Use of Digital Whole Slide Imaging in Dermatopathology

Abstract

Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation, with specific challenges for dermatopathology, yet little is known about pathologists' practice patterns or perceptions regarding WSI for interpretation of melanocytic lesions. A national sample of pathologists (N = 207) was recruited from 864 invited pathologists from ten US states (CA, CT, HI, IA, KY, LA, NJ, NM, UT, and WA). Pathologists who had interpreted melanocytic lesions in the past year were surveyed in this cross-sectional study. The survey included questions on pathologists' experience, WSI practice patterns and perceptions using a 6-point Likert scale. Agreement was summarized with descriptive statistics to characterize pathologists' use and perceptions of WSI. The majority of participating pathologists were between 40 and 59 years of age (62%) and not affiliated with an academic medical center (71%). Use of WSI was seen more often among dermatopathologists and participants affiliated with an academic medical center. Experience with WSI was reported by 41%, with the most common type of use being for education and testing (CME, board exams, and teaching in general, 71%), and clinical use at tumor boards and conferences (44%). Most respondents (77%) agreed that accurate diagnoses can be made with this technology, and 59% agreed that benefits of WSI outweigh concerns. However, 78% of pathologists reported that digital slides are too slow for routine clinical interpretation. The respondents were equally split as to whether they would like to adopt WSI (49%) or not (51%). The majority of pathologists who interpret melanocytic lesions do not use WSI, but among pathologists who do, use is largely for CME, licensure/board exams, and teaching. Positive perceptions regarding WSI slightly outweigh negative perceptions. Understanding practice patterns with WSI as dissemination advances may facilitate concordance of perceptions with adoption of the technology.

Pathologists’ diagnosis of invasive melanoma and melanocytic proliferations: observer accuracy and reproducibility study

“…Detailed information about development of the cases, participant recruitment, and diagnostic classification is provided elsewhere. [10][11][12][13][14] Histology form and mapping scheme We gathered assessment and recommendations on each case using a standardized online histology form and then classified the diverse terms using the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) histology form. 13 This tool organizes pathologists' diverse descriptive terms of melanocytic skin lesions into five diagnostic classes, with suggested treatment recommendations (table 1).…”

Pathologists' Use of Second Opinions in Interpretation of Melanocytic Cutaneous Lesions: Policies, Practices, and Perceptions

“…A detailed description of this study has been reported elsewhere. 12,13 Pathologists eligible for participation had completed their pathology training (residency and/or fellowship), diagnosed melanocytic lesions in practice within the previous year, and expected to continue diagnosing melanocytic lesions for the next 2 years. Eligible pathologists were invited to take part in the study through electronic mail.…”

The self‐reported use of immunostains and cytogenetic testing in the diagnosis of melanoma by practicing U.S. pathologists of 10 selected states

“…The details of the melanoma pathology study (M-Path) are summarized in detail elsewhere. 2,3 In brief, pathologists who interpret melanocytic lesions as part of their clinical practice were recruited to participate in an online survey and test-set interpretation. Approval was obtained from the Institutional Review Board of the University of Washington Human Subjects Division.…”