全玻片成像数字病理学作为远程会诊平台：一项采用配对亚专科专家相关性的试点研究。
Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations.
机构信息
Department of Pathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, and the Department of Pathology, Harvard Medical School, Boston, MA 02114, USA.
出版信息
Arch Pathol Lab Med. 2009 Dec;133(12):1949-53. doi: 10.5858/133.12.1949.
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.
背景
-全切片成像技术为机构间快速的基于互联网的远程病理咨询提供了希望。在实施之前，必须充分了解技术问题、病理学家的适应性和形态学陷阱。
目的
-确定在困难的外科病理学病例中，全切片图像的解释是否与玻璃切片解释不同。
设计
-从外部实验室的各种解剖部位扫描具有诊断挑战性的病理载玻片以形成全数字格式。由 2 名亚专科病理学家独立对数字和玻璃载玻片进行诊断。比较参考、数字和玻璃载玻片的解释。收集操作人员对技术问题的意见。
结果
-分析了 53 对病例。在 45 例（85%）和 48 例（91%）病例中，数字、玻璃和参考诊断结果一致，数字和玻璃诊断结果一致。有 5 例（9%）数字病例与参考和玻璃诊断均不一致。对这些病例中的每一个进一步审查表明数字全切片解释错误。肿瘤病例的相关性更好（93%），而非肿瘤性疾病病例的相关性更差（88%）。对不一致病例的评论涉及数字全技术的问题，例如精细分辨率和在高倍放大时的导航能力。
结论
-数字全切片与标准玻璃切片解释之间的总体一致性很好，达到 91%。通过技术、病例选择和技术熟悉度的调整，应该可以提高性能，使数字全切片审查能够更广泛地应用于远程病理亚专科咨询。
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