided under license from 3Dconnexion. © 3Dconnexion 1992 - 2013. All rights
reserved.
Contact Information – Leica Biosystems Imaging, Inc.
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Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 2019 3
Customer Service Contacts
Please contact the office for your country for technical assistance.
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Tokyo 169-0075
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Email: [email protected]

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 20194
New Zealand:
96 Ricketts Road
Mount Waverly, VIC 3149
AUSTRALIA
Tel: [phone] (toll free)
Between 8:30 AM-5 PM, Monday-Friday, AEST
Email: [email protected]
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Direct International Tel: [phone]
Email: T[email protected]

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 2019 5
1 Introduction ...................................................................................................................... 7
Intended Use...................................................................................................................................7
Image Viewing Restrictions for Primary Diagnosis....................................................................................7
Supported Image Types......................................................................................................................7
Aperio AT2 DX Viewing Stations and Monitors........................................................................................8
Aperio AT2 DX System Information.......................................................................................................8
2 Aperio ImageScope DX Overview and Quick Reference.............................................. 9
Open a Case in Aperio ImageScope DX..................................................................................................9
Aperio ImageScope DX Window Overview .............................................................................................9
Aperio ImageScope DX Quick Reference..............................................................................................10
The Slide Tray................................................................................................................................13
Work with eSlides in the Slide Tray.................................................................................................13
View Different Areas of the eSlide .....................................................................................................15
Change the Viewing Zoom Level ........................................................................................................16
View Detailed Data for an eSlide .......................................................................................................16
Image Rendering............................................................................................................................16
Keyboard Shortcuts.........................................................................................................................17
Close Aperio ImageScope DX............................................................................................................18
3 Basic eSlide Viewing ..................................................................................................... 19
Before You Begin............................................................................................................................19
Open Case eSlides in Aperio ImageScope DX........................................................................................19
Close a Case in Aperio ImageScope DX ...............................................................................................20
eSlide Quality Control......................................................................................................................20
Basic eSlide Viewing.......................................................................................................................20
View an eSlide...........................................................................................................................21
4 View and Annotate eSlides............................................................................................ 23
Annotate eSlides............................................................................................................................23
Draw Annotations.......................................................................................................................23
Delete an Annotation...................................................................................................................25
View eSlides With Annotations ..................................................................................................25
Contents

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 20196
Contents
Change the Color of Annotations ....................................................................................................25
Copy and Paste Annotations..........................................................................................................25
Move From One Annotation to the Next ...........................................................................................26
Draw Annotations With a Fixed Size or Fixed Aspect Ratio ................................................................... 26
Draw an Annotation with a Fixed-Size.......................................................................................... 26
Draw an Annotation with a Fixed Aspect Ratio............................................................................... 26
Edit Free-Form Annotations Drawn with the Pen Tool ..........................................................................26
Complete or Edit a Free-Form Annotation......................................................................................26
Change eSlide Views ......................................................................................................................27
Rotate the eSlide........................................................................................................................27
Annotate a Rotated eSlide ........................................................................................................28
Rotate the eSlide Label ................................................................................................................28
Save a Snapshot of the eSlide...........................................................................................................29
Track Pan and Zoom Navigation With the Track Map...............................................................................29
Clear the Track Map ....................................................................................................................29
Open Multiple eSlides.....................................................................................................................30
Synchronize Navigation of Multiple eSlides..........................................................................................31
Viewing a Z-Stack eSlide .................................................................................................................31
Viewing and Navigating a Z-Stack Image .........................................................................................31
Viewing Different Z-Stack Layers ................................................................................................32
Drawing and Viewing Annotations on a Z-Stack eSlide........................................................................33
Viewing Annotations On Different Z-Stack Layers ...........................................................................34
5 Aperio ImageScope DX Options................................................................................... 35
View the Aperio ImageScope DX Options.............................................................................................35
Navigation Options .....................................................................................................................36
Annotation Options .....................................................................................................................36
Viewer Options ..........................................................................................................................36
Tracking Options.........................................................................................................................37
Monitor Quality Check .................................................................................................................37
A Perform a Monitor Quality Check ................................................................................. 38
B 3-D Mouse Quick Reference.......................................................................................... 41
Set Up the SpaceMouse Pro .............................................................................................................42
Rotate the eSlide with the SpaceMouse Pro Device ...............................................................................43
Navigate a Z-Stack Image with the SpaceMouse Pro Device ....................................................................43
Index ..................................................................................................................................... 44
Symbols................................................................................................................................ 49

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 2019 7
1 Introduction
This guide contains information on the Aperio ImageScope DX viewing software, which is part of the Aperio
AT2 DX System. Aperio ImageScope DX enables you to view eSlides created by the Aperio AT2 DX scanner
for the purpose of performing a primary diagnosis.
