Feasibility and diagnostic agreement in teledermatopathology using a virtual slide system

Massone, Cesare; Soyer, H. Peter; Lozzi, Gian Piero; Stefani, Alessandro; Leinweber, Bernd; Gabler, Gerald; Asgari, Masoud; Boldrini, Renata; Bugatti, Leonardo; Canzonieri, Vincenzo; Ferrara, Gerardo; Kodama, Kazuo; Mehregan, Darius; Rongioletti, Franco; Janjua, Shahbaz A.; Mashayekhi, Vahid; Vassilaki, Ismini; Zelger, Bernhard; Žgavec, Borut; Cerroni, Lorenzo; Kerl, Helmut

doi:10.1016/j.humpath.2006.10.006

Cited by 77 publications

(72 citation statements)

References 19 publications

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“…Data verification was performed by CAP staff and 4 more studies were removed at that point, providing a total of 23 references for final recommendations. 12,13,17,[20][21][22][23][24][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] Excluded articles were available as discussion or background references.…”

Section: Outcomes Expert Panel Literature Review and Analysismentioning

confidence: 99%

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Pantanowitz

Sinard

Henricks

et al. 2013

Archives of Pathology & Laboratory Medicine

503

495

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Context.-There is increasing interest in using whole slide imaging (WSI) for diagnostic purposes (primary and/ or consultation). An important consideration is whether WSI can safely replace conventional light microscopy as the method by which pathologists review histologic sections, cytology slides, and/or hematology slides to render diagnoses. Validation of WSI is crucial to ensure that diagnostic performance based on digitized slides is at least equivalent to that of glass slides and light microscopy. Currently, there are no standard guidelines regarding validation of WSI for diagnostic use.Objective.-To recommend validation requirements for WSI systems to be used for diagnostic purposes.Design.-The College of American Pathologists Pathology and Laboratory Quality Center convened a nonvendor panel from North America with expertise in digital pathology to develop these validation recommendations. A literature review was performed in which 767 international publications that met search term requirements were identified. Studies outside the scope of this effort and those related solely to technical elements, education, and image analysis were excluded. A total of 27 publications were graded and underwent data extraction for evidence evaluation. Recommendations were derived from the strength of evidence determined from 23 of these published studies, open comment feedback, and expert panel consensus.Results.-Twelve guideline statements were established to help pathology laboratories validate their own WSI systems intended for clinical use. Validation of the entire WSI system, involving pathologists trained to use the system, should be performed in a manner that emulates the laboratory's actual clinical environment. It is recommended that such a validation study include at least 60 routine cases per application, comparing intraobserver diagnostic concordance between digitized and glass slides viewed at least 2 weeks apart. It is important that the validation process confirm that all material present on a glass slide to be scanned is included in the digital image.Conclusions.-Validation should demonstrate that the WSI system under review produces acceptable digital slides for diagnostic interpretation. The intention of validating WSI systems is to permit the clinical use of this technology in a manner that does not compromise patient care.

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Section: Outcomes Expert Panel Literature Review and Analysismentioning

confidence: 99%

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Pantanowitz

Sinard

Henricks

et al. 2013

Archives of Pathology & Laboratory Medicine

503

495

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“…Our samples' adjusted major discrepancy rates for WSI and GS in the second protocol were both 1.9% (1 of 52 cases); there was no difference in sampling accuracy between the 2 methods. Massone et al 20 reported, in 2007, significant problems with a WSI system for inflammatory cases; they noted that further system and technology development and additional training might improve accuracy. In 2012, Al Habeeb et al 15 reported concordance rates of 96% (76 of 79) and 100% (12 of 12) in a multiple-armed study, and they concluded modern WSI systems were adequate for diagnosis of challenging dermatopathology cases; our results agree with those findings.…”

Section: Commentmentioning

confidence: 99%

Interinstitutional Whole Slide Imaging Teleconsultation Service Development: Assessment Using Internal Training and Clinical Consultation Cases

