Whole slide images for primary diagnostics in dermatopathology: a feasibility study

• Published in: Journal of clinical pathology Vol. 65; no. 2; pp. 152 - 158
• Main Authors: Al-Janabi, Shaimaa, Huisman, André, Vink, Aryan, Leguit, Roos J, Offerhaus, G Johan A, ten Kate, Fiebo J W, van Dijk, Marijke R, van Diest, Paul J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.02.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Biological and medical sciences; Biopsy; breast; breast cancer; breast pathology; cancer research; cell cycle regulation; colorectal cancer; comparative genomic hybridisation; dermatopathology; diagnostics; Digital archives; digital pathology; Education; FDA approval; Feasibility Studies; gastric cancer; GI neoplasms; gut pathology; Histopathology; Humans; image analysis; Image Interpretation, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Laboratories; Medical sciences; Microscopy; molecular pathology; morphometry; Observer Variation; pancreas; Pathology; Pathology, Clinical - methods; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; proliferation; Quality control; quantitation; Single-Blind Method; Skin - pathology; Skin Diseases - pathology; stomach; tumour markers; validation; Whole slide images; Anatomic pathology; Feasibility; Skin; Diagnosis; Image; Primary
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jclinpath-2011-200277

BackgroundDuring the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have not regularly been used for routine diagnosis, because of the lack of validation studies.AimTo test the validity of using WSI for primary diagnosis of skin diseases.Materials and methods100 skin biopsies and resections which had been diagnosed light microscopically one year previously were scanned at 20× magnification, and rediagnosed by six pathologists (every pathologist assessed his own cases), having the original clinical information available, but blinded to the original diagnoses. The WSI diagnoses were compared to the initial light microscopy diagnosis and classified as concordant, slightly discordant (without clinical consequences) or discordant.ResultsThe light microscopy and the WSI based diagnosis were concordant in 94% of the cases. The light microscopy and WSI diagnosis were slightly discordant in 6% of the cases. For one of the slightly discrepant cases the WSI diagnosis was considered better, while the original diagnosis was preferred for the other five cases. There were no discordant cases with clinical or prognostic implications.ConclusionPrimary histopathological diagnosis of skin biopsies and resections can be done digitally using WSI.