scholarly journals Whole-Slide Imaging Digital Pathology as a Platform for Teleconsultation: A Pilot Study Using Paired Subspecialist Correlations

2009 ◽  
Vol 133 (12) ◽  
pp. 1949-1953 ◽  
Author(s):  
David C. Wilbur ◽  
Kalil Madi ◽  
Robert B. Colvin ◽  
Lyn M. Duncan ◽  
William C. Faquin ◽  
...  
Keyword(s):  
Digital Pathology ◽  
Glass Slide ◽  
Whole Slide Imaging ◽  
Improve Performance ◽  
Standard Glass ◽  
Digital Format ◽  
Glass Slides ◽  
Technical Issues ◽  
Fine Resolution ◽  
Whole Slide Images

Abstract Context.—Whole-slide imaging technology offers promise for rapid, Internet-based telepathology consultations between institutions. Before implementation, technical issues, pathologist adaptability, and morphologic pitfalls must be well characterized. Objective.—To determine whether interpretation of whole-slide images differed from glass-slide interpretation in difficult surgical pathology cases. Design.—Diagnostically challenging pathology slides from a variety of anatomic sites from an outside laboratory were scanned into whole digital format. Digital and glass slides were independently diagnosed by 2 subspecialty pathologists. Reference, digital, and glass-slide interpretations were compared. Operator comments on technical issues were gathered. Results.—Fifty-three case pairs were analyzed. There was agreement among digital, glass, and reference diagnoses in 45 cases (85%) and between digital and glass diagnoses in 48 (91%) cases. There were 5 digital cases (9%) discordant with both reference and glass diagnoses. Further review of each of these cases indicated an incorrect digital whole-slide interpretation. Neoplastic cases showed better correlation (93%) than did cases of nonneoplastic disease (88%). Comments on discordant cases related to digital whole technology focused on issues such as fine resolution and navigating ability at high magnification. Conclusions.—Overall concordance between digital whole-slide and standard glass-slide interpretations was good at 91%. Adjustments in technology, case selection, and technology familiarization should improve performance, making digital whole-slide review feasible for broader telepathology subspecialty consultation applications.

scholarly journals Digital Whole Slide Imaging Compared With Light Microscopy for Primary Diagnosis in Surgical Pathology

2020 ◽  
Vol 144 (10) ◽  
pp. 1245-1253 ◽  
Author(s):  
Alexander D. Borowsky ◽  
Eric F. Glassy ◽  
William Dean Wallace ◽  
Nathash S. Kallichanda ◽  
Cynthia A. Behling ◽  
...  
Keyword(s):  
Digital Pathology ◽  
Diagnostic Category ◽  
Primary Diagnosis ◽  
Current Standard ◽  
Diagnostic Categories ◽  
Standard Glass ◽  
Specific Subset ◽  
Glass Slides ◽  
Major Discrepancy ◽  
Whole Slide Images

Context.— The adoption of digital capture of pathology slides as whole slide images (WSI) for educational and research applications has proven utility. Objective.— To compare pathologists' primary diagnoses derived from WSI versus the standard microscope. Because WSIs differ in format and method of observation compared with the current standard glass slide microscopy, this study is critical to potential clinical adoption of digital pathology. Design.— The study enrolled a total of 2045 cases enriched for more difficult diagnostic categories and represented as 5849 slides were curated and provided for diagnosis by a team of 19 reading pathologists separately as WSI or as glass slides viewed by light microscope. Cases were reviewed by each pathologist in both modalities in randomized order with a minimum 31-day washout between modality reads for each case. Each diagnosis was compared with the original clinical reference diagnosis by an independent central adjudication review. Results.— The overall major discrepancy rates were 3.64% for WSI review and 3.20% for manual slide review diagnosis methods, a difference of 0.44% (95% CI, −0.15 to 1.03). The time to review a case averaged 5.20 minutes for WSI and 4.95 minutes for glass slides. There was no specific subset of diagnostic category that showed higher rates of modality-specific discrepancy, though some categories showed greater discrepancy than others in both modalities. Conclusions.— WSIs are noninferior to traditional glass slides for primary diagnosis in anatomic pathology.

