The histopathological diagnosis of atypical meningioma: glass slide versus whole slide imaging for grading assessment

Abstract

Limited studies on whole slide imaging (WSI) in surgical neuropathology reported a perceived limitation in the recognition of mitoses. This study analyzed and compared the inter- and intra-observer concordance for atypical meningioma, using glass slides and WSI. Two neuropathologists and two residents assessed the histopathological features of 35 meningiomas—originally diagnosed as atypical—in a representative glass slide and corresponding WSI. For each histological parameter and final diagnosis, we calculated the inter- and intra-observer concordance in the two viewing modes and the predictive accuracy on recurrence. The concordance rates for atypical meningioma on glass slides and on WSI were 54% and 60% among four observers and 63% and 74% between two neuropathologists. The inter-observer agreement was higher using WSI than with glass slides for all parameters, with the exception of high mitotic index. For all histological features, we found median intra-observer concordance of ≥ 79% and similar predictive accuracy for recurrence between the two viewing modes. The higher concordance for atypical meningioma using WSI than with glass slides and the similar predictive accuracy for recurrence in the two modalities suggest that atypical meningioma may be safely diagnosed using WSI.

Digital Pathology Using Primary Case Sign-Out

“…6 This report identified and included 13 diagnostic cohort studies that all used a single-gate approach and blinded observers. [1][2][3][4][5]7,8,[16][17][18][19][20][21] Five of the included studies prospectively examined a diagnostic cohort of current cases, 3,5,7,18,19 while the remaining 8 studies retrospectively examined a diagnostic cohort of cases. 1,2,4,8,16,17,20,21 The prospective studies used a consecutive series of current patient cases.…”

“…[1][2][3][4][5]7,8,[16][17][18][19][20][21] Five of the included studies prospectively examined a diagnostic cohort of current cases, 3,5,7,18,19 while the remaining 8 studies retrospectively examined a diagnostic cohort of cases. 1,2,4,8,16,17,20,21 The prospective studies used a consecutive series of current patient cases. 3,5,7,18,19 One retrospective study randomly selected cases, 16 while 7 used a curated sample of cases intended to be representative.…”

“…3,5,7,18,19 One retrospective study randomly selected cases, 16 while 7 used a curated sample of cases intended to be representative. 1,2,4,8,17,20,21 Davidson et al used a retrospective representative sample of cases; however, this study also uniquely randomly allocated a large number of pathologist readers to 1 of the 2 diagnostic modalities twice. 4…”

“…1 Digital pathology using primary case sign-out with WSIs may also have other advantages over glass slides such as ease of archiving, research, teaching, remote expert consultation, improved ergonomics, side-by-side comparisons, larger field of vision, workflow improvements, and quantification of prognostic parameters. 2,3 Furthermore, algorithm-based pathological diagnostics using WSIs are in development, with current top-performing automated methods comparable to concordance among pathologists. 4 The clear benefits of this technology, in addition to the logistical pressures of COVID-19, are accelerating adoption of this technology.…”

Computer-Aided Decision-Making System for Endometrial Atypical Hyperplasia based on Multimodal & Multi-Instance Deep Convolution Networks

“…First of all, the size of a histopathological whole slide image (WSI) it too large to be input directly into a convolutional neural network (Ciresan et al 2013;Shahzad et al 2020). Secondly, the precise annotations of the lesion and normal regions are infeasible and unavailable in clinical practice, because it takes both time and effort to make manual labeling on a large number of digital image patches, especially when the lesion and normal regions are consistently mixed-up in the images(Am Mendola et al 2020;Hashimoto et al 2020). Furthermore, there are some unique challenges when the technology is applied in a specific field.…”