Your Aperio AT2 DX Viewing Stations come with Aperio ImageScope DX installed.
Intended Use
The Aperio AT2 DX System is an automated digital slide creation and viewing system. The Aperio AT2 DX System is
intended for in vitro diagnostic use as an aid to the pathologist to review and interpret digital images of surgical pathology
slides prepared from formalin-fixed paraffin embedded (FFPE) tissue. The Aperio AT2 DX System is not intended for use with
frozen section, cytology, or non-FFPE hematopathology specimens.
The Aperio AT2 DX System is composed of the Aperio AT2 DX scanner, the Aperio ImageScope DX review application
and display. The Aperio AT2 DX System is for creation and viewing of digital images of scanned glass slides that would
otherwise be appropriate for manual visualization by conventional light microscopy. It is the responsibility of a qualified
pathologist to employ appropriate procedures and safeguards to assure the validity of the interpretation of images obtained
using the Aperio AT2 DX System.
Image Viewing Restrictions for Primary Diagnosis
The images produced by the Aperio AT2 DX are for diagnostic use within the Aperio AT2 DX System only. Images opened
outside the system with non-cleared Aperio viewers will display an error alerting the user that these images cannot be used
for primary diagnosis.
Non-cleared Aperio viewers include:
Ì`Aperio ImageScope (all non-DX versions)
Ì`Aperio WebViewer
Ì`Aperio WebScope
Ì`Aperio ePathViewer
Supported Image Types
For primary diagnosis procedures, Aperio ImageScope DX supports only SVS files created by the Aperio AT2 DX scanner.
Aperio ImageScope DX enables you to open TIFF files for non-diagnostic purposes only. The pan and zoom features are not
available when viewing a TIFF file.

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 20198
Chapter 1: Introduction
Aperio AT2 DX Viewing Stations and Monitors
Your Aperio AT2 DX System comes with a local Aperio AT2 DX Viewing Station that is connected to the Aperio AT2 DX
scanner, and one or more Aperio AT2 DX Viewing Stations used to read eSlides created by the Aperio AT2 DX. Only the
Aperio ImageScope DX viewing software and the Aperio AT2 DX Viewing Stations and medical-grade, calibrated monitors
that you receive as part of the Aperio AT2 DX System are supported for primary diagnosis.
As part of monthly maintenance, we recommend that you do a visual quality check of your monitors once a month. See
“Appendix A: Perform a Monitor Quality Check” on page 38 for complete instructions.
Aperio AT2 DX System Information
This Aperio ImageScope DX User’s Guide contains details on viewing Slides created by the Aperio AT2 DX using the Aperio
ImageScope DX viewing software. For further information, see:
Ì`Aperio AT2 DX System Overview for information on the entire Aperio AT2 DX System.
Ì`Aperio AT2 DX User’s Guide for information on using the Aperio AT2 DX scanner.

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 2019 9
2
Aperio ImageScope DX
Overview and Quick
Reference
This chapter includes an overview of the interface, along with quick reference information for the
navigation and annotation tools.