scholarly journals Use of whole slide imaging (WSI) for distance teaching

2020 ◽  
pp. jclinpath-2020-206763
Author(s):  
Andrew John Evans ◽  
Nadia Depeiza ◽  
Shara-Gaye Allen ◽  
Kimone Fraser ◽  
Suzanne Shirley ◽  
...  
Keyword(s):  
Distance Education ◽  
Digital Pathology ◽  
Daily Practice ◽  
Distance Teaching ◽  
Whole Slide Imaging ◽  
Glass Slides ◽  
Slide Image ◽  
Technical Issues ◽  
Initial Sessions ◽  
The University

BackgroundTime, travel and financial constraints have meant that traditional visiting teaching engagements are more difficult to accomplish. This has been exacerbated with the advent of the COVID-19 pandemic. The use of digital pathology and whole slide imaging (WSI) as an educational tool for distance teaching is underutilised and not fully exploited. This paper highlights the utility and feedback on the use of WSI for distance education/teaching.Materials and methodsBuilding on an existing relationship with the University of the West Indies (UWI), pathologists at University Health Network, Toronto, provided distance education using WSI, a digitised slide image hosting repository and videoconferencing facilities to provide case-based teaching to 15 UWI pathology trainees. Feedback was obtained from residents via a questionnaire and from teachers via a discussion.ResultsThere was uniform support from teachers who felt that teaching was not hampered by the ‘virtual’ engagement. Comfort levels grew with each engagement and technical issues with sound diminished with the use of a portable speaker. The residents were very supportive and enthusiastic in embracing this mode of teaching. While technical glitches marred initial sessions, the process evened out especially when the slide hosting facility, teleconferencing and sound issues were changed.ConclusionsThere was unanimous endorsement that use of WSI was the future, especially for distance teaching. However, it was not meant to supplant the use of glass slides in their current routine, daily practice.

scholarly journals A Digital Pathology Solution to Resolve the Tissue Floater Conundrum

2020 ◽  
Author(s):  
Liron Pantanowitz ◽  
Pamela Michelow ◽  
Scott Hazelhurst ◽  
Shivam Kalra ◽  
Charles Choi ◽  
...  
Keyword(s):  
Digital Pathology ◽  
Primary Diagnosis ◽  
Image Search ◽  
Molecular Tests ◽  
Tissue Identification ◽  
Digital Database ◽  
Glass Slides ◽  
Search Tool ◽  
Hematoxylin And Eosin ◽  
Whole Slide Images

Context.— Pathologists may encounter extraneous pieces of tissue (tissue floaters) on glass slides because of specimen cross-contamination. Troubleshooting this problem, including performing molecular tests for tissue identification if available, is time consuming and often does not satisfactorily resolve the problem. Objective.— To demonstrate the feasibility of using an image search tool to resolve the tissue floater conundrum. Design.— A glass slide was produced containing 2 separate hematoxylin and eosin (H&E)-stained tissue floaters. This fabricated slide was digitized along with the 2 slides containing the original tumors used to create these floaters. These slides were then embedded into a dataset of 2325 whole slide images comprising a wide variety of H&E stained diagnostic entities. Digital slides were broken up into patches and the patch features converted into barcodes for indexing and easy retrieval. A deep learning-based image search tool was employed to extract features from patches via barcodes, hence enabling image matching to each tissue floater. Results.— There was a very high likelihood of finding a correct tumor match for the queried tissue floater when searching the digital database. Search results repeatedly yielded a correct match within the top 3 retrieved images. The retrieval accuracy improved when greater proportions of the floater were selected. The time to run a search was completed within several milliseconds. Conclusions.— Using an image search tool offers pathologists an additional method to rapidly resolve the tissue floater conundrum, especially for those laboratories that have transitioned to going fully digital for primary diagnosis.

scholarly journals A Practical Guide to Whole Slide Imaging: A White Paper From the Digital Pathology Association

