Journal Article
. 2009 Dec; 133(12):1949-53.
doi: 10.1043/1543-2165-133.12.1949.

Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations

David C Wilbur 1 Kalil Madi  Robert B Colvin  Lyn M Duncan  William C Faquin  Judith A Ferry  Matthew P Frosch  Stuart L Houser  Richard L Kradin  Gregory Y Lauwers  David N Louis  Eugene J Mark  Mari Mino-Kenudson  Joseph Misdraji  Gunnlauger P Nielsen  Martha B Pitman  Andrew E Rosenberg  R Neal Smith  Aliyah R Sohani  James R Stone  Rosemary H Tambouret  Chin-Lee Wu  Robert H Young  Artur Zembowicz  Wolfgang Klietmann  
Affiliations
  • PMID: 19961250
  •     14 References
  •     46 citations

Abstract

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.

Evaluation of whole slide image immunohistochemistry interpretation in challenging prostate needle biopsies.
Jeffrey L Fine, Dana M Grzybicki, +8 authors, Drazen M Jukic.
Hum Pathol, 2008 Feb 01; 39(4). PMID: 18234276
A feasibility study of virtual slides in surgical pathology in China.
Xinxia Li, Jianying Liu, +5 authors, Jiang Gu.
Hum Pathol, 2007 Sep 18; 38(12). PMID: 17868776
Introduction and evaluation of virtual microscopy in teaching veterinary cytopathology.
Jennifer A Neel, Carol B Grindem, David G Bristol.
J Vet Med Educ, 2008 Feb 22; 34(4). PMID: 18287470
Primary histologic diagnosis using automated whole slide imaging: a validation study.
John R Gilbertson, Jonhan Ho, +3 authors, Anil V Parwani.
BMC Clin Pathol, 2006 Apr 29; 6. PMID: 16643664    Free PMC article.
Use of whole slide imaging in surgical pathology quality assurance: design and pilot validation studies.
Jonhan Ho, Anil V Parwani, +3 authors, John R Gilbertson.
Hum Pathol, 2006 Apr 15; 37(3). PMID: 16613327
Digital imaging in anatomic pathology.
M J O'Brien, A V Sotnikov.
Am J Clin Pathol, 1996 Oct 01; 106(4 Suppl 1). PMID: 8853053
Review.
Factors to keep in mind when introducing virtual microscopy.
Katharina Glatz-Krieger, Udo Spornitz, +2 authors, Dieter Glatz.
Virchows Arch, 2005 Dec 20; 448(3). PMID: 16362822
Review.
An array microscope for ultrarapid virtual slide processing and telepathology. Design, fabrication, and validation study.
Ronald S Weinstein, Michael R Descour, +15 authors, Peter H Bartels.
Hum Pathol, 2005 Jan 26; 35(11). PMID: 15668886
Development and evaluation of the virtual pathology slide: a new tool in telepathology.
Sean S P Costello, Daniel J Johnston, Peter A Dervan, Daniel G O'Shea.
J Med Internet Res, 2003 Jul 15; 5(2). PMID: 12857667    Free PMC article.
Digital slide and virtual microscopy based routine and telepathology evaluation of routine gastrointestinal biopsy specimens.
B Molnar, L Berczi, +4 authors, Z Tulassay.
J Clin Pathol, 2003 Jun 05; 56(6). PMID: 12783970    Free PMC article.
Ovarian frozen section diagnosis: use of whole-slide imaging shows excellent correlation between virtual slide and original interpretations in a large series of cases.
Margaret A Fallon, David C Wilbur, Manju Prasad.
Arch Pathol Lab Med, 2010 Jul 01; 134(7). PMID: 20586631
Critical comparison of 31 commercially available digital slide systems in pathology.
Marcial García Rojo, Gloria Bueno García, +2 authors, Manuel Carbajo Vicente.
Int J Surg Pathol, 2006 Oct 17; 14(4). PMID: 17041192
Virtual microscopy for cytology proficiency testing: are we there yet?
Jimmie Stewart, Kayo Miyazaki, +3 authors, Suzanne M Selvaggi.
Cancer, 2007 Jun 21; 111(4). PMID: 17580360
Virtual slides: application in pulmonary pathology consultations.
