Complete Digital Pathology for Routine Histopathology Diagnosis in a Multicenter Hospital Network

Abstract

Context.— Complete digital pathology and whole slide imaging for routine histopathology diagnosis is currently in use in few laboratories worldwide. Granada University Hospitals, Spain, which comprises 4 hospitals, adopted full digital pathology for primary histopathology diagnosis in 2016. Objective.— To describe the methodology adopted and the resulting experience at Granada University Hospitals in transitioning to full digital diagnosis. Design.— All histopathology glass slides generated for routine diagnosis were digitized at ×40 using the Philips IntelliSite Pathology Solution, which includes an ultrafast scanner and an image management system. All hematoxylin-eosin–stained preparations and immunohistochemistry and histochemistry slides were digitized. The existing sample-tracking software and image management system were integrated to allow data interchange through the Health Level 7 protocol. Results.— Circa 160 000 specimens have been signed out using digital pathology for primary diagnosis. This comprises more than 800 000 digitized glass slides. The scanning error rate during the implementation phase was below 1.5%, and subsequent workflow optimization rendered this rate negligible. Since implementation, Granada University Hospitals pathologists have signed out 21% more cases per year on average. Conclusions.— Digital pathology is an adequate medium for primary histopathology diagnosis. Successful digitization relies on existing sample tracking and integration of the information technology infrastructure. Rapid and reliable scanning at ×40 equivalent was key to the transition to a fully digital workflow. Digital pathology resulted in efficiency gains in the preanalytical and analytical phases, and created the basis for computational pathology: the use of computer-assisted tools to aid diagnosis.

Digital pathology and computational image analysis in nephropathology

“…Processes might indeed be slower when digital pathology workflows are first adopted; however, following an initial training and acclimatization period, overall pathologist performance greatly increases for measurements of both speed and accuracy. As a result, perceptions are changing, with digital pathology becoming increasingly accepted, helping the pathology specialty move towards fully digital workflows and associated platforms for clinical operations 26 – 29 .…”

Immune contexture analysis in immuno‐oncology: applications and challenges of multiplex fluorescent immunohistochemistry

“…While some clinical centres utilise slide scanning to digitise histopathology samples, 144 there are only a few centres that utilise complete digital pathology for routine histopathology. 145,146 Digital pathology systems that support multiplexing have not yet been adopted in clinical pathology laboratories; however, they are widely used in early discovery and clinical studies. Although the widespread adoption of mfIHC in the clinic may still be futuristic, contract research organisations (CROs) are currently offering highquality image acquisition and analysis based on mfIHC to clinic and research which may be helpful in patient management ( Table 3).…”

Clinically applicable histopathological diagnosis system for gastric cancer detection using deep learning

“…However, there is a critical shortage of anatomical pathologists both nationally and globally, which has created overloaded workforces, thus effecting diagnostic accuracy 4 . An increasing number of pathology laboratories have adopted digital slides in standard practice in the form of whole slide images (WSIs) in daily routine diagnostics 5 – 7 . The transformation of practice from microscope to WSI has paved the way for using artificial intelligence (AI) assistance systems in pathology to overcome human limitations and reduce diagnostic errors.…”