2018 ◽  
Vol 143 (2) ◽  
pp. 222-234 ◽  
Author(s):  
Mark D. Zarella ◽  
Douglas Bowman; ◽  
Famke Aeffner ◽  
Navid Farahani ◽  
Albert Xthona; ◽  
...  
Keyword(s):  
Practical Knowledge ◽  
Digital Pathology ◽  
Executive Leadership ◽  
The United States ◽  
White Paper ◽  
Primary Diagnosis ◽  
Basic Function ◽  
Whole Slide Imaging ◽  
Interinstitutional Collaboration ◽  
Glass Slides

Context.— Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. Its basic function is to digitize glass slides, but its impact on pathology workflows, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and intrainstitutional and interinstitutional collaboration exemplifies a significant innovative movement with far-reaching effects. Although the benefits of WSI to pathology practices, academic centers, and research institutions are many, the complexities of implementation remain an obstacle to widespread adoption. In the wake of the first regulatory clearance of WSI for primary diagnosis in the United States, some barriers to adoption have fallen. Nevertheless, implementation of WSI remains a difficult prospect for many institutions, especially those with stakeholders unfamiliar with the technologies necessary to implement a system or who cannot effectively communicate to executive leadership and sponsors the benefits of a technology that may lack clear and immediate reimbursement opportunity. Objectives.— To present an overview of WSI technology—present and future—and to demonstrate several immediate applications of WSI that support pathology practice, medical education, research, and collaboration. Data Sources.— Peer-reviewed literature was reviewed by pathologists, scientists, and technologists who have practical knowledge of and experience with WSI. Conclusions.— Implementation of WSI is a multifaceted and inherently multidisciplinary endeavor requiring contributions from pathologists, technologists, and executive leadership. Improved understanding of the current challenges to implementation, as well as the benefits and successes of the technology, can help prospective users identify the best path for success.

scholarly journals Validation of grading of non-invasive urothelial carcinoma by digital pathology for routine diagnosis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Colling ◽  
Hayleigh Colling ◽  
Lisa Browning ◽  
Clare Verrill
Keyword(s):  
Urothelial Carcinoma ◽  
Digital Pathology ◽  
Glass Slide ◽  
Low Grade ◽  
Non Invasive ◽  
Routine Diagnosis ◽  
Grade Versus ◽  
Glass Slides ◽  
Urothelial Bladder ◽  
Bladder Carcinomas

Abstract Background Pathological grading of non-invasive urothelial carcinoma has a direct impact upon management. This study evaluates the reproducibility of grading these tumours on glass slides and digital pathology. Methods Forty eight non-invasive urothelial bladder carcinomas were graded by three uropathologists on glass and on a digital platform using the 1973 WHO and 2004 ISUP/WHO systems. Results Consensus grades for glass and digital grading gave Cohen’s kappa scores of 0.78 (2004) and 0.82 (1973). Of 142 decisions made on the key therapeutic borderline of low grade versus high grade urothelial carcinoma (2004) by the three pathologists, 85% were in agreement. For the 1973 grading system, agreement overall was 90%. Conclusions Agreement on grading on glass slide and digital screen assessment is similar or in some cases improved, suggesting at least non-inferiority of DP for grading of non-invasive urothelial carcinoma.

scholarly journals Implementation of Whole Slide Imaging for Clinical Purposes: Issues to Consider From the Perspective of Early Adopters

2017 ◽  
Vol 141 (7) ◽  
pp. 944-959 ◽  
Author(s):  
Andrew J. Evans ◽  
Mohamed E. Salama ◽  
Walter H. Henricks ◽  
Liron Pantanowitz
Keyword(s):  
Transition Period ◽  
Clinical Laboratory ◽  
Panel Discussion ◽  
Digital Pathology ◽  
Primary Diagnosis ◽  
Glass Slide ◽  
Whole Slide Imaging ◽  
Early Adopters ◽  
Implementation Team ◽  
Intended Use

