A feasibility study of multisite networked digital pathology reporting in England

Abstract

Background: The objective of the project was to evaluate the feasibility of introducing a single-networked digital histopathology reporting platform in the Southwest Peninsula region of England by allowing pathologists to experience the technology and recording their perceptions. This information was then used in planning future service development. The project was funded by the National Health Service (NHS) Peninsula Cancer Alliance and took place in 2020 during the COVID-19 pandemic. Materials and Methods: Digital slides of 500 cases from Taunton were reported remotely in Truro, Plymouth, Exeter, Bristol, or Bath by using a single remote reporting platform located on the secure Health and Social Care Network (HSCN) that links NHS sites. These were mainly small gastrointestinal, skin, and gynecological specimens. The digital diagnoses were compared with the diagnoses issued on reporting the glass slides. At the end of the project, the pathologists completed a Google Forms questionnaire of their perceptions of digital pathology. The results were presented at a meeting with the funder and discussed. Results: From the 500 cases there were nine cases of significant diagnostic discrepancy, seven of which involved the misrecognition of Helicobacter pylori in gastric biopsies. The questionnaire at the end of the project showed that there was a general agreement that the platform was easy to use, and the image quality was acceptable. It was agreed that extra work, such as deeper levels, was easy to request on the software platform. Most pathologists did not agree that digital reporting was quicker than glass slide reporting. Some were less confident in their digital diagnoses than glass diagnoses. They agreed that some types of specimens cannot easily be reported digitally. All users indicated that they would like to report at least half of their work digitally in the future if they could, and all strongly agreed that digital pathology would improve access to expert opinions, teaching, and multidisciplinary meetings. It was difficult to find pathologists with time to undertake remote digital reporting, in addition to their existing commitments. Conclusions: Overall, the pathologists developed a positive perception of digital pathology and wished to continue using it.

Use of digital pathology and artificial intelligence for the diagnosis of Helicobacter pylori in gastric biopsies

“…While our study was under review, Mayall et al published their findings on multisite networked digital pathology reporting in England. In this study, seven out of nine significant diagnostic discrepancies concerned misrecognition of HP in gastric biopsies 7 . HP is a gram-negative, spiral-shaped bacterium that infects 50% of the world’s population 8 and is known to be a major cause of chronic gastritis, peptic ulcers, gastric adenocarcinomas and lymphomas 9 .…”

The Nomadic Digital Pathologist. Validation of a simple, dual slide scanner with remote reporting for a regional upper gastrointestinal specialist multidisciplinary meeting

“…1 ), and several of the cancer MDTMs are centralised, necessitating transport of material and reports between different organisations with ring-fenced IT systems, leading to the potential for delays to the diagnosis and management of cancer patients. Although previous studies have examined the use of DP across cancer networks, in tertiary centres, local tumour boards, and for frozen sections, 6 , 13 , 14 , 15 the author is not aware of another publication documenting the use of a small slide scanner to support a remote regional expert histopathologist to continue a lead role in a multisite specialist MDTM. This simple single- and dual slide scanner with remote viewing software was used to validate slides from 44 cases, comprising a tenth of the author’s annual OGSMDT workload.…”

“…Despite being involved in a recent feasibility study of multisite DP reporting in the UK, 6 the author is not aware of any previous publication where DP has been used specifically to facilitate a multiple hospital-site, remote specialist cancer multidisciplinary team (MDT) meeting.…”

Two‐tiered deep‐learning‐based model for histologic diagnosis of Helicobacter gastritis

“…Using 40× or 60× magnification is suggested to avoid misdiagnosis 24 . In the study conducted by Mayall et al ., 9 of 500 cases showed a significant diagnostic discrepancy in 40× magnification WSIs; seven of them involved the misrecognition of HP in gastric biopsies 25 . Besides, if an algorithm is aimed at detecting HP in high‐magnification WSIs, the computational resource needed will be very high.…”