Virchows Archiv

, Volume 467, Issue 2, pp 137–144 | Cite as

Digital slide viewing for primary reporting in gastrointestinal pathology: a validation study

  • Maurice B. Loughrey
  • Paul J. Kelly
  • Oisin P. Houghton
  • Helen G. Coleman
  • Joseph P. Houghton
  • Anne Carson
  • Manuel Salto-Tellez
  • Peter W. Hamilton
Original Article

Abstract

Despite the increasing availability of digital slide viewing, and numerous advantages associated with its application, a lack of quality validation studies is amongst the reasons for poor uptake in routine practice. This study evaluated primary digital pathology reporting in the setting of routine subspecialist gastrointestinal pathology, commonplace in most tissue pathology laboratories and representing one of the highest volume specialties in most laboratories. Individual digital and glass slide diagnoses were compared amongst three pathologists reporting in a gastrointestinal subspecialty team, in a prospective series of 100 consecutive diagnostic cases from routine practice in a large teaching hospital laboratory. The study included a washout period of at least 6 months. Discordant diagnoses were classified, and the study evaluated against recent College of American Pathologists (CAP) recommendations for evaluating digital pathology systems for diagnostic use. The study design met all 12 of the CAP recommendations. The 100 study cases generated 300 pairs of diagnoses, comprising 100 glass slide diagnoses and 100 digital diagnoses from each of the three study pathologists. 286 of 300 pairs of diagnoses were concordant, representing intraobserver concordance of 95.3 %, broadly comparable to rates previously published in this field. In ten of the 14 discordant pairs, the glass slide diagnosis was favoured; in four cases, the digital diagnosis was favoured, but importantly, the 14 discordant intraobserver diagnoses were considered to be of minor clinical significance. Interobserver, or viewing modality independent, concordance was found in 94 of the total of 100 study cases, providing a comparable baseline discordance rate expected in any second viewing of pathology material. These overall results support the safe use of digital pathology in primary diagnostic reporting in this setting.