Context.— There is growing interest in the use of digital pathology, especially whole slide imaging, for diagnostic purposes. Many issues need to be considered when incorporating this technology into a clinical laboratory. The College of American Pathologists (CAP) established a Digital Pathology Committee to support the development of CAP programs related to digital pathology. One of its many initiatives was a panel discussion entitled “Implementing Whole-Slide Imaging for Clinical Use: What to Do and What to Avoid,” given for 3 years at the CAP annual meetings starting in 2014. Objectives.— To review major issues to consider when implementing whole slide imaging for clinical purposes as covered during the panel discussion. Design.— The views expressed and recommendations given are based primarily on the personal experience of the authors as early adopters of this technology. It is not intended to be an exhaustive review of digital pathology. Results.— Implementation is best approached in phases. Early efforts are directed toward identifying initial clinical applications and assembling an implementation team. Scanner selection should be based on intended use and budget. Recognizing pathologist concerns over the use of digital pathology for diagnostic purposes, ensuring adequate training, and performing appropriate validation studies will enhance adoption. Once implemented, the transition period from glass slide to image-based diagnostics will be associated with challenges, especially those related to a hybrid glass slide–digital slide workflow. Conclusions.— With appropriate preparation, planning, and stepwise implementation, whole slide imaging can be used safely and reliably for frozen sections, consultation, quality assurance, and primary diagnosis.

Concordance between digital pathology and light microscopy in general surgical pathology: a pilot study of 100 cases

2014 ◽  
Vol 67 (12) ◽  
pp. 1052-1055 ◽  
Author(s):  
Joseph P Houghton ◽  
Aaron J Ervine ◽  
Sarah L Kenny ◽  
Paul J Kelly ◽  
Seamus S Napier ◽  
...  
Keyword(s):  
Pilot Study ◽  
Light Microscopy ◽  
Digital Images ◽  
Digital Pathology ◽  
Glass Slide ◽  
Clinical Consequence ◽  
Histopathological Diagnosis ◽  
Original Diagnosis ◽  
Glass Slides ◽  
Viable Method

Aim(1) A pilot study to determine the accuracy of interpretation of whole slide digital images in a broad range of general histopathology cases of graded complexity. (2) To survey the participating histopathologists with regard to acceptability of digital pathology.Materials and methodsGlass slides of 100 biopsies and minor resections were digitally scanned in their entirety, producing digital slides. These cases had been diagnosed by light microscopy at least 1 year previously and were subsequently reassessed by the original reporting pathologist (who was blinded to their original diagnosis) using digital pathology. The digital pathology-based diagnosis was compared with the original glass slide diagnosis and classified as concordant, slightly discordant (without clinical consequence) or discordant. The participants were surveyed at the end of the study.ResultsThere was concordance between the original light microscopy diagnosis and digital pathology-based diagnosis in 95 of the 100 cases while the remaining 5 cases showed only slight discordance (with no clinical consequence). None of the cases were categorised as discordant. Participants had mixed experiences using digital pathology technology.ConclusionsIn the broad range of cases we examined, digital pathology is a safe and viable method of making a primary histopathological diagnosis.

Integrating a Web-Based Whole-Slide Imaging System and Online Questionnaires in a National Cytopathology Peer Comparison Educational Program in Taiwan

2015 ◽  
Vol 59 (3) ◽  
pp. 278-283 ◽  
Author(s):  
Jen-Fan Hang ◽  
Wen-Yih Liang ◽  
Chih-Yi Hsu ◽  
Chiung-Ru Lai
Keyword(s):  
Educational Program ◽  
Large Scale ◽  
Imaging System ◽  
Whole Slide Imaging ◽  
Easy Method ◽  
Web Based ◽  
Glass Slides ◽  
Promising Solution ◽  
First Time ◽  
Whole Slide Images

