Assessment of diagnostic accuracy and feasibility of dynamic telepathology in China

Li, Xinxia; Gong, Encong; McNutt, Michael A.; Liu, Jianying; Li, Feng; Li, Ting; Anderson, Virginia; Gu, Jiang

doi:10.1016/j.humpath.2007.06.008

Cited by 28 publications

(28 citation statements)

References 15 publications

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“…[14] A small study involving 40 pulmonary specimens found three significant intraobserver discrepancies (92.5% agreement) using the Nikon system. [7] Other studies report intraobserver agreement approaching 100% for surgical pathology cases with multiple slides using the Apollo,[23] Trestle,[6] and Motic[24] systems. Overall, it seems that the iScan Coreo Au RT module performs at approximately the same level of effectiveness as previous RT-specific modalities tested by intraobserver agreement, while also having the capacity to perform WSI.…”

Section: Discussionmentioning

confidence: 99%

Validation of a novel robotic telepathology platform for neuropathology intraoperative touch preparations

Thrall

Rivera

Takei

et al. 2014

Journal of Pathology Informatics

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Background:Robotic telepathology (RT) allows a remote pathologist to control and view a glass slide over the internet. This technology has been demonstrated to be effective on several platforms, but we present the first report on the validation of RT using the iScan Coreo Au whole slide imaging scanner.Methods:One intraoperative touch preparation slide from each of 100 cases were examined twice (200 total cases) using glass slides and RT, with a 3 week washout period between viewings, on two different scanners at two remote sites. This included 75 consecutive neuropathology cases and 25 consecutive general surgical pathology cases. Interpretations were compared using intraobserver variability.Results:Of the 200 total cases, one failed on RT. There were 47 total interpretive variances. Most of these were the result of less specific interpretations or an inability to identify scant diagnostic material on RT. Nine interpretive variances had potentially significant clinical implications (4.5%). Using the final diagnosis as a basis for comparison to evaluate these nine cases, three RT interpretations and three glass slide interpretations were considered to be discrepant. In the other three cases, both modalities were discrepant. This distribution of discrepancies indicates that underlying case difficulty, not the RT technology, probably accounts for these major variances. For the subset of 68 neoplastic neuropathology cases, the unweighted kappa of agreement between glass slides and RT was 0.68 (good agreement). RT took 225 s on average versus only 71 s per glass slide.Conclusions:This validation demonstrates that RT using the iScan Coreo Au system is a reasonable method for supplying remote neuropathology expertise for the intraoperative interpretation of touch preparations, but is limited by the slowness of the robotics, crude focusing, and the challenge of determining where to examine the slide using small thumbnail images.

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Section: Discussionmentioning

confidence: 99%

Validation of a novel robotic telepathology platform for neuropathology intraoperative touch preparations

Thrall

Rivera

Takei

et al. 2014

Journal of Pathology Informatics

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“…Static image telepathology is an accessible technique that can also be used in developing countries. Newer and more time-consuming techniques like WSI and virtual microscopy are superior to static image pathology with a diagnostic accuracy between 91-100% compared to conventional light microscopy [Szymas et al, 2001;Kaplan et al, 2002;Leong et al, 2002;Li et al, 2008;Evans et al, 2009b;Pantanowitz et al, 2012;Campbell et al, 2014;Shah et al, 2016]. Diagnostic accuracy can be improved by experience in a subspecialty and electronic consultation [Williams et al, 2001].…”

Section: Low Accuracy Of Diagnosis In Telepathologymentioning

confidence: 99%

Histological Assessment of Gonads in DSD: Relevance for Clinical Management

Spoor

Oosterhuis²,

Hersmus³

et al. 2017

Sex Dev

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Malignant gonadal germ cell tumors, referred to as germ cell cancers (GCC), occur with increased frequency in individuals who have specific types of differences (disorders) of sex development (DSD). Recent population-based studies have identified new environmental and genetic risk factors that have led to a ‘genvironment' hypothesis, which may potentially be helpful in risk assessment in DSD-related GCC. In DSD, the malignancy risk is highly heterogeneous, but recent studies allow now to discriminate between high- and low-risk conditions. Gonadal biopsy is in some cases the best procedure of choice to assess the risk, and with the availability of immunohistochemical biomarkers [OCT3/4 (POU5F1), TSPY, SOX9, FOXL2 and KITLG (SCF)], a reliable classification of GCC and its precursors can be made. The opportunities in the field of virtual diagnostic pathology will be presented, having possibilities for rare diseases in general and DSD specifically. It is expected that the International DSD Registry will stimulate international collaborations, facilitating better diagnostic procedures as well as research.

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“…In one particular study in which digital and glass slides from 600 cases were compared, the results showed a diagnostic accuracy of 94% with WSI versus 99% with light microscopy. 10 Several studies in recent years have demonstrated that primary histopathologic diagnoses can be rendered digitally using WSI. [11][12][13][14][15][16][17][18] Discrepancies in diagnoses between digital and glass slides in publications were attributed to image quality, rarely missed tissue on the digital image, inadequate clinical metadata, and pathologists' lack of experience using the WSI system.…”

mentioning

confidence: 99%

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Pantanowitz

Sinard

Henricks

et al. 2013

Archives of Pathology & Laboratory Medicine

503

495

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Context.-There is increasing interest in using whole slide imaging (WSI) for diagnostic purposes (primary and/ or consultation). An important consideration is whether WSI can safely replace conventional light microscopy as the method by which pathologists review histologic sections, cytology slides, and/or hematology slides to render diagnoses. Validation of WSI is crucial to ensure that diagnostic performance based on digitized slides is at least equivalent to that of glass slides and light microscopy. Currently, there are no standard guidelines regarding validation of WSI for diagnostic use.Objective.-To recommend validation requirements for WSI systems to be used for diagnostic purposes.Design.-The College of American Pathologists Pathology and Laboratory Quality Center convened a nonvendor panel from North America with expertise in digital pathology to develop these validation recommendations. A literature review was performed in which 767 international publications that met search term requirements were identified. Studies outside the scope of this effort and those related solely to technical elements, education, and image analysis were excluded. A total of 27 publications were graded and underwent data extraction for evidence evaluation. Recommendations were derived from the strength of evidence determined from 23 of these published studies, open comment feedback, and expert panel consensus.Results.-Twelve guideline statements were established to help pathology laboratories validate their own WSI systems intended for clinical use. Validation of the entire WSI system, involving pathologists trained to use the system, should be performed in a manner that emulates the laboratory's actual clinical environment. It is recommended that such a validation study include at least 60 routine cases per application, comparing intraobserver diagnostic concordance between digitized and glass slides viewed at least 2 weeks apart. It is important that the validation process confirm that all material present on a glass slide to be scanned is included in the digital image.Conclusions.-Validation should demonstrate that the WSI system under review produces acceptable digital slides for diagnostic interpretation. The intention of validating WSI systems is to permit the clinical use of this technology in a manner that does not compromise patient care.

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Assessment of diagnostic accuracy and feasibility of dynamic telepathology in China

Cited by 28 publications

References 15 publications

Validation of a novel robotic telepathology platform for neuropathology intraoperative touch preparations

Validation of a novel robotic telepathology platform for neuropathology intraoperative touch preparations

Histological Assessment of Gonads in DSD: Relevance for Clinical Management

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

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