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

机译:全幻灯片成像数字病理学作为远程会诊的平台:使用成对的亚专业相关性的初步研究

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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.
机译:上下文:-整体幻灯片成像技术为机构之间基于Internet的快速病理咨询提供了希望。在实施之前,必须很好地描述技术问题,病理学家的适应性和形态缺陷。目的:-确定在困难的手术病理情况下,对全玻片图像的解释是否与对玻片的解释不同。设计:-将来自外部实验室各种解剖部位的具有诊断挑战性的病理幻灯片扫描为全数字格式。数字和载玻片由两名专科病理学家独立诊断。比较了参考,数字和幻灯片的解释。收集了操作员对技术问题的评论。结果:-对53个案例进行了分析。数字,玻璃和参考诊断在45例(85%)之间,数字和玻璃诊断在48(91%)例之间存在共识。有5例数字病例(9%)与参考诊断和玻璃镜诊断不一致。对这些情况中的每一个进行的进一步审查表明,错误的数字全幻灯片解释。与非肿瘤疾病病例(88%)相比,肿瘤病例显示出更好的相关性(93%)。关于与数字整体技术有关的不协调案件的评论集中在诸如高分辨率和高倍率导航能力等问题上。结论:-数字全幻灯片和标准玻片解释之间的总体一致性为91%。技术,案例选择和技术熟悉程度的调整应提高性能,使数字化全幻灯片复查对于更广泛的远程病理亚专业咨询应用程序而言是可行的。

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    《Archives of Pathology & Laboratory Medicine》 |2009年第12期|p.1949-1953|共5页
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    David C. Wilbur, MD, Kalil Madi, MD, Robert B. Colvin, MD, Lyn M. Duncan, MD, William C. Faquin, MD, PhD, Judith A. Ferry, MD, Matthew P. Frosch, MD, PhD, Stuart L. Houser, MD, Richard L. Kradin, MD, Gregory Y. Lauwers, MD, David N. Louis, MD, Eugene J. Mark, MD, Mari Mino-Kenudson, MD, Joseph Misdraji, MD, Gunnlauger P. Nielsen, MD, Martha B. Pitman, MD, Andrew E. Rosenberg, MD, R. Neal Smith, MD, PhD, Aliyah R. Sohani, MD, James R. Stone, MD, PhD, Rosemary H. Tambouret, MD, Chin-Lee Wu, MD, PhD, Robert H. Young, MD, Artur Zembowicz, MD, Wolfgang Klietmann, MDAccepted for publication March 5, 2009.From the Department of Pathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, and the Department of Pathology, Harvard Medical School, Boston (Drs Wilbur, Colvin, Duncan, Faquin, Ferry, Frosch, Houser, Kradin, Lauwers, Louis, Mark, Mino-Kenudson, Misdraji, Nielsen, Pitman, Rosenberg, Smith, Sohani, Stone, Tambouret, Wu, Young, and Zembowicz), the Department of Pathology, University Federal de Rio de Janeiro, Rio de Janeiro, Brazil (Dr Madi), and Corista LLC, Concord, Massachusetts (Dr Klietmann). Dr Klietmann is now with the Department of Pathology, Harvard Medical School.The authors have no relevant financial interest in the products or companies described in this article.Presented in part at the 97th Annual Meeting of the United States and Canadian International Academy of Pathology, Denver, Colorado, March 1-7, 2008.Reprints: David C. Wilbur, MD, Department of Pathology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 (e-mail: dwilbur@partners.org).,;

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