Conventional Microscopical versus Digital Whole-Slide Imaging-Based Diagnosis of Thin-Layer Cervical Specimens: A Validation Study

Bongaerts, Odille; Clevers, Carla; Debets, Marij; Paffen, Daniëlle; Senden, Lisanne; Rijks, Kim; Ruiten, Linda; Sie-Go, Daisy M. D. S.; Diest, Paul J. van; Nap, Marius

doi:10.4103/jpi.jpi_28_18

Cited by 35 publications

(34 citation statements)

References 31 publications

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“…Furthermore, we are currently exploring ways of integrating in‐house‐developed deep‐learning algorithms and Visiopharm image‐processing algorithms for routine diagnostic work in order to determine how effective they would be in practice. Finally, we have started working on the implementation of Z‐scanning for cytology . When Z‐stacks appear to be necessary, this will have consequences for our scanning and storage workflow.…”

Section: Discussionmentioning

confidence: 99%

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Being fully digital: perspective of a Dutch academic pathology laboratory

et al. 2019

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The introduction of fast and robust whole slide scanners has facilitated the implementation of ‘digital pathology’ with various uses, the final challenge being full digital diagnostics. In this article, we describe the implementation process of a fully digital workflow for primary diagnostics in 2015 at the University Medical Centre in Utrecht, The Netherlands, as one of the first laboratories going fully digital with a future‐proof complete digital archive. Furthermore, we evaluated the experience of the first 2 years of working with the system by pathologists and residents. The system was successfully implemented in 6 months, including a European tender procedure. Most pathologists and residents had high confidence in working fully digitally, the expertise areas lagging behind being paediatrics, haematopathology, and neuropathology. Reported limitations concerned recognition of microorganisms and mitoses. Neither the age of respondents nor the number of years of pathology experience was correlated with the confidence level regarding digital diagnostics. The ergonomics of digital diagnostics were better than those of traditional microscopy. In this article, we describe our experiences in implementing our fully digital primary diagnostics workflow, describing in depth the implementation steps undertaken, the interlocking components that are required for a fully functional digital pathology system (laboratory management, hospital information systems, data storage, and whole slide scanners), and the changes required in workflow and slide production.

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Section: Discussionmentioning

confidence: 99%

“…Finally, we have started working on the implementation of Zscanning for cytology. 22,23 When Z-stacks appear to be necessary, this will have consequences for our scanning and storage workflow.…”

Section: Discussionmentioning

confidence: 99%

Being fully digital: perspective of a Dutch academic pathology laboratory

et al. 2019

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“…1) Cytology slides: In most cases with cell smears, liquid-based cytology, or blood smears, the results are similar to those from microscopic diagnoses made using glass slides with appropriate focus stacking (Z-stacking) during scanning and sufficient validation [52]. However, the optimal focus stacking method must be carefully selected for certain sample types (e.g., samples with many 3-dimensional structures, such as thyroid gland fine-needle aspirates [53]), staining conditions, and smear conditions.…”

Section: Scope Of Applicationmentioning

confidence: 80%

Recommendations for pathologic practice using digital pathology: consensus report of the Korean Society of Pathologists

Chong

Kim

Jung

et al. 2020

J Pathol Transl Med

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Digital pathology (DP) using whole slide imaging (WSI) is becoming a fundamental issue in pathology with recent advances and the rapid development of associated technologies. However, the available evidence on its diagnostic uses and practical advice for pathologists on implementing DP remains insufficient, particularly in light of the exponential growth of this industry. To inform DP implementation in Korea, we developed relevant and timely recommendations. We first performed a literature review of DP guidelines, recommendations, and position papers from major countries, as well as a review of relevant studies validating WSI. Based on that information, we prepared a draft. After several revisions, we released this draft to the public and the members of the Korean Society of Pathologists through our homepage and held an open forum for interested parties. Through that process, this final manuscript has been prepared. This recommendation contains an overview describing the background, objectives, scope of application, and basic terminology; guidelines and considerations for the hardware and software used in DP systems and the validation required for DP implementation; conclusions; and references and appendices, including literature on DP from major countries and WSI validation studies.

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“…Indeed, most of the studies dealing with gynaecological cytology highlight these points. 6,17,20,22,36 Moreover, not only WSI but also other digital solutions, such as automated cervical cytology slide readers, are considered of higher risk by European regulations. 37 At the same time, because these barriers reside mainly in the technical features and the lack of training and acceptance of diagnosticians, in the future, WSI will be reasonably adopted for daily diagnostic use in cytology, 38 after validation studies of adequate sample size and with a more refined study design.…”

Section: Area Of Interestmentioning

confidence: 99%

Current state of whole slide imaging use in cytopathology: Pros and pitfalls

Eccher¹,

Girolami²

2020

Cytopathology

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Whole slide imaging (WSI) allows generation of large whole slide images and their navigation with zoom in and out like a true virtual microscope. It has become widely used in surgical pathology for many purposes, such as education and training, research activity, teleconsultation, and primary diagnosis. However, in cytopathology, the use of WSI has been lagging behind histology, mainly due to the cytological specimen's characteristics, as groups of cells of different thickness are distributed throughout the slide. To allow the same focusing capability of light microscope, slides have to be scanned at multiple focal planes, at the cost of longer scan times and larger file size. These are the main technical pitfalls of WSI for cytopathology, partly overcome by solutions like liquid‐based preparations. Validation studies for the use in primary diagnosis are less numerous and more heterogeneous than in surgical pathology. WSI has been proved effective for training students and successfully used in proficiency testing, allowing the creation of digital cytology atlases. Longer scan times are also a barrier for use in rapid on‐site evaluation, but WSI retains its advantages of easy sharing of images for consultation, multiple simultaneous viewing in different locations, the possibility of unlimited annotations and easy integration with medical records. Moreover, digital slides set the laboratory free from reliance on a physical glass slide, with no more concern of fading of stain or slide breakage. Costs are still a problem for small institutions, but WSI can also represent the beginning of a more efficient way of working.

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Conventional Microscopical versus Digital Whole-Slide Imaging-Based Diagnosis of Thin-Layer Cervical Specimens: A Validation Study

Cited by 35 publications

References 31 publications

Being fully digital: perspective of a Dutch academic pathology laboratory

Being fully digital: perspective of a Dutch academic pathology laboratory

Recommendations for pathologic practice using digital pathology: consensus report of the Korean Society of Pathologists

Current state of whole slide imaging use in cytopathology: Pros and pitfalls

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