Journal Article
. 2011 Sep; 43(5):702-7.
doi: 10.1016/j.humpath.2011.06.017.

Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study

Shaimaa Al-Janabi 1 André Huisman  Aryan Vink  Roos J Leguit  G Johan A Offerhaus  Fiebo J W ten Kate  Paul J van Diest  
  • PMID: 21937077
  •     31 citations


During the last decade, whole slide images have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation, and quality assurance testing. However, whole slide images have as yet not much been used for up-front diagnostics because of the lack of validation studies. The aim of this study was, therefore, to test the feasibility of whole slide images for diagnosis of gastrointestinal tract specimens, one of the largest areas of diagnostic pathology. One hundred gastrointestinal tract biopsies and resections that had been diagnosed using light microscopy 1 year before were rediagnosed on whole slide images scanned at ×20 magnification by 5 pathologists (all reassessing their own cases), having the original clinical information available but blinded to their original light microscopy diagnoses. The original light microscopy and whole slide image-based diagnoses were compared and classified as concordant, slightly discordant (without clinical consequences), and discordant. The diagnoses based on light microscopy and the whole slide image-based rediagnoses were concordant in 95% of the cases. Light microscopy and whole slide image diagnosis in the remaining 5% of cases were slightly discordant, none of these were with clinical or prognostic implications. Up-front histopathologic diagnosis of gastrointestinal biopsies and resections can be done on whole slide images.

