Systematic Review
. 2017 May; 141(12):1712-1718.
doi: 10.5858/arpa.2016-0494-OA.

A Systematic Analysis of Discordant Diagnoses in Digital Pathology Compared With Light Microscopy

Bethany J Williams  Philip DaCosta  Edward Goacher  Darren Treanor  
  • PMID: 28467215
  •     18 citations

Abstract

Context: - Relatively little is known about the significance and potential impact of glass-digital discordances, and this is likely to be of importance when considering digital pathology adoption.

Objective: - To apply evidence-based medicine to collect and analyze reported instances of glass-digital discordance from the whole slide imaging validation literature.

Design: - We used our prior systematic review protocol to identify studies assessing the concordance of light microscopy and whole slide imaging between 1999 and 2015. Data were extracted and analyzed by a team of histopathologists to classify the type, significance, and potential root cause of discordances.

Results: - Twenty-three studies were included, yielding 8069 instances of a glass diagnosis being compared with a digital diagnosis. From these 8069 comparisons, 335 instances of discordance (4%) were reported, in which glass was the preferred diagnostic medium in 286 (85%), and digital in 44 (13%), with no consensus in 5 (2%). Twenty-eight discordances had the potential to cause moderate/severe patient harm. Of these, glass was the preferred diagnostic medium for 26 (93%). Of the 335 discordances, 109 (32%) involved the diagnosis or grading of dysplasia. For these cases, glass was the preferred diagnostic medium in 101 cases (93%), suggesting that diagnosis and grading of dysplasia may be a potential pitfall of digital diagnosis. In 32 of 335 cases (10%), discordance on digital was attributed to the inability to find a small diagnostic/prognostic object.

Conclusions: - Systematic analysis of concordance studies reveals specific areas that may be problematic on whole slide imaging. It is important that pathologists are aware of these areas to ensure patient safety.

Development of a Whole Slide Imaging System on Smartphones and Evaluation With Frozen Section Samples.
Hong Yu, Feng Gao, Liren Jiang, Shuoxin Ma.
JMIR Mhealth Uhealth, 2017 Sep 17; 5(9). PMID: 28916508    Free PMC article.
Digital pathology access and usage in the UK: results from a national survey on behalf of the National Cancer Research Institute's CM-Path initiative.
Bethany Jill Williams, Jessica Lee, Karin A Oien, Darren Treanor.
J Clin Pathol, 2018 Jan 11; 71(5). PMID: 29317516    Free PMC article.
Commentary: Whole-slide Images - Good Enough for Primary Diagnosis?
Thomas W Bauer.
J Pathol Inform, 2018 Mar 14; 9. PMID: 29531848    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.
Review.
Artificial intelligence in digital breast pathology: Techniques and applications.
Asmaa Ibrahim, Paul Gamble, +4 authors, Emad A Rakha.
Breast, 2020 Jan 15; 49. PMID: 31935669    Free PMC article.
Review.
The Importance of eSlide Macro Images for Primary Diagnosis with Whole Slide Imaging.
Filippo Fraggetta, Yukako Yagi, +6 authors, Liron Pantanowitz.
J Pathol Inform, 2019 Jan 22; 9. PMID: 30662792    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.
Review.
The Landscape of Digital Pathology in Transplantation: From the Beginning to the Virtual E-Slide.
Ilaria Girolami, Anil Parwani, +8 authors, Albino Eccher.
J Pathol Inform, 2019 Aug 02; 10. PMID: 31367473    Free PMC article.
Review.
Whole-Slide Imaging Allows Pathologists to Work Remotely in Regions with Severe Logistical Constraints Due to Covid-19 Pandemic.
Daniel S Liscia, Donata Bellis, +3 authors, Umberto Dianzani.
J Pathol Inform, 2020 Oct 13; 11. PMID: 33042599    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.
Review.
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.
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.
Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study.
Simone Giaretto, Salvatore Lorenzo Renne, +19 authors, Luca Di Tommaso.
J Med Internet Res, 2021 Jan 28; 23(2). PMID: 33503002    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.
Discrepancies in digital hematopathology diagnoses for consultation and expert panel analysis.
Michiel van den Brand, Peet T G A Nooijen, +6 authors, Konnie M Hebeda.
Virchows Arch, 2020 Aug 26; 478(3). PMID: 32840673    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.
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.
Selection of Representative Histologic Slides in Interobserver Reproducibility Studies: Insights from Expert Review for Ovarian Carcinoma Subtype Classification.
Marios A Gavrielides, Brigitte M Ronnett, +2 authors, Jeffrey D Seidman.
J Pathol Inform, 2021 May 21; 12. PMID: 34012719    Free PMC article.