Digital slide images for primary diagnostics in breast pathology: a feasibility study

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

“…In this study, we have only four cases where the presence of glass slide was necessary to complete the diagnosis; two of them to check the double refraction in gingival and skin infection as this feature cannot be supported in WSI. Perhaps the easiest category to start primary digital diagnosis with may be Gastro-intestinal (GI) and breast biopsies 16 17 Table 4. details these cases.…”

“…In this hospital, digitisation of the whole daily production of histopathological specimens was initiated around the same time as in AMCH and has resulted in a situation where 75% of the diagnostics are performed digitally in addition to teleconsultations for frozen sections from other hospitals without local pathologists. Assessing the feasibility of primary WSI based diagnostics is ongoing currently in the University of Pittsburgh Medical Center, USA,5 University Medical Center Utrecht, The Netherlands16 17 19 and University Medical Center Nijmegen in collaboration with AMCH (manuscript in preparation). In addition, the Digital Pathology Association has presented two papers at the Pathology Vision conference 2011 discussing the high level validation approach of WSI for primary diagnostics.…”

Validation of Whole-Slide Imaging for Histolopathogical Diagnosis: Current State

“…Most of these studies analyzed a relatively small number of routine biopsies (between 100 and 150), including either only needle biopsies or both needle and surgical specimens [32,46,47]. Although scanning at ×400 was recommended in one of the studies [32], in two of the studies a scanning magnification of ×200 was considered as sufficient [46,47]. …”

“…Most of the discrepancies detected did not have clinical repercussion. Interestingly, in two of the reports, the WSI diagnosis was more frequently considered as correct compared to the diagnosis performed with CLM [32,46]. A study specifically dealing with the distinction between hyperplasia and cancer reported interobserver concordance in the diagnosis of 90.2%.…”

High agreement between whole slide imaging and optical microscopy for assessment of HER2 expression in breast cancer

“…Most studies trying to validate WSI in breast pathology are meant for research or for diagnostic purposes, with hematoxylin and eosin (H&E)-stained slides and for hormonal receptors and HER2 status using computer-aided softwares with quantitative staining algorithms [1,7,12,[23][24][25]40]. As HER2 expression evaluation is quantitative and qualitative, depending on morphology, intensity of color, and contrast, few studies evaluated the sensitivity and specificity of HER2 immunostained slides without computeraided IHC systems, compared to conventional optical microscopy [18].…”