For instructions on how to view and annotate eSlides, see "Chapter 3: Basic eSlide Viewing" on page 19 and "Chapter
4: View and Annotate eSlides" on page 23.
Open a Case in Aperio ImageScope DX
You open a case in Aperio ImageScope DX from your organization’s medical device data system (MDDS). For information and
instructions on using your MDDS, contact your site administrator.
Aperio ImageScope DX Window Overview
This example shows the Aperio ImageScope DX window with the main tools identified.
12
13
15
9
8
3
5
10 11
14
4
16
7
21
61Slide Tray
2Viewer window
3Menu
4Active eSlide
5Image toolbar
6Annotation toolbar
7View toolbar
8Thumbnail
9Thumbnail
Navigation box
10 Zoom slider
11 eSlide Label
12 Status Bar
13 Aperio ImageScope
DX indicator
14 Rotation Dial
15 Scale Bar
16 Monitor Calibration
status

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Aperio ImageScope DX Quick Reference
This section provides a description of the areas and tools shown in the example on the previous page. The numbers in the
left column below correspond to the numbers in the example on page 9.
Feature Description
1Slide Tray The Slide Tray contains all of the scanned eSlides associated with the case. You use the Slide Tray
to open eSlides in the Viewer window. See "The Slide Tray" on page 13.
2Viewer window The Viewer window displays the open eSlides. You view, navigate, and annotate eSlides in the
Viewer window.
3Menu The menu provides access to commands, tool visibility, and options.
4Active eSlide The active eSlide is the eSlide open in the Viewer window. If multiple eSlides are open in the
Viewer window, the active eSlide is the one that is currently selected.
5Image toolbar The Image toolbar contains tools for viewing eSlide information, taking a snapshot, and
synchronizing the navigation when viewing multiple eSlides. To show the Image toolbar, go to the
View menu, select Toolbars, and select Image.
The following tools are available:
Information Displays detailed data about the scanned eSlide image. See "View
Detailed Data for an eSlide" on page 16.
Snapshot Takes a screen shot of the current view, and allows you to save it as a
TIFF file. See "Save a Snapshot of the eSlide" on page 29.
Synchronize Synchronize navigation of all open eSlides. See "Synchronize
Navigation of Multiple eSlides" on page 31.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Feature Description
6Annotation
toolbar
The Annotation toolbar contains tools you use to pan, zoom, and annotate the eSlide. To show the
Annotation toolbar, go to the View menu, select Toolbars, and select Annotation. The following
tools are available:
Pan and Zoom Pan through the eSlide or double-click to zoom in and out.
Pen Draw a freehand annotation.
Ruler
Measurement Create a measurement annotation of an area of interest.
Rectangle Draw a rectangle or hold down the Shift key to draw a square.
Ellipse Draw an oval or hold down the Shift key to draw a circle.
Counter Mark the eSlide with numeric counters.
Observation Pin Mark areas of interest on the eSlide.
Annotation
Color Picker Change the color of annotations.
Copy annotation Copy the selected annotation.
Paste
annotation Paste the copied annotation into the eSlide.
Previous
annotation Go to the previous annotation.
Next annotation Go to the next annotation.
See "Annotate eSlides" on page 23 for more information on using annotations.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Feature Description
7View toolbar The View toolbar is where you can expand the view to full screen and show or hide navigation and
zoom tools. To show the View toolbar, go to the View menu, select Toolbars, and select View.
The following tools are available:
Go to full-screen view.
Click to show or hide the Scalebar, Axes, or Axes and Grid.
Show or hide the Zoom Slider.
Show or hide the eSlide Label Image.
Show or hide the Thumbnail.
Show or hide the Rotation Dial.
8Thumbnail Shows a representative view of the entire eSlide. Use the Thumbnail to navigate around the eSlide.