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.
Going fully digital: Perspective of a Dutch academic pathology lab.
Nikolas Stathonikos, Mitko Veta, André Huisman, Paul J van Diest.
J Pathol Inform, 2013 Jul 17; 4. PMID: 23858390    Free PMC article.
Evaluation of mitotic activity index in breast cancer using whole slide digital images.
Shaimaa Al-Janabi, Henk-Jan van Slooten, +3 authors, Mehdi Jiwa.
PLoS One, 2014 Jan 05; 8(12). PMID: 24386102    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.
Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis.
Tai-Hua Yang, Hsin-Chen Chen, +8 authors, Fong-Chin Su.
Biomed Eng Online, 2014 Jul 25; 13. PMID: 25055721    Free PMC article.
Whole slide images for primary diagnostics of urinary system pathology: a feasibility study.
Shaimaa Al-Janabi, André Huisman, +3 authors, Paul J van Diest.
J Renal Inj Prev, 2015 Jan 23; 3(4). PMID: 25610886    Free PMC article.
A comparative study of input devices for digital slide navigation.
Jesper Molin, Claes Lundström, Morten Fjeld.
J Pathol Inform, 2015 Mar 17; 6. PMID: 25774318    Free PMC article.
Digital slide viewing for primary reporting in gastrointestinal pathology: a validation study.
Maurice B Loughrey, Paul J Kelly, +5 authors, Peter W Hamilton.
Virchows Arch, 2015 May 20; 467(2). PMID: 25982098
Nanoscale refractive index fluctuations detected via sparse spectral microscopy.
John E Chandler, Lusik Cherkezyan, Hariharan Subramanian, Vadim Backman.
Biomed Opt Express, 2016 May 28; 7(3). PMID: 27231596    Free PMC article.
Interobserver Agreement Using Histological Scoring of the Canine Liver.
J A Lidbury, A Rodrigues Hoffmann, +7 authors, J M Steiner.
J Vet Intern Med, 2017 Mar 16; 31(3). PMID: 28295598    Free PMC article.
Digital pathology in nephrology clinical trials, research, and pathology practice.
Laura Barisoni, Jeffrey B Hodgin.
Curr Opin Nephrol Hypertens, 2017 Sep 01; 26(6). PMID: 28858910    Free PMC article.
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.
Being fully digital: perspective of a Dutch academic pathology laboratory.
Nikolas Stathonikos, Tri Q Nguyen, +2 authors, Paul J van Diest.
Histopathology, 2019 Jul 14; 75(5). PMID: 31301690    Free PMC article.
Whole slide imaging compared with light microscopy for primary diagnosis in surgical neuropathology: a validation study.
Ali Alassiri, Amna Almutrafi, +5 authors, Walid Khalbuss.
Ann Saudi Med, 2020 Feb 07; 40(1). PMID: 32026707    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.
Density and size of lymphoid follicles are useful clues in differentiating primary intestinal follicular lymphoma from intestinal reactive lymphoid hyperplasia.
Hsin-Ni Li, Ren Ching Wang, +2 authors, Shih-Sung Chuang.
Diagn Pathol, 2020 Jul 09; 15(1). PMID: 32635930    Free PMC article.
Twenty Years of Digital Pathology: An Overview of the Road Travelled, What is on the Horizon, and the Emergence of Vendor-Neutral Archives.
Liron Pantanowitz, Ashish Sharma, +3 authors, Joel Saltz.
J Pathol Inform, 2019 Jan 05; 9. PMID: 30607307    Free PMC article.
Agreement in Histological Assessment of Mitotic Activity Between Microscopy and Digital Whole Slide Images Informs Conversion for Clinical Diagnosis.
Bih-Rong Wei, Charles H Halsey, +21 authors, R Mark Simpson.
Acad Pathol, 2019 Jul 20; 6. PMID: 31321298    Free PMC article.
Head-tracking as an interface device for image control in digital pathology: a comparative study.
Eduardo Alcaraz-Mateos, Iva Turic, +2 authors, Enrique Poblet.
Rev Esp Patol, 2020 Oct 06; 53(4). PMID: 33012490    Free PMC article.
Digital pathology in the time of corona.
Nikolas Stathonikos, Nadege C van Varsseveld, +7 authors, Paul J van Diest.
J Clin Pathol, 2020 Jul 24; 73(11). PMID: 32699117    Free PMC article.
Recommendations for pathologic practice using digital pathology: consensus report of the Korean Society of Pathologists.
Yosep Chong, Dae Cheol Kim, +5 authors, Medical Informatics Study Group of the Korean Society of Pathologists.
J Pathol Transl Med, 2020 Oct 08; 54(6). PMID: 33027850    Free PMC article.
The performance of digital microscopy for primary diagnosis in human pathology: a systematic review.
Anna Luíza Damaceno Araújo, Lady Paola Aristizábal Arboleda, +13 authors, Alan Roger Santos-Silva.
Virchows Arch, 2019 Jan 28; 474(3). PMID: 30685784
Systematic Review.
Regional registration of whole slide image stacks containing major histological artifacts.
Mahsa Paknezhad, Sheng Yang Michael Loh, +11 authors, Hwee Kuan Lee.
BMC Bioinformatics, 2020 Dec 06; 21(1). PMID: 33276732    Free PMC article.
Comparison of the whole slide imaging and conventional light microscopy in the grading of oral epithelial dysplasia: a multi-institutional study.
P-B Diniz, M Sena-Filho, +4 authors, J Jorge.
Med Oral Patol Oral Cir Bucal, 2020 Nov 29; 26(1). PMID: 33247580    Free PMC article.
Rapid Validation of Whole-Slide Imaging for Primary Histopathology Diagnosis.
Megan I Samuelson, Stephanie J Chen, +5 authors, Anand Rajan K D.
Am J Clin Pathol, 2021 Jan 30; 155(5). PMID: 33511392    Free PMC article.
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.
State of machine and deep learning in histopathological applications in digestive diseases.
Soma Kobayashi, Joel H Saltz, Vincent W Yang.
World J Gastroenterol, 2021 Jun 08; 27(20). PMID: 34092975    Free PMC article.
Diagnostic Pitfalls of Digital Microscopy Versus Light Microscopy in Gastrointestinal Pathology: A Systematic Review.
Wangpan Shi, Petros Georgiou, +6 authors, Safeera Khan.
Cureus, 2021 Sep 23; 13(8). PMID: 34548958    Free PMC article.