How closely did digital slide diagnoses match the consensus?

Details

Digital microscopy hardware and software for pathologists have advanced in recent years, and reports have supported the reliability of digital slides in routine diagnosis. The researchers designed a retrospective, comparative study to assess scanning properties and the diagnostic accuracy of digital slides.

Eight pathologists reevaluated 306 randomly selected cases from their archives. Slides were scanned with a 20× Plan-Apochromat objective and a 3-chip Hitachi camera, producing a resolution of 0.465 μm/pixel. Dedicated Data Base and Viewer software supported slide management. The pathologists evaluated slides on their office PCs, accessing them through an intranet. The researchers analyzed diagnostic agreement, uncertainty related to digital slides, and scanning quality.

Image quality was rated good to excellent in 96% of slides. Among 61 digital slides identified as critical, poor image quality was related to section folds or floatings in half. Digital diagnoses fully agreed with the consensus in 88.2% of the cases studied. Of 36 discordant cases, seven (2.3%) were graded relevant without the pathologist recording any uncertainty. After excluding cases outside each pathologist's field from their records, this ratio was 1.76% of all cases.

The authors concluded that digital-slide histopathological diagnoses can be highly consistent with diagnoses using optical microscopy and that pathologist competency is more important than digital slide quality. They also concluded that poor digital slide quality does not endanger patient safety because pathologists can recognize these errors and take corrective action.

The article's virtual slides are available at http://www.diagnosticpathology.diagnomx.eu/vs/1913324336747310.