Histopathology, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK.
Histopathology. 2011 Oct;59(4):703-9. doi: 10.1111/j.1365-2559.2011.03987.x.
To evaluate the use of virtual images as an alternative to glass slides to expand the number of participants in the External Quality Assurance Scheme for prostatic biopsies.
Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10) and a lesser degree of agreement (n = 10). Whole slide virtual images were circulated to 68 pathologists; 51 responses were returned. The levels of agreement for the primary diagnosis and for Gleason grading of cancers were analysed using kappa statistics. Responses for glass slides versus images were compared for the 24 pathologists for whom data were available. Levels of agreement for diagnostic categories using virtual slides were moderate to substantial, comparable to those found using glass slides. The level of agreement for Gleason grades 8-10 was substantial, but for lower grades was fair or moderate, poorer than for the glass slide circulation.
Circulation of virtual images of biopsy material is a suitable alternative to glass slide-based schemes for the evaluation of diagnostic consistency. The majority of participants agreed that the ability to evaluate limited diagnostic material outweighed the disadvantages of a virtual system.
评估虚拟图像作为替代玻璃载玻片的方法，以扩大前列腺活检外部质量保证计划的参与者数量。
选择良性和肿瘤病例作为玻璃载玻片的循环，包括具有高度一致性（n=10）和较低一致性的病例（n=10）。全幻灯片虚拟图像被分发给 68 位病理学家；51 位病理学家做出了回应。使用kappa 统计分析了主要诊断和癌症 Gleason 分级的一致性水平。对于有可用数据的 24 位病理学家，比较了玻璃载玻片和图像的回应。使用虚拟幻灯片的诊断类别具有中度到高度的一致性，与使用玻璃载玻片的结果相当。Gleason 分级 8-10 的一致性水平较高，但较低的分级则是公平或中度，不如玻璃载玻片循环的结果好。
循环使用活检材料的虚拟图像是评估诊断一致性的玻璃载玻片方案的一种合适替代方法。大多数参与者认为评估有限的诊断材料的能力超过了虚拟系统的缺点。