Objective: In a peer comparison educational program, transferring glass slides between laboratories and collecting responses are time- and cost-consuming. Integrating a web-based whole-slide imaging (WSI) system and online questionnaires may serve as a promising solution. Study Design: Five gynecologic Papanicolaou-stained smears and 5 nongynecologic slides were selected. The 10 whole-slide images were acquired by a Leica SCN-400 system and released via an Aperio eSlide Manager. Online questionnaires generated by Google Forms with access to the 10 whole-slide images were released to all the practitioners in Taiwan by e-mail. After closing the program, an online posttest feedback survey was conducted. Results: A total of 302 participants joined the gynecologic test, and 291 joined the nongynecologic test. The correct interpretation rates were 81.8-93.7% in the former and 28.5-93.1% in the latter. In the posttest feedback survey, there were 63.2% of the participants reporting first-time WSI experience, and 97.9% of them said they would like to participate in a similar program again. Conclusion: Integrating a web-based WSI system and online questionnaires is an easy method to access nationwide practitioners. Participants can make interpretations using WSI even without prior experience. The model is valuable for those who want to initiate a large-scale cytopathology peer comparison educational program.

Establishment of a remote diagnostic histopathology service using whole slide imaging (digital pathology)

2020 ◽  
pp. jclinpath-2020-206762
Author(s):  
Andrew John Evans ◽  
Rajkumar Vajpeyi ◽  
Michele Henry ◽  
Runjan Chetty
Keyword(s):  
Digital Pathology ◽  
Business Case ◽  
Whole Slide Imaging ◽  
Northern Ontario ◽  
Remote Areas ◽  
Glass Slides ◽  
Viable Solution ◽  
Resource Requirements ◽  
Cost Efficient ◽  
And Training

BackgroundWhole slide imaging (WSI) has diverse applications in modern pathology practice, including providing histopathology services to remote locations.Materials and methodsUtilising an existing contractual partnership with a Northern Ontario group of hospitals, the feasibility of using WSI for primary diagnostic services from Toronto was explored by the dedicated working group. All aspects explored from information technology (IT), laboratory information system (LIS) integration, scanning needs, laboratory workflow and pathologist needs and training, were taken into account in the developing the rationale and business case.ResultsThe financial outlay for a scanner was $CA180K (approximately £105.6 k) after discounts. There were no human resource requirements as staff were reorganised to cater for slide scanning. Additional IT/LIS costs were not incurred as existing connectivity was adapted to allow two site groups (gastrointestinal and skin) to pilot this study. Scanned slides were available for pathologist review 24–96 hours sooner than glass slides; there was a 2-day improvement for final authorised cases, and per annum savings were: $CA26 000 (£15.2 k) in courier costs, $CA60 000 (£35.2 k) travel and $CA45 000 (£26.4 k) in accommodation, meals and car rental expense.ConclusionWSI is a viable solution to provide timely, high-quality and cost efficient histopathology services to underserviced, remote areas.

The Application, Challenges, and Advancement Toward Regulatory Acceptance of Digital Toxicologic Pathology: Results of the 7th ESTP International Expert Workshop (September 20-21, 2019)

2020 ◽  
pp. 019262332097584
Author(s):  
Vanessa L. Schumacher ◽  
Famke Aeffner ◽  
Erio Barale-Thomas ◽  
Catherine Botteron ◽  
Jonathan Carter ◽  
...  
Keyword(s):  
European Society ◽  
International Workshop ◽  
Digital Pathology ◽  
Remote Access ◽  
Whole Slide Imaging ◽  
International Expert ◽  
Digital Slide ◽  
Regulatory Acceptance ◽  
Expert Workshop ◽  
Whole Slide Images

With advancements in whole slide imaging technology and improved understanding of the features of pathologist workstations required for digital slide evaluation, many institutions are investigating broad digital pathology adoption. The benefits of digital pathology evaluation include remote access to study or diagnostic case materials and integration of analysis and reporting tools. Diagnosis based on whole slide images is established in human medical pathology, and the use of digital pathology in toxicologic pathology is increasing. However, there has not been broad adoption in toxicologic pathology, particularly in the context of regulatory studies, due to lack of precedence. To address this topic, as well as practical aspects, the European Society of Toxicologic Pathology coordinated an expert international workshop to assess current applications and challenges and outline a set of minimal requirements needed to gain future regulatory acceptance for the use of digital toxicologic pathology workflows in research and development, so that toxicologic pathologists can benefit from digital slide technology.

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