Janina Słodkowska, Lech Chyczewski, Michał Wojciechowski.
Folia Histochem Cytobiol, 2008 Feb 26; 46(1). PMID: 18296275
Whole slide imaging for teleconsultation and clinical use.
Bryan Dangott, Anil Parwani.
J Pathol Inform, 2010 Sep 02; 1. PMID: 20805956    Free PMC article.
Development and use of a genitourinary pathology digital teaching set for trainee education.
Li Li, Bryan J Dangott, Anil V Parwani.
J Pathol Inform, 2010 Sep 02; 1. PMID: 20805961    Free PMC article.
Recent advances in standards for Collaborative Digital Anatomic Pathology.
Christel Daniel, François Macary, +4 authors, Vincenzo Della Mea.
Diagn Pathol, 2011 Apr 22; 6 Suppl 1. PMID: 21489187    Free PMC article.
Digital imaging in cytopathology.
Walid E Khalbuss, Liron Pantanowitz, Anil V Parwani.
Patholog Res Int, 2011 Jul 26; 2011. PMID: 21785680    Free PMC article.
Review of the current state of whole slide imaging in pathology.
Liron Pantanowitz, Paul N Valenstein, +5 authors, Terence J Colgan.
J Pathol Inform, 2011 Sep 03; 2. PMID: 21886892    Free PMC article.
Highly Cited.
The accuracy of dynamic predictive autofocusing for whole slide imaging.
Richard R McKay, Vipul A Baxi, Michael C Montalto.
J Pathol Inform, 2011 Oct 05; 2. PMID: 21969919    Free PMC article.
Implementation of whole slide imaging in surgical pathology: A value added approach.
Mike Isaacs, Jochen K Lennerz, +3 authors, John D Pfeifer.
J Pathol Inform, 2011 Oct 05; 2. PMID: 21969920    Free PMC article.
Telecytology: Clinical applications, current challenges, and future benefits.
Michael Thrall, Liron Pantanowitz, Walid Khalbuss.
J Pathol Inform, 2012 Jan 26; 2. PMID: 22276242    Free PMC article.
SurfaceSlide: a multitouch digital pathology platform.
Yinhai Wang, Kate E Williamson, +2 authors, Peter W Hamilton.
PLoS One, 2012 Feb 01; 7(1). PMID: 22292040    Free PMC article.
Development of multigene expression signature maps at the protein level from digitized immunohistochemistry slides.
Gregory J Metzger, Stephen C Dankbar, +3 authors, Stephen C Schmechel.
PLoS One, 2012 Mar 23; 7(3). PMID: 22438942    Free PMC article.
Compressing pathology whole-slide images using a human and model observer evaluation.
Elizabeth A Krupinski, Jeffrey P Johnson, +2 authors, Ronald S Weinstein.
J Pathol Inform, 2012 May 23; 3. PMID: 22616029    Free PMC article.
Pathology Imaging Informatics for Clinical Practice and Investigative and Translational Research.
Evita T Sadimin, David J Foran.
N Am J Med Sci (Boston), 2012 Aug 03; 5(2). PMID: 22855694    Free PMC article.
Diagnosis of dysplasia in upper gastro-intestinal tract biopsies through digital microscopy.
Dorina Gui, Galen Cortina, +4 authors, Sarah Dry.
J Pathol Inform, 2012 Oct 02; 3. PMID: 23024886    Free PMC article.
Application of whole slide image markup and annotation for pathologist knowledge capture.
Walter S Campbell, Kirk W Foster, Steven H Hinrichs.
J Pathol Inform, 2013 Apr 20; 4. PMID: 23599902    Free PMC article.
Needs and workflow assessment prior to implementation of a digital pathology infrastructure for the US Air Force Medical Service.
Jonhan Ho, Orly Aridor, +10 authors, Anil V Parwani.
J Pathol Inform, 2014 Jan 07; 4. PMID: 24392246    Free PMC article.
Optimal z-axis scanning parameters for gynecologic cytology specimens.
Amber D Donnelly, Maheswari S Mukherjee, +8 authors, Stanley J Radio.
J Pathol Inform, 2014 Feb 14; 4. PMID: 24524004    Free PMC article.
Histological quantitation of brain injury using whole slide imaging: a pilot validation study in mice.
