Diagnosing Pathological Prognostic Factors in Retinoblastoma: Correlation between Traditional Microscopy and Digital Slides

Abstract

Objective: It was the aim of this study to determine the diagnostic accuracy of high-risk prognostic factors and morphological characteristics of retinoblastomas using digital whole slide images (WSI) generated by a scanner. Methods: Forty-seven H&E sections of glass slides with high-risk morphological features of retinoblastoma were analyzed. Slides were scanned as WSI and reviewed. The results were compared with those obtained after reviewing the slides using a regular microscope as the gold standard. McNemar's test (MT), the percentage of agreement (POA), and sensitivity (S) and specificity (Sp) were evaluated between WSI and conventional microscopy. Results: There were no differences with respect to multicentricity, growth type, rosette formation, choroidal invasion, anterior chamber invasion, extraocular extension, scleral extension, optic nerve invasion, necrosis, or Azzopardi effect between WSI analysis and light microscopy (MT, p = 1.0; POA = 100%; S = 100%, and Sp = 100%). Discordance was found in 1 case where calcification could not be found using WSI (MT, p = 1.00; POA = 97.9%; S = 100%, and Sp = 97.8%). Conclusion: To the best of our knowledge, this is the first report using digital pathology (WSI) to evaluate prognostic factors in eyes containing retinoblastomas. Using WSI, the pathologist was able to detect highrisk morphological features in retinoblastoma. To date, WSI is an important tool, in particular for ophthalmic pathologists examining enucleation and exenteration specimens.

Clinicopathological Findings of Retinoblastoma: A 10-Year Experience from a Tertiary Hospital in Kampala, Uganda

“…Studies have shown that the degree of differentiation is not associated with the adverse prognostic factors such as stage, optic nerve invasion, massive choroidal invasion, and metastasis. For example, Zoroquiain and associates [28] reported no association between the degree of differentiation and metastasis among the patients and also differentiation did not predict the prognosis of the patients independently. There is no known reason why the degree of differentiation does not correlate with many other prognostic factors.…”

Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions

“…Among the 71 articles, 12 fulfilled the main selection criteria for our study that is reporting at least 2 of the primary outcomes (i.e., DTA indicators, diagnostic concordance, and overdiagnosis). From the 12 studies in our review, 4 did not specify the kind of study 20 , 21 , 22 , 23 ; 3 were retrospective studies, 24 , 25 , 26 2 comparative studies, 27 , 28 and the remaining 3 randomized, 29 evaluation, 30 and validation study, 31 respectively. The characteristics of the studies are presented in the Supplementary Tables 1 and 2.…”

“… 21 The most used WSI scanner as reported in 4 studies, was Aperio ScanScope XT (Aperio Technologies, Vista, Calif., USA), 22 , 24 , 26 , 28 followed by iScan Coreo (Ventana, Tucson, Ariz., USA) used in 3 studies. 20 , 23 , 29 In the remaining studies, there were diverse scanners used such as Mirax scanner (Carl Zeiss MicroImaging, Jena, Germany), 25 , 30 NanoZoomer S260 (Hamamatsu photonics, Japan), 27 Navigo (Visia Imaging, Arezzo, Italy), 31 and digital camera with NetCam software (Olympus America, Center Valley, PA). 21 …”

Histopathological analysis of residual lens cells in capsular opacities after cataract surgery using objective software

“…The Positive Pixel Count algorithm can be a useful and quick tool to quantify the immunohistochemical expression in small tissue samples like the CB in both research and clinical settings. Pathology sectors have increasingly been using digital pathology tools for both patient diagnosis[ 17 18 ] and research purposes in all research fields. [ 19 20 21 ] Benefits of digital pathology scanned slides include but are not limited to higher picture quality, ability to view entire tissue sections at different magnifications, and facility to share images with users at another location through a web-based platform.…”

“…[ 19 20 21 ] Benefits of digital pathology scanned slides include but are not limited to higher picture quality, ability to view entire tissue sections at different magnifications, and facility to share images with users at another location through a web-based platform. [ 17 ]…”