See"Thumbnail" in the table under"View Different Areas of the eSlide" on page 15.
9Thumbnail
Navigation box
Represents the area currently shown in the Viewer window. Drag the box around the Thumbnail to
view the corresponding area of the eSlide. See "Thumbnail Navigation box" in the table under "View
Different Areas of the eSlide" on page 15.
10 Zoom slider Enables you to select a specific zoom level or manually zoom in and out of the eSlide. See "Change
the Viewing Zoom Level" on page 16.
11 eSlide Label The image of the label on the glass slide. The eSlide Label appears if a photo of the glass slide
label is associated with the eSlide.
12 Status Bar Contains details about the current display.
13 Aperio
ImageScope DX
indicator
This symbol indicates that you are working in the Aperio ImageScope DX viewer.
14 Rotation Dial Rotates the eSlide from 0 to 360°. See "Rotate the eSlide" on page 27.
15 Scale Bar Represents the scale of the eSlide in microns or millimeters, depending on the current zoom level.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Feature Description
16 Monitor status A green check mark means that the monitor connected to your viewing station is the
correct medical-grade calibrated monitor for the Aperio AT2 DX System, and that the
monitor and viewing station are configured correctly.
A red X appears if the color profile settings on your viewing station monitor is incorrect, or
if someone attempts to calibrate the monitor with a third-party software. Your eSlides will
not display unless the monitor and viewing station are configured correctly.
A red X also appears if you attempt to use Aperio ImageScope DX with a monitor other
than the monitor approved for the Aperio AT2 DX System.
The Slide Tray
The Slide Tray contains all of the eSlides associated with the open case.
Work with eSlides in the Slide Tray
The following describes the tasks you can perform in the Slide Tray.
To do this: Follow these steps:
View an eSlide. Click an eSlide to open it in the Viewer window.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
To do this: Follow these steps:
Enlarge the eSlide view. Point to an eSlide in the tray.
If you do not want eSlides to enlarge when you point to them, clear the Display
Hover Popups for Images check box in the Viewer options. See "Viewer
Options" on page 36.
Open multiple eSlides. Click the circle next to the eSlide you want to open. A pushpin in the circle
indicates the eSlide is open and “pinned” in the Viewer window.
To close the pinned eSlide, click the circle again. You can open up to four eSlides
at one time. See "Open Multiple eSlides" on page 30.
Flip an eSlide horizontally to mark it as
read or unread.
By default, eSlides are flipped in the tray after you read them. To manually flip
the eSlide, right-click an eSlide and select Flip Slide.
Flag an eSlide. To flag an eSlide for follow-up, right-click an eSlide and select Flag. A small red
flag appears in the Slide Tray:
To remove the flag, right-click the eSlide in the Slide Tray and select Flag.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
To do this: Follow these steps:
View eSlides that have annotations. In the Slide Tray, look for eSlides with a pencil symbol. The pencil appears on
eSlides that have annotations.
View a different Slide Tray for the
open case.
If there is more than one Slide Tray for the case, click the <<Prev and Next>>
links at the bottom of the Slide Tray.
Hide the Slide Tray to expand the
Viewer window.
Click the Slide Tray arrow in the upper-right of the Slide Tray:
To view the Slide Tray, click the arrow again.
View Different Areas of the eSlide
The following describes different ways to move around the eSlide.
Use the
Thumbnail
The Thumbnail shows the entire eSlide. The small navigation box represents the area that currently
appears in the Viewer window.
To move around the eSlide using the Thumbnail, do one of the following:
Ìy Drag the navigation box around the Thumbnail to view the corresponding areas of the eSlide.
Ìy Click inside the main Thumbnail to move to the corresponding area on the eSlide.
You can also track your navigation in the Thumbnail. See "Track Pan and Zoom Navigation With the
Track Map" on page 29.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Manually pan
around the
eSlide
Click the Pan and Zoom tool , and drag your mouse pointer to move around the eSlide.
