Evaluation of 2 whole-slide imaging applications in dermatopathology

Vélez, Nicole F.; Jukic, D.M.; Ho, Jonhan

doi:10.1016/j.humpath.2008.01.006

Cited by 73 publications

(68 citation statements)

References 15 publications

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“…These studies used tissue from different anatomic sites, such as the breast, prostate, skin, lungs, and stomach. [21][22][23][24][25][26] Similar to that in our study, the interpretive agreement between the 2 platforms was high: more than the 90th percentile. The concordance between WSI and OM was reported to be lower for nonneoplastic lesions and inflammatory lesions in previous studies.…”

Section: Commentsupporting

confidence: 88%

Multi-Institutional Comparison of Whole Slide Digital Imaging and Optical Microscopy for Interpretation of Hematoxylin-Eosin–Stained Breast Tissue Sections

Krishnamurthy¹,

Mathews²,

McClure³

et al. 2013

Archives of Pathology & Laboratory Medicine

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Context.-Whole slide imaging (WSI) is now used for educational purposes, for consultation, and for archiving and quantitation of immunostains. However, it is not routinely used for the primary diagnosis of hematoxylineosin-stained tissue sections.Objective.-To compare WSI using the Aperio digital pathology system (Aperio Technologies, Inc, Vista, California) with optical microscopy (OM) for the interpretation of hematoxylin-eosin-stained tissue sections of breast lesions.Design.-The study was conducted at 3 clinical sites; 3 breast pathologists interpreted 150 hematoxylin-eosinstained slides at each site, 3 times each by WSI and 3 times each by OM. For WSI, slides were scanned using an Aperio ScanScope and interpreted on a computer monitor using Aperio ImageScope software and Aperio Spectrum data management software. Pathologic interpretations were recorded using the College of American Pathologists breast checklist. WSI diagnoses were compared with OM diagnoses for accuracy, precision (interpathologist variation), and reproducibility (intrapathologist variation). Results were considered accurate only if the interpretation matched exactly between WSI and OM. The proportion of accurate results reported by each pathologist was expressed as a percentage for the comparison of the 2 platforms.Results.-The accuracy of WSI for classifying lesions as not carcinoma or as noninvasive (ductal or lobular) or invasive (ductal, lobular, or other) carcinoma was 90.5%. The accuracy of OM was 92.1%. The precision and reproducibility of WSI and OM were determined on the basis of pairwise comparisons (3 comparisons for each slide, resulting in 36 possible comparisons). The overall precision of WSI was 90.5% in comparison with 92.1% for OM; reproducibility of WSI was 91.6% in comparison with 94.5% for OM, respectively.Conclusions.-In this study, we demonstrated that WSI and OM have similar accuracy, precision, and reproducibility for interpreting hematoxylin-eosin-stained breast tissue sections. Further clinical studies using routine surgical pathology specimens would be useful to confirm these findings and facilitate the incorporation of WSI into diagnostic practice. (Arch Pathol Lab Med. 2013;137:1733-1739 doi: 10.5858/arpa.2012-0437-OA) T he practice of surgical pathology relies on image-based light microscopy diagnosis, which enables the detailed evaluation of the cytologic and architectural features of hematoxylin-eosin (H&E)-stained tissue sections. Significant recent technological advancements have allowed for the acquisition and storage of high-quality digital images. Several commercially available platforms are available for scanning H&E-stained tissue sections, generating digital whole slide images (WSI) for viewing and interpretation. The field of digital pathology is rapidly evolving toward the creation of a digital environment for interpreting and managing pathologic information contained in a glass slide.Several applications of digital pathology are currently being embraced by pathologists. Whole slide imaging is ...

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Section: Commentsupporting

confidence: 88%

Multi-Institutional Comparison of Whole Slide Digital Imaging and Optical Microscopy for Interpretation of Hematoxylin-Eosin–Stained Breast Tissue Sections

Krishnamurthy¹,

Mathews²,

McClure³

et al. 2013

Archives of Pathology & Laboratory Medicine

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“…For instance, regarding the user interface, Yagi et al 21 showed that a game controller could provide a smoother and more ergonomic interface, which could substantially improve the user experience. Velez et al 22 showed that differences in the time of pathologist interpretation between optical and digital analysis decreased at greater complexities.…”

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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“…Average time per task was 67% longer with the virtual slides than the glass slides, but was over 300% longer for certain tasks [9]. Velez et al compared the time taken by three pathologists to examine dermatopathology cases [10]. Average time spent per slide was 23 seconds on the microscope, 34 seconds with the in-house slide viewing software, and 38 seconds with vendor supplied slide viewing software.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of major cancer resection specimens with virtual slides: impact of a novel digital pathology workstation

et al. 2014

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Summary:Digital pathology promises a number of benefits in efficiency in surgical pathology, yet the longer time required to review a virtual slide than a glass slide currently represents a significant barrier to the routine use of digital pathology. We aimed to create a novel workstation that enables pathologists to view a case as quickly as on the conventional microscope. The Leeds Virtual Microscope (LVM) was evaluated using a mixed factorial experimental design. Twelve consultant pathologists took part, each viewing one long cancer case (12-25 slides) on the LVM and one on a conventional microscope. Total time taken and diagnostic confidence were similar for the microscope and LVM, as was the mean slide viewing time. On the LVM, participants spent a significantly greater proportion of the total task time viewing slides and revisited slides more often. The unique design of the LVM, enabling real time rendering of virtual slides while providing users with a quick and intuitive way to navigate within and between slides, makes use of digital pathology in routine practice a realistic possibility. With further practice with the system, diagnostic efficiency on the LVM is likely to increase yet more.3

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Evaluation of 2 whole-slide imaging applications in dermatopathology

Cited by 73 publications

References 15 publications

Multi-Institutional Comparison of Whole Slide Digital Imaging and Optical Microscopy for Interpretation of Hematoxylin-Eosin–Stained Breast Tissue Sections

Multi-Institutional Comparison of Whole Slide Digital Imaging and Optical Microscopy for Interpretation of Hematoxylin-Eosin–Stained Breast Tissue Sections

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

Diagnosis of major cancer resection specimens with virtual slides: impact of a novel digital pathology workstation

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