Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training

Williams, Bethany; Hanby, Andrew; Millican-Slater, Rebecca; Nijhawan, Anju; Verghese, Eldo T.; Treanor, Darren

doi:10.1111/his.13403

Cited by 63 publications

(52 citation statements)

References 12 publications

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“…Complete clinical concordance was observed in 98.1% of cases, indicating excellent agreement between digital primary diagnosis and glass slide assessment. This statistic is similar to the published validation findings using the same protocol for breast histopathology 12. Our findings suggest that suitably trained and validated pathologists can competently and confidently use digital pathology for standard primary neuropathology reporting practice.…”

Section: Discussionsupporting

confidence: 87%

Clinical digital neuropathology: experience and observations from a departmental digital pathology training programme, validation and deployment

et al. 2020

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AimTo train and individually validate the neuropathologists in digital primary diagnosis and frozen section reporting using a novel protocol endorsed by the Royal College of Pathologists. The protocol allows early exposure to live digital reporting in a risk mitigated environment.MethodsTwo specialist neuropathologists completed training in the use of a digital microscopy system for primary neuropathological diagnosis and frozen section assessment. Participants were exposed to training sets of 20 histology cases and 10 frozen sections designed to help them identify their personal digital diagnostic pitfalls. Following this, the pathologists viewed 340 live, complete neuropathology cases. All primary diagnoses were made on digital slides with immediate glass slide reconciliation before final case sign-out.ResultsThere was 100% clinical concordance between the digital slide and glass slide assessment of frozen section cases for each pathologist, and these assessments corresponded with the ground truth diagnoses obtained from examination of definitive histology. For primary diagnosis, there was complete clinical concordance between digital slide and glass slide diagnosis in 98.1% of cases. The majority of discordances were related to grading differences attributable to mitotic count differences.ConclusionNeuropathologists can develop the ability to make primary digital diagnosis competently and confidently following a course of individual training and validation.

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Section: Discussionsupporting

confidence: 87%

Clinical digital neuropathology: experience and observations from a departmental digital pathology training programme, validation and deployment

et al. 2020

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“…This protocol was devised and originally implemented at Leeds Teaching Hospitals NHS Trust, where it was utilised to validate the performance of a cohort of three consultant breast histopathologists 15 . In this study there was complete clinical concordance between the glass and digital impressions of breast histopathology in 98.8% of cases.…”

Section: Literature Reviewmentioning

confidence: 99%

Digital pathology for primary diagnosis of screen‐detected breast lesions – experimental data, validation and experience from four centres

et al. 2020

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2020) Histopathology 76, 968-975. https://doi.org/10. 1111/his.14079 Digital pathology for primary diagnosis of screen-detected breast lesionsexperimental data, validation and experience from four centres Aim: The rate of deployment of digital pathology (DP) systems for primary diagnosis in the UK is accelerating. The flexibility and resilience of digital versus standard glass slides could be of great benefit in the NHS breast screening programme (NHSBSP). This study aims to document the safety and benefits of DP for preoperative tissue diagnosis of screen-detected breast lesions. Methods and results: Concordance data for glass and digital slides of the same cases from four sites were subjected to detailed concordance-discordance analysis. A literature review of DP in the primary diagnosis of breast lesions is presented, making this the most comprehensive synthesis of digital breast cancer histopathological diagnostic data to date. Detailed concordance analysis of experimental data from two histopathology departments reveals clinical concordance rates for breast biopsies of 96% (216 of 225) and 99.6% (249 of 250). Data from direct comparison validation studies in two histopathology departments, utilising the protocol recommended by the Royal College of Pathologists, found concordance rates for breast histology cases of 99.4% (180 of 181) and 99.0% (887 of 896). An intraobserver variation study for glass versus digital slides for difficult cases from the NHSBSP yielded a kappa statistic of 0.80, indicating excellent agreement. Discordances encountered in the studies most frequently concerned discrepancies in grading attributable to mitotic countscoring and identification of weddelite. Conclusions: The experience of four histopathology laboratories and our review of pre-existing literature suggests that DP is safe for the primary diagnosis of NHSBSP breast histology specimens, and does not increase the risk of misclassification.

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“…Now, back to breast pathology, a recent study using digital pathology for the primary diagnosis of breast pathology specimens by three specialty breast pathologists showed complete clinical concordance between glass slide and digital impressions in 98.8% of cases [12]. While a reassuring result when compared to the pigeons, the study did not state whether or not the participants received food reinforcement.…”

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confidence: 92%

Advancing diagnostic hematopathology: pigeons or pixels?

Macon

2019

J Hematopathol

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Digital pathology for the primary diagnosis of breast histopathological specimens: an innovative validation and concordance study on digital pathology validation and training

Abstract: Individual training and validation for digital primary diagnosis allows pathologists to develop competence and confidence in their digital diagnostic skills, and aids safe and responsible transition from the light microscope to the digital microscope.

Cited by 63 publications

References 12 publications

Clinical digital neuropathology: experience and observations from a departmental digital pathology training programme, validation and deployment

Clinical digital neuropathology: experience and observations from a departmental digital pathology training programme, validation and deployment

Digital pathology for primary diagnosis of screen‐detected breast lesions – experimental data, validation and experience from four centres

Advancing diagnostic hematopathology: pigeons or pixels?

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