Abstract
BackgroundRobust hardware and software tools have been developed in digital microscopy during the past years for pathologists. Reports have been advocated the reliability of digital slides in routine diagnostics. We have designed a retrospective, comparative study to evaluate the scanning properties and digital slide based diagnostic accuracy.Methods8 pathologists reevaluated 306 randomly selected cases from our archives. The slides were scanned with a 20× Plan-Apochromat objective, using a 3-chip Hitachi camera, resulting 0.465 μm/pixel resolution. Slide management was supported with dedicated Data Base and Viewer software tools. Pathologists used their office PCs for evaluation and reached the digital slides via intranet connection. The diagnostic coherency and uncertainty related to digital slides and scanning quality were analyzed.ResultsGood to excellent image quality of slides was recorded in 96%. In half of the critical 61 digital slides, poor image quality was related to section folds or floatings. In 88.2% of the studied cases the digital diagnoses were in full agreement with the consensus. Out of the overall 36 incoherent cases, 7 (2.3%) were graded relevant without any recorded uncertainty by the pathologist. Excluding the non-field specific cases from each pathologist's record this ratio was 1.76% of all cases.ConclusionsOur results revealed that: 1) digital slide based histopathological diagnoses can be highly coherent with those using optical microscopy; 2) the competency of pathologists is a factor more important than the quality of digital slide; 3) poor digital slide quality do not endanger patient safety as these errors are recognizable by the pathologist and further actions for correction could be taken.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1913324336747310.
Highlights
Using still digital images in pathology for various purposes became increasingly popular and become essential as an easy way to archive and share medical information
This is an obvious paradox condition that we trust the quality of DS for quality control (QC) of optical slides (OS), but we are still reluctant to accept DS equivalently for the routine pathology practice
Out of the 1858 scanned slides 1621 were evaluated by the pathologists for digital diagnose, the remaining slides were not asked
Summary
Using still digital images in pathology for various purposes became increasingly popular and become essential as an easy way to archive and share medical information. The first telepathology networks to provide pathological diagnosis and consultation to remote sites used still images as well [1] In science where the regulations are not as strict as in health care, the success of DS is unquestionable and offers additional benefits (e.g. the core finding on a TMA digital slide is easier, while on a FISH-TMA slide is impossible without fluorescens-scanning of the whole slide) [10]. We have designed a retrospective, comparative study to evaluate the scanning properties and digital slide based diagnostic accuracy
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