From the Department of Pathology, University of Washington, Seattle.
Arch Pathol Lab Med. 2020 Nov 1;144(11):1311-1320. doi: 10.5858/arpa.2020-0372-SA.
CONTEXT.—: The coronavirus disease 19 (COVID-19) pandemic is placing unparalleled burdens on regional and institutional resources in medical facilities across the globe. This disruption is causing unprecedented downstream effects to traditionally established channels of patient care delivery, including those of essential anatomic pathology services. With Washington state being the initial North American COVID-19 epicenter, the University of Washington in Seattle has been at the forefront of conceptualizing and implementing innovative solutions in order to provide uninterrupted quality patient care amidst this growing crisis.
OBJECTIVE.—: To conduct a rapid validation study assessing our ability to reliably provide diagnostic neuropathology services via a whole slide imaging (WSI) platform as part of our departmental COVID-19 planning response.
DESIGN.—: This retrospective study assessed diagnostic concordance of neuropathologic diagnoses rendered via WSI as compared to those originally established via traditional histopathology in a cohort of 30 cases encompassing a broad range of neurosurgical and neuromuscular entities. This study included the digitalization of 93 slide preparations, which were independently examined by groups of board-certified neuropathologists and neuropathology fellows.
RESULTS.—: There were no major or minor diagnostic discrepancies identified in either the attending neuropathologist or neuropathology trainee groups for either the neurosurgical or neuromuscular case cohorts.
CONCLUSIONS.—: Our study demonstrates that accuracy of neuropathologic diagnoses and interpretation of ancillary preparations via WSI are not inferior to those generated via traditional microscopy. This study provides a framework for rapid subspecialty validation and deployment of WSI for diagnostic purposes during a pandemic event.
2019 年冠状病毒病(COVID-19)大流行给全球各地医疗机构的区域和机构资源带来了前所未有的负担。这种中断正在对传统上建立的患者护理提供渠道造成前所未有的下游影响,包括基本解剖病理学服务。华盛顿州是北美 COVID-19 的最初震中,西雅图的华盛顿大学一直在率先构思和实施创新解决方案,以便在这场不断升级的危机中提供不间断的高质量患者护理。
进行一项快速验证研究,评估我们通过全玻片成像(WSI)平台可靠地提供诊断神经病理学服务的能力,作为我们部门 COVID-19 规划应对的一部分。
这项回顾性研究评估了通过 WSI 做出的神经病理学诊断与通过传统组织病理学最初建立的诊断之间的一致性,涉及涵盖广泛神经外科和神经肌肉实体的 30 例病例队列。这项研究包括 93 个载玻片的数字化,这些载玻片由经过董事会认证的神经病理学家和神经病理学家学员小组独立检查。
在神经外科或神经肌肉病例队列中,无论是主治神经病理学家还是神经病理学家学员组,都没有发现主要或次要诊断差异。
我们的研究表明,通过 WSI 进行神经病理学诊断的准确性和对辅助制剂的解释并不逊于通过传统显微镜生成的诊断。这项研究为在大流行期间快速进行专业验证和部署 WSI 进行诊断提供了框架。