Primary histologic diagnosis using automated whole slide imaging: a validation study
TLDR
The results indicated that the image information contained in current whole slide images is sufficient for pathologists to make reliable diagnostic decisions and compose complex diagnostic reports, but this does not mean that WSI is as good as a microscope.Abstract:
Only prototypes 5 years ago, high-speed, automated whole slide imaging (WSI) systems (also called digital slide systems, virtual microscopes or wide field imagers) are becoming increasingly capable and robust. Modern devices can capture a slide in 5 minutes at spatial sampling periods of less than 0.5 micron/pixel. The capacity to rapidly digitize large numbers of slides should eventually have a profound, positive impact on pathology. It is important, however, that pathologists validate these systems during development, not only to identify their limitations but to guide their evolution. Three pathologists fully signed out 25 cases representing 31 parts. The laboratory information system was used to simulate real-world sign-out conditions including entering a full diagnostic field and comment (when appropriate) and ordering special stains and recuts. For each case, discrepancies between diagnoses were documented by committee and a "consensus" report was formed and then compared with the microscope-based, sign-out report from the clinical archive. In 17 of 25 cases there were no discrepancies between the individual study pathologist reports. In 8 of the remaining cases, there were 12 discrepancies, including 3 in which image quality could be at least partially implicated. When the WSI consensus diagnoses were compared with the original sign-out diagnoses, no significant discrepancies were found. Full text of the pathologist reports, the WSI consensus diagnoses, and the original sign-out diagnoses are available as an attachment to this publication. The results indicated that the image information contained in current whole slide images is sufficient for pathologists to make reliable diagnostic decisions and compose complex diagnostic reports. This is a very positive result; however, this does not mean that WSI is as good as a microscope. Virtually every slide had focal areas in which image quality (focus and dynamic range) was less than perfect. In some cases, there was evidence of over-compression and regions made "soft" by less than perfect focus. We expect systems will continue to get better, image quality and speed will continue to improve, but that further validation studies will be needed to guide development of this promising technology.read more
Citations
More filters
Journal ArticleDOI
Validating Whole Slide Imaging for Diagnostic Purposes in Pathology: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center
Liron Pantanowitz,John H. Sinard,Walter H. Henricks,Lisa A. Fatheree,Alexis B. Carter,Lydia Contis,Bruce A. Beckwith,Andrew J. Evans,Avtar Lal,Anil V. Parwani +9 more
TL;DR: Validation of whole slide imaging systems should demonstrate that the WSI system under review produces acceptable digital slides for diagnostic interpretation, to permit the clinical use of this technology in a manner that does not compromise patient care.
Journal ArticleDOI
Digital imaging in pathology: whole-slide imaging and beyond.
TL;DR: This review highlights the emerging field of digital pathology and explores the methods and analytic approaches being developed for the application and use of these methods in clinical care and research settings.
Journal ArticleDOI
Review of the current state of whole slide imaging in pathology
Liron Pantanowitz,Paul N. Valenstein,Andrew J. Evans,Keith J. Kaplan,John D. Pfeifer,David C. Wilbur,Laura C. Collins,Terence J. Colgan +7 more
TL;DR: 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 W SI in routine clinical practice are addressed.
Journal ArticleDOI
Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study).
Sanjay Mukhopadhyay,Michael Feldman,Esther Abels,Raheela Ashfaq,Senda Beltaifa,Nicolas G. Cacciabeve,Helen P. Cathro,Liang Cheng,Kumarasen Cooper,Glenn E. Dickey,Ryan M. Gill,Robert P. Heaton,René Kerstens,Guy Lindberg,Reenu Malhotra,James Mandell,Ellen D. Manlucu,Anne M. Mills,Stacey E. Mills,Christopher A. Moskaluk,Mischa E. T. Nelis,Deepa T. Patil,Christopher G. Przybycin,Jordan P. Reynolds,Brian P. Rubin,Mohammad H. Saboorian,Mauricio Salicru,Mark A. Samols,Charles D. Sturgis,Kevin Turner,Mark R. Wick,Ji Y. Yoon,Po Zhao,Clive R. Taylor +33 more
TL;DR: It is concluded that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains, valid across a wide variety of organ systems and specimen types.
Journal ArticleDOI
Critical comparison of 31 commercially available digital slide systems in pathology.
Marcial García Rojo,Gloria Bueno García,Carlos Peces Mateos,Jesús González García,Manuel Carbajo Vicente +4 more
TL;DR: Technical aspects of 31 different digital microscopy systems, including the cameras used, the speed of digitization, and the image quality, are described, which can offer important benefits to pathology departments.
References
More filters
Journal ArticleDOI
Virtual microscopy for learning and assessment in pathology
TL;DR: The successful implementation of teaching microscopic pathology with virtual slides is described and, for the first time, their use in summative assessment is described, with no technical or security issues arising despite high peak demand.
Proceedings Article
The Virtual Microscope.
Renato Ferreira,Bongki Moon,Jim Humphries,Alan Sussman,Joel H. Saltz,Robert Miller,Angelo Demarzo +6 more
TL;DR: The design and implementation of the virtual microscope, a software system employing a client/server architecture to provide a realistic emulation of a high power light microscope, provides a form of completely digital telepathology, allowing simultaneous access to archived digital slide images by multiple clients.
Journal ArticleDOI
Teaching medical histology at the University of South Carolina School of Medicine: Transition to virtual slides and virtual microscopes
TL;DR: The histology course the authors teach to first-year medical students changed successfully from using glass slides and microscopes to using virtual slides and virtual microscopes, which provides greater versatility for sample study and speed in localizing structures than was possible with the actual microscope.
Journal ArticleDOI
An array microscope for ultrarapid virtual slide processing and telepathology. Design, fabrication, and validation study.
Ronald S. Weinstein,Michael R. Descour,Chen Liang,Gail P. Barker,Katherine M. Scott,Lynne Richter,Elizabeth A. Krupinski,Achyut K. Bhattacharyya,John R. Davis,Anna R. Graham,Margaret A. Rennels,William C. Russum,James F. Goodall,Pixuan Zhou,Artur Olszak,Bruce H. Williams,James C. Wyant,Peter H. Bartels +17 more
TL;DR: The DMetrix virtual slide processor has been found to reduce the virtual slide processing cycle more than 10 fold, as compared with other virtual slide systems reported to date.
Related Papers (5)
Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations.
David C. Wilbur,Kalil Madi,Robert B. Colvin,Lyn M. Duncan,William C. Faquin,Judith A. Ferry,Matthew P. Frosch,Stuart L. Houser,Richard L. Kradin,Gregory Y. Lauwers,David N. Louis,Eugene J. Mark,Mari Mino-Kenudson,Joseph Misdraji,Gunnlauger P. Nielsen,Martha B. Pitman,Andrew E. Rosenberg,R. Neal Smith,Aliyah R. Sohani,James R. Stone,Rosemary H. Tambouret,Chin-Lee Wu,Robert H. Young,Artur Zembowicz,Wolfgang Klietmann +24 more