You can set an option to reverse the panning direction (pathologist mode). See "Navigation Options"
on page 36.
Scrolling Point to the edge of the Viewer window. When the pointer changes to an arrow , hold the mouse
button to scroll in the direction of the arrow. Release the mouse button to stop scrolling.
Change the Viewing Zoom Level
You can use any of the following methods to change the zoom level of the eSlide.
Use your mouse
to zoom in and
out
Do one of the following:
Ìy Click anywhere on the eSlide, and then rotate the mouse wheel button up to zoom out farther,
and down to zoom in closer.
Ìy Double-click anywhere on the eSlide to go to the maximum zoom level (highest resolution).
Double-click again to return to the previous zoom level.
Use the Zoom
Slider
Click the Zoom buttons (Fit, 4x, 10x, and so on) to select a specific zoom level, or drag
the slider to manually adjust the zoom. Click Fit to display the entire eSlide in the Viewer
window.
The maximum zoom available (20x or 40x) depends on the magnification at which the slide
was scanned. The highest number on the Zoom Slider is the scan magnification. In this
example, the slide was scanned at 20x.
View Detailed Data for an eSlide
Click the Information tool to display detailed data for the active eSlide.
The Information tab contains eSlide metadata. Click the Thumbnail, Label, and Macro tabs for different views of the
eSlide.
Image Rendering
When you pan, rotate, or otherwise change the view of the eSlide, the "Rendering" message may appear. This means
ImageScope DX is still adjusting the eSlide image, and you should wait until the message disappears before reviewing the
eSlide for diagnostic purposes.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Keyboard Shortcuts
This section contains a quick reference list of keyboard shortcuts you can use with ImageScope DX.
Key Sequence Menu Command Tool Action
Arrow keys None None
Nudge image left, right, up, and down.
Note: Pan and Zoom must be active to move the
image with the Arrow keys.
Ctrl + Plus key None None Zoom in.
Ctrl + Minus key None None Zoom out.
Ctrl None None Press while drawing an annotation to draw the annotation
in a predefined size.
Ctrl + C Annotations > Copy None
Ìy Take a screen shot of the current view: Press Ctrl + C,
then paste the image into Paint or another application.
Ìy Copy and paste an annotation into the same eSlide:
Selected an annotation, press Ctrl + C, click inside the
eSlide and press Ctrl + V to paste the annotation.
Ctrl + F4 File > Close Case None Closes the image currently open in ImageScope.
Alt + F4 File > Exit Closes ImageScope DX.
Ctrl + M Image > Manual
Synchronization Activates Manual Synchronization.
Ctrl + P
Tools > Navigation,
Annotations, Viewer,
Tracking, or Monitor
Quality Check
None
Opens the Options window to set navigation, annotation,
viewer, and tracking options. The Monitor Quality Check
option enables you to perform a visual monitor check.
Ctrl + Shift None None Press while using the arrow keys to move the selected
annotation.
Ctrl + T View > Thumbnail None Shows or hides the Thumbnail window.
F1 Help > ImageScope Help None Opens ImageScope DX help.
F2 Annotations > Pen Activates the Pen drawing tool.
F4 Annotations > Ruler
Measurement Activates the Ruler Measurement drawing tool.
F5 Annotations > Rectangle Activates the Rectangle drawing tool.
F6 Annotations > Ellipse Activates the Ellipse drawing tool.
F9 Annotations > Counter
Tool Activates the Counter annotation tool.
F10 Annotations >
Observation Pin Activates the Observation pen annotation tool.
F11 View > Full Screen None Expands ImageScope DX to a full-screen view.

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Chapter 2: Aperio ImageScope DX Overview and Quick Reference
Key Sequence Menu Command Tool Action
Shift None None Press while drawing annotations: ellipse becomes a circle;
rectangle becomes a square.
Shift + Arrow key None None
Moves image left, right, up, and down one screen width at
a time.
