University of Nebraska Medical Center, Department of Pathology and Microbiology, Omaha, NE 68198-5900.
University of Nebraska Medical Center, Department of Pathology and Microbiology, Omaha, NE 68198-5900.
Hum Pathol. 2014 Aug;45(8):1713-21. doi: 10.1016/j.humpath.2014.04.007. Epub 2014 Apr 24.
This study investigated the diagnostic accuracy of whole slide imaging (WSI) in breast needle biopsy diagnosis in comparison with standard light microscopy (LM). The study examined the effects of image capture magnification and computer monitor quality on diagnostic concordance of WSI and LM. Four pathologists rendered diagnoses using WSI to examine 85 breast biopsies (92 parts; 786 slides) consisting of benign and malignant cases. Each WSI case was evaluated using images captured at either ×20 or ×40 magnifications and viewed using a Digital Imaging and Communication in Medicine (DICOM) grade, color-calibrated monitor or a standard, desktop liquid-crystal display (LCD) monitor. For each combination, the WSI result was compared with the original, LM diagnosis. The overall concordance rate observed between WSI and LM was 97.1% (95% confidence intervals [CI]: 94.3%-98.5%). After a washout period, all cases were reviewed a second time by each pathologist after using LM, and the second LM diagnosis was compared with the WSI diagnosis rendered by the same pathologist. Intraobserver concordance between WSI and LM was 95.4% (95% CI: 92.2%-97.4%). The second LM diagnoses were also compared with the original LM diagnoses, and the observed interobserver LM concordance rate was 97.3% (95% CI: 93.1%-99.0%). The study data demonstrated that breast needle biopsy diagnoses rendered by WSI were equivalent to diagnoses rendered by LM. No diagnostic differences were detected between the underlying viewing system parameters of monitor quality and image capture resolution. The results of this study demonstrated that WSI can be effectively used in subspecialty diagnostic cases where a minimum amount of tissue is available.
本研究调查了全玻片成像（WSI）与标准光学显微镜（LM）在乳腺针吸活检诊断中的诊断准确性。研究考察了图像采集放大倍数和计算机显示器质量对 WSI 和 LM 诊断一致性的影响。四位病理学家使用 WSI 检查了 85 例乳腺活检（92 个部位；786 张切片），包括良性和恶性病例。每个 WSI 病例均使用×20 或×40 放大倍数捕获的图像进行评估，并使用符合数字成像和通信医学（DICOM）标准的彩色校准显示器或标准的桌面液晶显示器（LCD）进行查看。对于每种组合，将 WSI 结果与原始的 LM 诊断进行比较。WSI 与 LM 之间观察到的总体一致性率为 97.1%（95%置信区间[CI]：94.3%-98.5%）。在洗脱期后，所有病例均由每位病理学家使用 LM 进行第二次审阅，然后将第二次 LM 诊断与同一病理学家做出的 WSI 诊断进行比较。WSI 与 LM 之间的观察者内一致性为 95.4%（95% CI：92.2%-97.4%）。还将第二次 LM 诊断与原始 LM 诊断进行了比较，观察到的观察者间 LM 一致性率为 97.3%（95% CI：93.1%-99.0%）。研究数据表明，WSI 做出的乳腺针吸活检诊断与 LM 做出的诊断相当。在显示器质量和图像采集分辨率等潜在观察系统参数方面，未发现诊断差异。本研究结果表明，WSI 可有效地用于可利用的组织量最少的专科诊断病例。
