Validation of diagnostic accuracy using digital slides in routine histopathology (original) (raw)

Abstract

Background: Robust hardware and software tools have been developed in digital microscopy during the past years for pathologists. Reports have been advocated the reliability of digital slides in routine diagnostics. We have designed a retrospective, comparative study to evaluate the scanning properties and digital slide based diagnostic accuracy.

Figures (9)

Table 2 Clinical research form

Table 2 Clinical research form

Figure 1 Results of the slide quality query. Column |. all slides, Cll: all slides of the incoherent cases, Cllll:all H&E slides, C.IV.; H&E slides of the incoherent cases, C.V.: all IHC slides, CVI. IHC slides of the incoherent cases, C.VIl.: all Giemsa slides, C.VIll.: Giemsa slides of the incoherent cases, CX. all slides with other stains, C.X.: all slides with other stains of the incoherent cases.

Figure 1 Results of the slide quality query. Column |. all slides, Cll: all slides of the incoherent cases, Cllll:all H&E slides, C.IV.; H&E slides of the incoherent cases, C.V.: all IHC slides, CVI. IHC slides of the incoherent cases, C.VIl.: all Giemsa slides, C.VIll.: Giemsa slides of the incoherent cases, CX. all slides with other stains, C.X.: all slides with other stains of the incoherent cases.

Table 3 Four types of incoherency

Table 3 Four types of incoherency

Table 4 Detailed parameters of the scanning properties of 1858 slides

Table 4 Detailed parameters of the scanning properties of 1858 slides

Figure 2 Quality of H&E slides and diagnostic confidence according to the type of incoherency.

Figure 2 Quality of H&E slides and diagnostic confidence according to the type of incoherency.

Figure 3 Incoherency, quality of H&E slides and diagnosti confidence according to the origin of the sample. |n 8,82% of the cases the consensus diagnoses were coherent with the digital diagnoses and overwrote the original OM-based diagnoses (reassessed case - straight line)

Figure 3 Incoherency, quality of H&E slides and diagnosti confidence according to the origin of the sample. |n 8,82% of the cases the consensus diagnoses were coherent with the digital diagnoses and overwrote the original OM-based diagnoses (reassessed case - straight line)

Figure 5 Correlation between the experience (in years) and the diagnostic confidence. overall = sum of all estimates. (Spearman rank R: R = -0.140, t(N-2) = -2.346, p = 0.019). Experience in years: PathA-20, PathB-25, PathC-22, PathD-24, PathE-13, PathF-15, PathG-28 incoherency-ratio of the specific samples to the overall ratio of the reassessed cases. The incoherency-ratio was below 8.82% - therefore we state that DM could be used equivalently to OM in our Institute in this set of cir- cumstance - in cases with samples from liver, lymph node, kidney, colon, and breast. In this series the results nicely correlate with the incidence of the type-IV errors and confirm our statement. Interestingly hematology cases of lymph nodes fell into this category. As the qual- ity of IHC digital slides were evaluated very good, the explanation of this observation could be the explicit importance of the IHC-profiles in haematopathology. This series of samples are specific for our institute in

Figure 5 Correlation between the experience (in years) and the diagnostic confidence. overall = sum of all estimates. (Spearman rank R: R = -0.140, t(N-2) = -2.346, p = 0.019). Experience in years: PathA-20, PathB-25, PathC-22, PathD-24, PathE-13, PathF-15, PathG-28 incoherency-ratio of the specific samples to the overall ratio of the reassessed cases. The incoherency-ratio was below 8.82% - therefore we state that DM could be used equivalently to OM in our Institute in this set of cir- cumstance - in cases with samples from liver, lymph node, kidney, colon, and breast. In this series the results nicely correlate with the incidence of the type-IV errors and confirm our statement. Interestingly hematology cases of lymph nodes fell into this category. As the qual- ity of IHC digital slides were evaluated very good, the explanation of this observation could be the explicit importance of the IHC-profiles in haematopathology. This series of samples are specific for our institute in

Figure 4 Importance of pathologists’ competence. Excluding the non-field specific cases from each pathologists’ record resulted in better coherency. No significant differences were found in the diagnostic confidence and how the pathologists rated the quality of the slides.

Figure 4 Importance of pathologists’ competence. Excluding the non-field specific cases from each pathologists’ record resulted in better coherency. No significant differences were found in the diagnostic confidence and how the pathologists rated the quality of the slides.

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  24. Cite this article as: Fónyad et al.: Validation of diagnostic accuracy using digital slides in routine histopathology. Diagnostic Pathology 2012 7:35.