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Abstract
By imaging large numbers of slides automatically at high resolution, modem automated
whole slide imaging (WSI) systems have the potential to become useful tools in pathology
practice. This article describes a pilot validation study for use of automated high-speed
WSI systems for surgical pathology quality assurance (QA). This was a retrospective
comparative study in which 24 full genitourinary cases (including 47 surgical parts
and 391 slides) were independently reviewed with traditional microscopy and whole
slide digital images. Approximately half the cases had neoplasia in the diagnostic
line. At the end of the study, diagnostic discrepancies were evaluated by a pathology
consensus committee. The study pathologists felt that the traditional and WSI methods
were comparable for case review. They reported no difference in perceived case complexity
or diagnostic confidence between the methods. There were 4 clinically insignificant
discrepancies with the signed-out cases: 2 from glass slide and 2 with WSI review.
Of the 2 discrepancies reported by the WSI method, the committee agreed with the reviewer
once and the original report once. At the end of the study, the participants agreed
that automated WSI is a viable potential modality for surgical pathology QA, especially
in multifacility health systems that would like to establish interfacility QA. The
participants felt that major issues limiting the implementation of WSI-based QA did
not involve image acquisition or quality but rather image management issues such as
the pathologist's interface, the hospital's network, and integration with the laboratory
information system.