Diagnosis of major cancer resection specimens with virtual slides: impact of a novel digital pathology workstation

Abstract

Summary:Digital pathology promises a number of benefits in efficiency in surgical pathology, yet the longer time required to review a virtual slide than a glass slide currently represents a significant barrier to the routine use of digital pathology. We aimed to create a novel workstation that enables pathologists to view a case as quickly as on the conventional microscope. The Leeds Virtual Microscope (LVM) was evaluated using a mixed factorial experimental design. Twelve consultant pathologists took part, each viewing one long cancer case (12-25 slides) on the LVM and one on a conventional microscope. Total time taken and diagnostic confidence were similar for the microscope and LVM, as was the mean slide viewing time. On the LVM, participants spent a significantly greater proportion of the total task time viewing slides and revisited slides more often. The unique design of the LVM, enabling real time rendering of virtual slides while providing users with a quick and intuitive way to navigate within and between slides, makes use of digital pathology in routine practice a realistic possibility. With further practice with the system, diagnostic efficiency on the LVM is likely to increase yet more.3

The Empirical Foundations of Telepathology: Evidence of Feasibility and Intermediate Effects

“…From the United Kingdom, a small study (n = 12) evaluated the feasibility of using VSs in the diagnosis of major cancer resection specimen to improve efficiency in surgical pathology. 120 VM was used for real-time rendering of diagnoses. ''Total time taken and diagnostic confidence were similar for the microscope and the virtual microscope, as was the mean slide viewing time.''…”

Validation of Whole-Slide Imaging for Histolopathogical Diagnosis: Current State

“…Indeed, most pathologists feel that more time is required to make a diagnosis with WSI. However, some studies have shown that although diagnosis with WSI is initially more time-consuming, this time quickly decreases as pathologists become familiar with the use of the WSI viewer [30,31,32,33,34,35]. Thus, there is a learning curve in the use of WSI and the time required for making a diagnosis, and a recent study conducted at our institution confirmed that the diagnostic performance improved with practice [36].…”

Digital pathology in clinical use: where are we now and what is holding us back?

“…It was concluded that most of the observed inefficiency was due to a combination of several factors, including: (i) the smaller field of view afforded by the digital slide system, (ii) issues with the design of the software used for viewing the slides and (iii) a lack of experience and training using digital slides with the participants. The first two of these issues were addressed in our subsequent work, which found that using higher‐resolution displays and moving the image pixels more quickly could improve pathologist efficiency with digital slides to the point that time to diagnosis could be equivalent with the appropriate systems . Subsequent commercial digital pathology systems have placed greater emphasis on performance and usability.…”