Note: Pan and Zoom must be active to move the
image with the Arrow keys.
Shift + Ctrl None None Press while drawing an annotation to create a region of the
same aspect ratio as the predefined fixed annotation size.
Close Aperio ImageScope DX
To close Aperio ImageScope DX, go to the File menu, and select Exit. You can also click in the upper-right corner of
the Aperio ImageScope DX window.

Aperio ImageScope DX User’s Guide, Revision A © Leica Biosystems Imaging, Inc. 2019 19
3 Basic eSlide Viewing
This chapter provides instructions on using Aperio ImageScope DX to read eSlides.
Before You Begin
Before you can review eSlides using Aperio ImageScope DX:
Ì`Use the Aperio AT2 DX scanner to scan the glass slides for the case you want to review. See the Aperio AT2 DX
User’s Guide for instructions.
Ì`Ensure the eSlides scanned on the Aperio AT2 DX are available in your MDDS.
Open Case eSlides in Aperio ImageScope DX
You can open one case at a time in Aperio ImageScope DX. When you open a case from your MDDS, Aperio ImageScope DX
automatically closes any previously opened case before it opens your next case.
It takes less time to open the eSlides for your case if Aperio ImageScope DX is already open. To achieve
optimum image loading performance when opening cases in ImageScope DX, we recommend that you
leave Aperio ImageScope DX open during your viewing session.
To open all of the eSlides associated with a case:
1. Following the instructions for your institution’s MDDS to open the case.
When Aperio ImageScope DX opens, all of the eSlides for the case appear in the Slide Tray. The first eSlide in the
tray opens in the Viewer window.

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Chapter 3: Basic eSlide Viewing
2. With the case opens in Aperio ImageScope DX, you can do the following:
Ì`Perform Quality Control on the eSlides scanned for the case. See”eSlide Quality Control” on page 20 .
Ì`View the eSlide and change the zoom level (pan and zoom). See “Basic eSlide Viewing” on page 20.
Ì`View one or more eSlides using advanced viewing techniques. See “Chapter 4: View and Annotate
eSlides” on page 23.
Ì`Draw annotations on the eSlide to indicate areas of interest. See “Annotate eSlides” on page 23.
Close a Case in Aperio ImageScope DX
To close the eSlides for a case without closing Aperio ImageScope DX, go to the File menu, and select Close Case.
Note that Aperio ImageScope DX closes a previously opened case when you open a new case.
eSlide Quality Control
The scanning technician should perform quality control on the glass slides and eSlides during the scanning process. The
pathologist must also perform quality control on the eSlides.
To assess the quality of the slide preparation, follow the instructions for the specific staining protocol.
To perform quality control on the eSlides, follow these steps:
1. Open the eSlides in Aperio ImageScope DX.
2. Look at the entire image, including the perimeter of the eSlide, to confirm that the entire tissue sample was
scanned.
3. Adjust the magnification using the Zoom tool. Click the thumbnail in the ImageScope window and pan the image.
4. All eSlides should be in focus and free of visible image stripes.
5. Rescan any eSlides that failed to scan or failed the image quality review.
If an eSlide has poor quality in any of the above areas, you may need to request a new slide or a re-scan of the slide.
For more details about preparing glass slides for scanning, see the Aperio AT2 DX User’s Guide.
Basic eSlide Viewing
Use the Aperio ImageScope DX navigation tools to move around the eSlide and to view areas of the eSlide at different zoom
levels. You do not need to focus the eSlide. Optimum focus is determined when the slide is scanned.
The steps below describe one method of reviewing eSlides:
1. Adjust the zoom to 4x and pan through the eSlide to look for areas of interest.
2. When you find an area of interest, adjust the zoom to 20x or 40x to assess the area.
3. Return to a lower zoom level and continue panning through the eSlide to look for more areas of interest.
The next section provides detailed steps for this viewing method.