Whole slide images as a platform for initial diagnostics in histopathology in a medium-sized routine laboratory

Al-Janabi, Shaimaa; Huisman, André; Nap, Marius; Clarijs, Ruud; Diest, Paul J. van

doi:10.1136/jclinpath-2012-200878

Cited by 61 publications

(41 citation statements)

References 19 publications

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“…Many pathology laboratories have questioned if digital pathology should be considered for large-scale implementation in routine clinical practice. The number of institutions that adopt digital pathology is limited because of the high costs and the complexity of digital pathology equipment [11,20,29]. …”

Section: Discussionmentioning

confidence: 99%

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer

Słodkowska¹,

Cierniak²,

Patera³

et al. 2016

Pathobiology

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Background: Ovarian cancer has one of the highest death/incidence rates and is commonly diagnosed at an advanced stage. In the recent WHO classification, new histotypes were classified which respond differently to chemotherapy. The e-standardized synoptic cancer pathology reports offer the clinicians essential and reliable information. The aim of our project was to develop an e-template for the standardized synoptic pathology reporting of ovarian carcinoma [based on the checklist of the College of American Pathologists (CAP) and the recent WHO/FIGO classification] to introduce a uniform and improved quality of cancer pathology reports. A functional and qualitative evaluation of the synoptic reporting was performed. Methods: An indispensable module for e-synoptic reporting was developed and integrated into the Hospital Information System (HIS). The electronic pathology system used a standardized structure with drop-down lists of defined elements to ensure completeness and consistency of reporting practices with the required guidelines. All ovarian cancer pathology reports (partial and final) with the corresponding glass slides selected from a 1-year current workflow were revised for the standard structured reports, and 42 tumors [13 borderline tumors and 29 carcinomas (mainly serous)] were included in the study. Results: Analysis of the reports for completeness against the CAP checklist standard showed a lack of pTNM staging in 80% of the partial or final unstructured reports; ICD-O coding was missing in 83%. Much less frequently missed or unstated data were: ovarian capsule infiltration, angioinvasion and implant evaluation. The e-records of ovarian tumors were supplemented with digital macro- and micro-images and whole-slide images. Conclusions: The e-module developed for synoptic ovarian cancer pathology reporting was easily incorporated into HIS.CGM CliniNet and facilitated comprehensive reporting; it also provided open access to the database for concerned recipients. The e-synoptic pathology reports appeared more accurate, clear and conclusive than traditional narrative reports. Standardizing structured reporting and electronic tools allows open access and downstream utilization of pathology data for clinicians and tumor registries.

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Section: Discussionmentioning

confidence: 99%

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer

Słodkowska¹,

Cierniak²,

Patera³

et al. 2016

Pathobiology

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“…However, WSI for upfront diagnostics are the least practised application of digital pathology. Nevertheless, they have been used for upfront diagnostics in some laboratories after performing their local validation studies, for example, in Atrium Medical Center Heerlen, Heerlen, The Netherlands12 and Kalmar County Hospital, Kalmar, Sweden 13…”

Section: Introductionmentioning

confidence: 99%

Whole slide images for primary diagnostics of paediatric pathology specimens: a feasibility study

et al. 2012

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“…Regarding clinical routine use, Al-Janabi et al .,[3] provides some hands on experience. In 2010 they scanned around 20% of their cases for primary digital diagnosis.…”

Section: Related Workmentioning

confidence: 99%

Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013

Thorstenson

Molin

Lundström

2014

Journal of Pathology Informatics

153

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Recent technological advances have improved the whole slide imaging (WSI) scanner quality and reduced the cost of storage, thereby enabling the deployment of digital pathology for routine diagnostics. In this paper we present the experiences from two Swedish sites having deployed routine large-scale WSI for primary review. At Kalmar County Hospital, the digitization process started in 2006 to reduce the time spent at the microscope in order to improve the ergonomics. Since 2008, more than 500,000 glass slides have been scanned in the routine operations of Kalmar and the neighboring Linköping University Hospital. All glass slides are digitally scanned yet they are also physically delivered to the consulting pathologist who can choose to review the slides on screen, in the microscope, or both. The digital operations include regular remote case reporting by a few hospital pathologists, as well as around 150 cases per week where primary review is outsourced to a private clinic. To investigate how the pathologists choose to use the digital slides, a web-based questionnaire was designed and sent out to the pathologists in Kalmar and Linköping. The responses showed that almost all pathologists think that ergonomics have improved and that image quality was sufficient for most histopathologic diagnostic work. 38 ± 28% of the cases were diagnosed digitally, but the survey also revealed that the pathologists commonly switch back and forth between digital and conventional microscopy within the same case. The fact that two full-scale digital systems have been implemented and that a large portion of the primary reporting is voluntarily performed digitally shows that large-scale digitization is possible today.

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Whole slide images as a platform for initial diagnostics in histopathology in a medium-sized routine laboratory

Abstract: The quality of the currently produced WSI is sufficient for primary diagnostics in 82.1% of the cases. Improving image quality, adequate retrieval and controlling scanning error will definitely encourage the wide adaptation in routine diagnostics.

Cited by 61 publications

References 19 publications

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer

Functional Assessment of Synoptic Pathology Reporting for Ovarian Cancer

Whole slide images for primary diagnostics of paediatric pathology specimens: a feasibility study

Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013

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