Department of Pathology, Hospital Clínic, Barcelona, Spain.
Department of Pathology, Hospital Clínic, Barcelona, Spain; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Dig Liver Dis. 2017 Nov;49(11):1240-1246. doi: 10.1016/j.dld.2017.07.002. Epub 2017 Jul 19.
Experience in the use of whole slide imaging (WSI) for primary diagnosis is limited and there are no comprehensive reports evaluating this technology in liver biopsy specimens.
To determine the accuracy of interpretation of WSI compared with conventional light microscopy (CLM) in the diagnosis of needle liver biopsies.
Two experienced liver pathologists blindly analyzed 176 consecutive biopsies from the Pathology Department at the Hospital Clinic of Barcelona. One of the observers performed the initial evaluation with CLM, and the second evaluation with WSI, whereas the second observer performed the first evaluation with WSI and the second with CLM. All slides were digitized in a Ventana iScan HT at 400× and evaluated with the Virtuoso viewer (Roche diagnostics). We used kappa statistics (κ) for two observations.
Intra-observer agreement between WSI and CLM evaluations was almost perfect (96.6%, κ=0.9; 95% confidence interval [95% CI]: 0.9-1 for observer 1, and 90.3%, κ=0.9; 95%CI: 0.8-0.9 for observer 2). Both native and transplantation biopsies showed an almost perfect concordance in the diagnosis.
Diagnosis of needle liver biopsy specimens using WSI is accurate. This technology can reliably be introduced in routine diagnosis.
全切片成像(WSI)在初次诊断中的应用经验有限,尚无全面评估该技术在肝活检标本中的应用的报告。
评估在诊断肝穿活检标本时,WSI 与传统光学显微镜(CLM)相比的解读准确性。
两位经验丰富的肝脏病理学家对巴塞罗那 Clinic 医院病理科的 176 例连续肝活检进行了盲法分析。其中一位观察者先用 CLM 进行初始评估,然后用 WSI 进行第二次评估;另一位观察者先用 WSI 进行第一次评估,再用 CLM 进行第二次评估。所有玻片均以 400×的分辨率在 Ventana iScan HT 上数字化,并使用 Virtuoso 查看器(罗氏诊断)进行评估。我们使用κ统计量(κ)进行了两次观察。
观察者 1 的 WSI 和 CLM 评估之间的观察者内一致性几乎为完美(96.6%,κ=0.9;95%置信区间[95%CI]:0.9-1;观察者 2 为 90.3%,κ=0.9;95%CI:0.8-0.9)。在诊断原发性和移植性活检时,两者的一致性均近乎完美。
使用 WSI 诊断肝穿活检标本的准确性较高。该技术可可靠地引入常规诊断。