Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA.
Hum Pathol. 2013 May;44(5):888-94. doi: 10.1016/j.humpath.2012.08.015. Epub 2012 Nov 28.
The use of digital whole slide images (WSI) in the field of pathology has become feasible for routine diagnostic purposes and has become more prevalent in recent years. This type of technology offers many advantages but must show the same degree of diagnostic reliability as conventional glass slides. Several studies have examined this issue in various settings and indicate that WSI are a reliable method for diagnostic pathology. Since transplant pathology is a highly specialized field that requires not only accurate but rapid diagnostic evaluation of biopsy materials, this field may greatly benefit from the use of WSI. In this study, we assessed the reliability of using WSI compared to conventional glass slides in renal allograft biopsies. We examined morphologic features and diagnostic categories defined by the Banff 07 Classification of Renal Allograft Pathology as well as additional morphologic features not included in this classification scheme. We found that intraobserver scores, when comparing the use of glass slides versus WSI, showed substantial agreement for both morphologic features (κ = 0.68) and acute rejection diagnostic categories (κ = 0.74). Furthermore, interobserver reliability was comparable for morphologic features (κ = 0.44 [glass] vs 0.42 [WSI]) and acute rejection diagnostic categories (κ = 0.49 [glass] vs 0.51 [WSI]). These data indicate that WSI are as reliable as glass slides for the evaluation of renal allograft biopsies.
数字全玻片图像（WSI）在病理学领域的应用已经成为常规诊断目的的可行方法，近年来越来越普及。这种技术有许多优点，但必须表现出与传统玻璃载玻片相同的诊断可靠性。许多研究已经在不同的环境中研究了这个问题，并表明 WSI 是一种可靠的诊断病理学方法。由于移植病理学是一个高度专业化的领域，不仅需要对活检材料进行准确的，而且需要快速的诊断评估，因此该领域可能会极大地受益于 WSI 的使用。在这项研究中，我们评估了与传统玻璃载玻片相比，在肾移植活检中使用 WSI 的可靠性。我们检查了形态特征和 Banff 07 分类定义的诊断类别肾移植病理学以及该分类方案中未包括的其他形态特征。我们发现，在比较使用玻璃载玻片与 WSI 时，观察者内评分在形态特征（κ = 0.68）和急性排斥诊断类别（κ = 0.74）方面均显示出实质性一致性。此外，形态特征的观察者间可靠性相当（κ = 0.44 [玻璃]与 0.42 [WSI]）和急性排斥诊断类别（κ = 0.49 [玻璃]与 0.51 [WSI]）。这些数据表明，WSI 与玻璃载玻片一样可靠，可用于评估肾移植活检。
