Tracking with virtual slides: a tool to study diagnostic error in histopathology

Treanor, Darren; Lim, C. H.; Magee, Derek R.; Bulpitt, Andrew J.; Quirke, Philip

doi:10.1111/j.1365-2559.2009.03325.x

Cited by 38 publications

(45 citation statements)

References 20 publications

(23 reference statements)

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“…WSI also allows one to track how users view, pan and zoom around a WSI. [4243] This function has been shown to be particularly helpful with respect to tutoring and assessing trainees [Figure 3], as well as for the development of image processing tools.…”

Section: Education Tumor Boards and Presentationsmentioning

confidence: 99%

Review of the current state of whole slide imaging in pathology

Pantanowitz

Valenstein

Evans

et al. 2011

Journal of Pathology Informatics

355

310

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Whole slide imaging (WSI), or “virtual” microscopy, involves the scanning (digitization) of glass slides to produce “digital slides”. WSI has been advocated for diagnostic, educational and research purposes. When used for remote frozen section diagnosis, WSI requires a thorough implementation period coupled with trained support personnel. Adoption of WSI for rendering pathologic diagnoses on a routine basis has been shown to be successful in only a few “niche” applications. Wider adoption will most likely require full integration with the laboratory information system, continuous automated scanning, high-bandwidth connectivity, massive storage capacity, and more intuitive user interfaces. Nevertheless, WSI has been reported to enhance specific pathology practices, such as scanning slides received in consultation or of legal cases, of slides to be used for patient care conferences, for quality assurance purposes, to retain records of slides to be sent out or destroyed by ancillary testing, and for performing digital image analysis. In addition to technical issues, regulatory and validation requirements related to WSI have yet to be adequately addressed. Although limited validation studies have been published using WSI there are currently no standard guidelines for validating WSI for diagnostic use in the clinical laboratory. This review addresses the current status of WSI in pathology related to regulation and validation, the provision of remote and routine pathologic diagnoses, educational uses, implementation issues, and the cost-benefit analysis of adopting WSI in routine clinical practice.

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Section: Education Tumor Boards and Presentationsmentioning

confidence: 99%

Review of the current state of whole slide imaging in pathology

Pantanowitz

Valenstein

Evans

et al. 2011

Journal of Pathology Informatics

355

310

View full text Add to dashboard Cite

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“…These studies have identified different patterns, such as a 'scanning style' and a 'selective style' (Tiersma et al 2003), as well as highlighting differences in the behaviour of expert histopathologists and trainees (Krupinski et al 2006;Treanor et al 2009). …”

Section: Previous Studies Of Histopathologymentioning

confidence: 99%

Diagnosis at the microscope: a workplace study of histopathology

et al. 2011

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Histopathologists diagnose cancer and other diseases by using a microscope to examine glass slides containing thin sections of human tissue. Technological advances mean that it is now possible to digitise the slides so that they can be viewed on a computer, promising a number of benefits in terms of both efficiency and safety.Despite this, uptake of digital microscopy for diagnostic work has been slow and research suggests scepticism and uncertainty amongst histopathologists. In order to design a successful digital microscope, one which fits with the work practices of histopathologists and which they are happy to use within their daily work, we have undertaken a workplace study of a histopathology department. In this paper, we present the findings of that study and discuss the implications of these findings for the design of a digital microscope. The findings emphasise the way in which a diagnosis is built up as particular features on the glass slides are noticed and highlighted and the various information sources that are drawn on in the process of making a diagnosis.

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“…Specifically, we hypothesized that novices and experts would display differential viewing of the vROI versus dROI, and relative attractions to the vROI would predict diagnostic errors; indeed increased attraction to diagnostically uninformative regions may be associated with a failure to identify diagnostic features [17]. Support for such a hypothesis would carry both theoretical and practical implications.…”

Section: Introductionmentioning

confidence: 97%

Eye Movements as an Index of Pathologist Visual Expertise: A Pilot Study

et al. 2014

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A pilot study examined the extent to which eye movements occurring during interpretation of digitized breast biopsy whole slide images (WSI) can distinguish novice interpreters from experts, informing assessments of competency progression during training and across the physician-learning continuum. A pathologist with fellowship training in breast pathology interpreted digital WSI of breast tissue and marked the region of highest diagnostic relevance (dROI). These same images were then evaluated using computer vision techniques to identify visually salient regions of interest (vROI) without diagnostic relevance. A non-invasive eye tracking system recorded pathologists’ (N = 7) visual behavior during image interpretation, and we measured differential viewing of vROIs versus dROIs according to their level of expertise. Pathologists with relatively low expertise in interpreting breast pathology were more likely to fixate on, and subsequently return to, diagnostically irrelevant vROIs relative to experts. Repeatedly fixating on the distracting vROI showed limited value in predicting diagnostic failure. These preliminary results suggest that eye movements occurring during digital slide interpretation can characterize expertise development by demonstrating differential attraction to diagnostically relevant versus visually distracting image regions. These results carry both theoretical implications and potential for monitoring and evaluating student progress and providing automated feedback and scanning guidance in educational settings.

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Tracking with virtual slides: a tool to study diagnostic error in histopathology

Cited by 38 publications

References 20 publications

Review of the current state of whole slide imaging in pathology

Review of the current state of whole slide imaging in pathology

Diagnosis at the microscope: a workplace study of histopathology

Eye Movements as an Index of Pathologist Visual Expertise: A Pilot Study

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