Jones

Nazarian

Duncan

et al. 2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Assessment of accuracy and feasibility of whole slide imaging (WSI) for interinstitutional consultation in surgical pathology.Objectives.-To train technical and pathologist staff in WSI technology, establish and evaluate a WSI workflow using training cases and second-opinion consultations, and assess diagnostic accuracy.Design.-First, WSI training and evaluation using selected subspecialty service cases were performed and compared with the clinical glass slide (GS) diagnosis. Second, WSI and GS diagnoses of consecutive, secondopinion consultation cases were compared. Discrepancies underwent adjudication to determine a reference diagnosis. Participant observations on WSI initiation to practice were gathered.Results.-There were 130 cases evaluated, with 123 correlations (94.6%) and 6 minor (4.6%) and 1 major (0.8%) discrepancies. The 74 consultation cases interpreted had 52 correlations (70.3%), and 18 minor (24.3%) and 4 major (5.4%) discrepancies. The WSI and GS adjusted major discrepancy rates in second-opinion consultations were 2.7% (2 of 74) and 4.1% (3 of 74), respectively. Statistical analysis showed that WSI was not inferior to GS interpretation. Pathologists agreed the software was easy to use and the images were adequate, but more time was spent rendering WSI interpretations.Conclusions.-A significant learning curve was observed in the transition from the training set to clinical consultation cases associated both with WSI interpretation and adjustments to the digital analogs of routine GS workflow. Results from second-opinion consultations indicated that WSI interpretation was as accurate as GS interpretation among properly trained and experienced users. Overall, WSI-based practice appears feasible for second-opinion consultations.(Arch Pathol Lab Med. 2015;139:627-635; doi: 10.5858/ arpa.2014-0133-OA) T he use of whole slide imaging (WSI) technology for surgical pathology diagnosis is being investigated in many laboratories around the world. Improvements in the technology during the past several years, coupled with better understanding of pitfalls and caveats of the digital pathology environment and reduced costs for instrumentation, networking, and memory, have allowed for a greater understanding of the promise and the remaining challenges. Many studies have shown potential alternatives or improvements to traditional pathology practice through use of WSI technology in intraoperative frozen section interpretations, 1-3 image analysis applications with hematoxylin-eosin stains 4 and immunohistochemical and special stains, 5 in archiving and quality assurance programs, 6,7 for primary diagnosis, 8,9 for potential laboratory workflow improvements and pathologist ergonomics, 10 with laser-capture microdissection 11 (and thus burgeoning molecular testing methods), and for consultation purposes. 12Teleconsultation with WSI could improve consultation services by dramatically decreasing the turnaround time, compared with shipping glass slides; decrease the amount of pathologist labor required in inte...

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“…Studies published from medical centres performing pathomorphology have demonstrated a high correlation between routinely used digital diagnostics and conventional microscopy, where the percent error is of the order 1-5% [24][25][26][27][28][29][30][31][32]. These discrepancies arise mainly from inferior image quality and the pathologist being inexperienced in using digital techniques.…”

Section: Digital Diagnosticsmentioning

confidence: 99%

Future perspectives of digital pathology

Prochorec‐Sobieszek

2016

Nowotwory. Journal of Oncology

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Technological advances have enabled innovative solutions to be achieved in pathology based on digital imaging, now superseding those of conventional microscopy. Digital pathology has been defined as 'virtual microscopy' and depends on computer-generated digital imaging of microscope slides (WSI -whole slide imaging) which are in turn created, reviewed, managed, shared, analysed and interpreted. Such WSI systems and digital consulting platforms are now used for teaching, scientific research, telepathology / teleconsultation and diagnostics. They also permit easy and interactive sharing of WSI that can be integrated into other medical information systems. The software for automated image analysis and computer aided diagnosis can thereby make highly accurate diagnoses and help standardise study findings. Despite the technique's many advantages, its noted drawbacks include high equipment and software costs, image quality issues of standardisation and most importantly, that pathologists are reluctant to use it routinely for making diagnoses. NOWOTWORY J Oncol 2016; 66, 4: 277-285

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Feasibility and diagnostic agreement in teledermatopathology using a virtual slide system

Cited by 77 publications

References 19 publications

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center

Interinstitutional Whole Slide Imaging Teleconsultation Service Development: Assessment Using Internal Training and Clinical Consultation Cases

Future perspectives of digital pathology

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