Zhenzhou Chen, Dmitriy Shin, +8 authors, Zezong Gu.
PLoS One, 2014 Mar 19; 9(3). PMID: 24637518    Free PMC article.
Mapping stain distribution in pathology slides using whole slide imaging.
Fang-Cheng Yeh, Qing Ye, +3 authors, Chien Ho.
J Pathol Inform, 2014 Mar 29; 5(1). PMID: 24672736    Free PMC article.
Color standardization in whole slide imaging using a color calibration slide.
Pinky A Bautista, Noriaki Hashimoto, Yukako Yagi.
J Pathol Inform, 2014 Mar 29; 5(1). PMID: 24672739    Free PMC article.
Digitized whole slides for breast pathology interpretation: current practices and perceptions.
Tracy Onega, Donald Weaver, +8 authors, Joann G Elmore.
J Digit Imaging, 2014 Apr 01; 27(5). PMID: 24682769    Free PMC article.
Intra-observer reproducibility of whole slide imaging for the primary diagnosis of breast needle biopsies.
Carolina Reyes, Offiong F Ikpatt, Mehrdad Nadji, Richard J Cote.
J Pathol Inform, 2014 Apr 18; 5(1). PMID: 24741464    Free PMC article.
Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013.
Sten Thorstenson, Jesper Molin, Claes Lundström.
J Pathol Inform, 2014 May 21; 5(1). PMID: 24843825    Free PMC article.
Carnegie Mellon University bioimaging day 2014: Challenges and opportunities in digital pathology.
Gustavo K Rohde, John A Ozolek, Anil V Parwani, Liron Pantanowitz.
J Pathol Inform, 2014 Sep 25; 5(1). PMID: 25250190    Free PMC article.
Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.
Jonhan Ho, Stefan M Ahlers, +6 authors, Anil V Parwani.
J Pathol Inform, 2014 Sep 25; 5(1). PMID: 25250191    Free PMC article.
Digital Pathology: Data-Intensive Frontier in Medical Imaging: Health-information sharing, specifically of digital pathology, is the subject of this paper which discusses how sharing the rich images in pathology can stretch the capabilities of all otherwise well-practiced disciplines.
Lee A D Cooper, Alexis B Carter, +10 authors, Joel H Saltz.
Proc IEEE Inst Electr Electron Eng, 2012 Apr 01; 100(4). PMID: 25328166    Free PMC article.
American Telemedicine Association clinical guidelines for telepathology.
Liron Pantanowitz, Kim Dickinson, +12 authors, Jordana Bernard.
J Pathol Inform, 2014 Nov 08; 5(1). PMID: 25379345    Free PMC article.
Web-based oil immersion whole slide imaging increases efficiency and clinical team satisfaction in hematopathology tumor board.
Zhongchuan Will Chen, Jessica Kohan, +2 authors, Mohamed E Salama.
J Pathol Inform, 2014 Nov 08; 5(1). PMID: 25379347    Free PMC article.
A nationwide telepathology consultation and quality control program in China: implementation and result analysis.
Je Chen, Yahui Jiao, +3 authors, Chen Zhou.
Diagn Pathol, 2015 Jan 08; 9 Suppl 1. PMID: 25565398    Free PMC article.
Automated tumor analysis for molecular profiling in lung cancer.
Peter W Hamilton, Yinhai Wang, +12 authors, Manuel Salto-Tellez.
Oncotarget, 2015 Sep 01; 6(29). PMID: 26317646    Free PMC article.
Validation of whole slide imaging for frozen section diagnosis in surgical pathology.
Thomas W Bauer, Renee J Slaw, Jesse K McKenney, Deepa T Patil.
J Pathol Inform, 2015 Oct 03; 6. PMID: 26430537    Free PMC article.
International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China.
Chengquan Zhao, Tao Wu, +13 authors, Liron Pantanowitz.
J Pathol Inform, 2016 Jan 06; 6. PMID: 26730353    Free PMC article.
The Empirical Foundations of Telepathology: Evidence of Feasibility and Intermediate Effects.
Rashid L Bashshur, Elizabeth A Krupinski, +2 authors, Noura Bashshur.
Telemed J E Health, 2017 Feb 09; 23(3). PMID: 28170313    Free PMC article.