Keywords

Digital pathology Whole slide imaging Validation Gastrointestinal 

References

  1. 1.
    Pantanowitz L, Valenstein PN, Evans AJ, Kaplan KJ, Pfeifer JD, Wilbur DC, Collins LC, Colgan TJ (2011) Review of the current state of whole slide imaging in pathology. J Pathol Inform. doi:10.4103/2153-3539.83746 Google Scholar
  2. 2.
    Ho J, Parwani AV, Jukic DM, Yagi Y, Anthony L, Gilbertson JR (2006) Use of whole slide imaging in surgical pathology quality assurance: design and pilot validation studies. Hum Pathol 37(3):322–331PubMedCrossRefGoogle Scholar
  3. 3.
    Cornish TC, McClintock DS (2014) Medicolegal and regulatory aspects of whole slide imaging-based telepathology. Diagn Histopathol 20(12):475–481CrossRefGoogle Scholar
  4. 4.
    Friedman B (2012) Digital pathology and the FDA; WSI systems called class iii devices. http://labsoftnews.typepad.com/lab_soft_news/2012/01/digital-pathology-and-the-fda.html. Accessed 3 March 2015
  5. 5.
    FDA action lends force to digital pathology (2014). http://www.captodayonline.com/fda-action-lends-force-to-digital-pathology/. Accessed 3 March 2015
  6. 6.
    Al-Janabi S, Huisman A, Willems SM, Van Diest PJ (2012) Digital slide images for primary diagnostics in breast pathology: a feasibility study. Hum Pathol. doi:10.1016/j.humpath.2012.03.027 Google Scholar
  7. 7.
    Al-Janabi S, Huisman A, Vink A, Leguit RJ, Offerhaus GJ, Ten Kate FJ, van Dijk MR, van Diest PJ (2012) Whole slide images for primary diagnostics in dermatopathology: a feasibility study. J Clin Pathol. doi:10.1136/jclinpath-2011-200277 Google Scholar
  8. 8.
    Al-Janabi S, Huisman A, Vink A, Leguit RJ, Offerhaus GJ, ten Kate FJ, van Diest PJ (2012) Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study. Hum Pathol. doi:10.1016/j.humpath.2011.06.017 Google Scholar
  9. 9.
    Bauer TW, Schoenfield L, Slaw RJ, Yerian L, Sun Z, Henricks WH (2013) Validation of whole slide imaging for primary diagnosis in surgical pathology. Arch Pathol Lab Med. doi:10.5858/arpa.2011-0678-OA PubMedGoogle Scholar
  10. 10.
    Brick KE, Sluzevich JC, Cappel MA, DiCaudo DJ, Comfere NI, Wieland CN (2013) Comparison of virtual microscopy and glass slide microscopy among dermatology residents during a simulated in-training examination. J Cutan Pathol. doi:10.1111/cup.12189 PubMedGoogle Scholar
  11. 11.
    Camparo P, Egevad L, Algaba F, Berney DM, Boccon-Gibod L, Comperat E, Evans AJ, Grobholz R, Kristiansen G, Langner C, Lopez-Beltran A, Montironi R, Oliveira P, Vainer B, Varma M (2012) Utility of whole slide imaging and virtual microscopy in prostate pathology. APMIS. doi:10.1111/j.1600-0463.2011.02872.x PubMedGoogle Scholar
  12. 12.
    Campbell WS, Lele SM, West WW, Lazenby AJ, Smith LM, Hinrichs SH (2012) Concordance between whole-slide imaging and light microscopy for routine surgical pathology. Hum Pathol. doi:10.1016/j.humpath.2011.12.023 PubMedCentralGoogle Scholar
  13. 13.
    Gage JC, Joste N, Ronnett BM, Stoler M, Hunt WC, Schiffman M, Wheeler CM (2013) A comparison of cervical histopathology variability using whole slide digitized images versus glass slides: experience with a statewide registry. Hum Pathol. doi:10.1016/j.humpath.2013.06.015 PubMedCentralPubMedGoogle Scholar
  14. 14.
    Jukic DM, Drogowski LM, Martina J, Parwani AV (2011) Clinical examination and validation of primary diagnosis in anatomic pathology using whole slide digital images. Arch Pathol Lab Med. doi:10.1043/2009-0678-OA.1 Google Scholar
  15. 15.
    Krishnamurthy S, Mathews K, McClure S, Murray M, Gilcrease M, Albarracin C, Spinosa J, Chang B, Ho J, Holt J, Cohen A, Giri D, Garg K, Bassett RL Jr, Liang K (2013) Multi-institutional comparison of whole slide digital imaging and optical microscopy for interpretation of hematoxylin-eosin-stained breast tissue sections. Arch Pathol Lab Med. doi:10.5858/arpa.2012-0437-OA PubMedGoogle Scholar
  16. 16.
    Molnar B, Berczi L, Diczhazy C, Tagscherer A, Varga SV, Szende B, Tulassay Z (2003) Digital slide and virtual microscopy based routine and telepathology evaluation of routine gastrointestinal biopsy specimens. J Clin Pathol 56(6):433–438PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Ordi J, Castillo P, Saco A, Del Pino M, Ordi O, Rodriguez-Carunchio L, Ramirez J (2015) Validation of whole slide imaging in the primary diagnosis of gynaecological pathology in a University Hospital. J Clin Pathol. doi:10.1136/jclinpath-2014-202524 PubMedGoogle Scholar
  18. 18.
    Risio M, Bussolati G, Senore C, Vigna S, Frangipane E, Segnan N, Cassoni P (2010) Virtual microscopy for histology quality assurance of screen-detected polyps. J Clin Pathol. doi:10.1136/jcp.2010.080580 PubMedGoogle Scholar
  19. 19.
    van der Post RS, van der Laak JA, Sturm B, Clarijs R, Schaafsma HE, van Krieken JH, Nap M (2013) The evaluation of colon biopsies using virtual microscopy is reliable. Histopathology. doi:10.1111/his.12131 PubMedGoogle Scholar
  20. 20.
    Houghton JP, Ervine AJ, Kenny SL, Kelly PJ, Napier SS, McCluggage WG, Walsh MY, Hamilton PW (2014) Concordance between digital pathology and light microscopy in general surgical pathology: a pilot study of 100 cases. J Clin Pathol. doi:10.1136/jclinpath-2014-202491 Google Scholar
  21. 21.
    Pantanowitz L, Sinard JH, Henricks WH, Fatheree LA, Carter AB, Contis L, Beckwith BA, Evans AJ, Lal A, Parwani AV, College of American Pathologists Pathology and Laboratory Quality Center (2013) Validating whole slide imaging for diagnostic purposes in pathology: guideline from the College of American Pathologists Pathology and Laboratory Quality Center. Arch Pathol Lab Med. doi:10.5858/arpa.2013-0093-CP Google Scholar
  22. 22.
    Lowe A, Chlipala E, Elin J, Kawano Y, Long RE, Tillman D (2011) Validation of digital pathology in a healthcare environment. https://digitalpathologyassociation.org/_data/files/DPA-Healthcare-White-Paper--FINAL_v1.0.pdf. Accessed 3 March 2015
  23. 23.
    Sanders DS, Grabsch H, Harrison R, Bateman A, Going J, Goldin R, Mapstone N, Novelli M, Walker MM, Jankowski J, AspECT Trial Management Group, Trial Principal Investigators (2012) Comparing virtual with conventional microscopy for the consensus diagnosis of Barrett’s neoplasia in the AspECT Barrett’s chemoprevention trial pathology audit. Histopathology. doi:10.1111/j.1365-2559.2012.04288.x PubMedGoogle Scholar
  24. 24.
    Raab SS, Nakhleh RE, Ruby SG (2005) Patient safety in anatomic pathology: measuring discrepancy frequencies and causes. Arch Pathol Lab Med 129(4):459--466Google Scholar
  25. 25.
    Treanor D, Lim CH, Magee D, Bulpitt A, Quirke P (2009) Tracking with virtual slides: a tool to study diagnostic error in histopathology. Histopathology. doi:10.1111/j.1365-2559.2009.03325.x Google Scholar
  26. 26.
    Stathonikos N, Veta M, Huisman A, van Diest PJ (2013) Going fully digital: perspective of a Dutch academic pathology lab. J Pathol Inform. doi:10.4103/2153-3539.114206 PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Maurice B. Loughrey
    • 1
    • 2
  • Paul J. Kelly
    • 1
    • 2
  • Oisin P. Houghton
    • 1
  • Helen G. Coleman
    • 3
  • Joseph P. Houghton
    • 4
  • Anne Carson
    • 5
    • 6
  • Manuel Salto-Tellez
    • 1
    • 2
  • Peter W. Hamilton
    • 6
  1. 1.Department of PathologyRoyal Victoria Hospital, Belfast TrustBelfastUK
  2. 2.Northern Ireland Molecular Pathology LaboratoryQueen’s University BelfastBelfastUK
  3. 3.Centre for Public HealthQueen’s University BelfastBelfastUK
  4. 4.Centre for Medical EducationQueen’s University BelfastBelfastUK
  5. 5.Northern Ireland Biobank, Centre for Cancer Research and Cell BiologyQueen’s University BelfastBelfastUK
  6. 6.Pathology Imaging and Informatics, Centre for Cancer Research and Cell BiologyQueen’s University BelfastBelfastUK

Personalised recommendations