Review.
Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study).
Sanjay Mukhopadhyay, Michael D Feldman, +31 authors, Clive R Taylor.
Am J Surg Pathol, 2017 Sep 30; 42(1). PMID: 28961557    Free PMC article.
Diagnostic Accuracy of Virtual Pathology vs Traditional Microscopy in a Large Dermatopathology Study.
Michael N Kent, Thomas G Olsen, +10 authors, Michael A Bottomley.
JAMA Dermatol, 2017 Oct 20; 153(12). PMID: 29049424    Free PMC article.
Validation of digital microscopy in the histopathological diagnoses of oral diseases.
Anna Luíza Damaceno Araújo, Gleyson Kleber Amaral-Silva, +6 authors, Alan Roger Santos-Silva.
Virchows Arch, 2018 Jun 03; 473(3). PMID: 29858684
Convolutional neural networks for whole slide image superresolution.
Lopamudra Mukherjee, Adib Keikhosravi, Dat Bui, Kevin W Eliceiri.
Biomed Opt Express, 2018 Nov 22; 9(11). PMID: 30460134    Free PMC article.
The California Telepathology Service: UCLA's Experience in Deploying a Regional Digital Pathology Subspecialty Consultation Network.
Thomas Chong, M Fernando Palma-Diaz, +10 authors, W Dean Wallace.
J Pathol Inform, 2019 Oct 18; 10. PMID: 31620310    Free PMC article.
Clinical Application of a Real-Time Telepathology System for Frozen Section Diagnosis in Comparison With Optical Microscope.
Yu Ting Huang, Salvatore Lorenzo Renne, +5 authors, Luca Di Tommaso.
Front Med (Lausanne), 2019 Oct 23; 6. PMID: 31637244    Free PMC article.
Super-resolution recurrent convolutional neural networks for learning with multi-resolution whole slide images.
Lopamudra Mukherjee, Huu Dat Bui, +2 authors, Kevin Eliceiri.
J Biomed Opt, 2019 Dec 15; 24(12). PMID: 31837128    Free PMC article.
Precise Identification of Cell and Tissue Features Important for Histopathologic Diagnosis by a Whole Slide Imaging System.
Thomas W Bauer, Cynthia Behling, +6 authors, Jinsong Qiu.
J Pathol Inform, 2020 Mar 11; 11. PMID: 32154040    Free PMC article.
Validating whole slide imaging for diagnostic purposes in pathology: guideline from the College of American Pathologists Pathology and Laboratory Quality Center.
Liron Pantanowitz, John H Sinard, +8 authors, College of American Pathologists Pathology and Laboratory Quality Center.
Arch Pathol Lab Med, 2013 May 03; 137(12). PMID: 23634907    Free PMC article.
Highly Cited. Review.
Validation of a digital pathology system including remote review during the COVID-19 pandemic.
Matthew G Hanna, Victor E Reuter, +21 authors, Meera Hameed.
Mod Pathol, 2020 Jun 24; 33(11). PMID: 32572154    Free PMC article.
Whole Slide Imaging (WSI) in Pathology: Current Perspectives and Future Directions.
Neeta Kumar, Ruchika Gupta, Sanjay Gupta.
J Digit Imaging, 2020 May 30; 33(4). PMID: 32468487    Free PMC article.
Review.
Remote Reporting from Home for Primary Diagnosis in Surgical Pathology: A Tertiary Oncology Center Experience during the COVID-19 Pandemic.
Vidya Rao, Rajiv Kumar, +17 authors, Sangeeta Desai.
J Pathol Inform, 2021 May 21; 12. PMID: 34012707    Free PMC article.
Verification and Validation of Digital Pathology (Whole Slide Imaging) for Primary Histopathological Diagnosis: All Wales Experience.
M Babawale, A Gunavardhan, +24 authors, Muhammad Aslam.
J Pathol Inform, 2021 May 21; 12. PMID: 34012708    Free PMC article.
Integrated digital pathology at scale: A solution for clinical diagnostics and cancer research at a large academic medical center.
Peter J Schüffler, Luke Geneslaw, +29 authors, Thomas J Fuchs.
J Am Med Inform Assoc, 2021 Jul 15; 28(9). PMID: 34260720    Free PMC article.