Department of Histopathology, School of Medicine, the University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham, UK.
Department of Pathology, Faculty of Medicine, Menoufia University, Shebin Elkom, Al-Menoufia, Egypt.
Mod Pathol. 2022 Jul;35(7):903-910. doi: 10.1038/s41379-021-01000-8. Epub 2021 Dec 27.
Using digitalized whole slide images (WSI) in routine histopathology practice is a revolutionary technology. This study aims to assess the clinical impacts of WSI quality and representation of the corresponding glass slides. 40,160 breast WSIs were examined and compared with their corresponding glass slides. The presence, frequency, location, tissue type, and the clinical impacts of missing tissue were assessed. Scanning time, type of the specimens, time to WSIs implementation, and quality control (QC) measures were also considered. The frequency of missing tissue ranged from 2% to 19%. The area size of the missed tissue ranged from 1-70%. In most cases (>75%), the missing tissue area size was <10% and peripherally located. In all cases the missed tissue was fat with or without small entrapped normal breast parenchyma. No missing tissue was identified in WSIs of the core biopsy specimens. QC measures improved images quality and reduced WSI failure rates by seven-fold. A negative linear correlation between the frequency of missing tissue and both the scanning time and the image file size was observed (p < 0.05). None of the WSI with missing tissues resulted in a change in the final diagnosis. Missing tissue on breast WSI is observed but with variable frequency and little diagnostic consequence. Balancing between WSI quality and scanning time/image file size should be considered and pathology laboratories should undertake their own assessments of risk and provide the relevant mitigations with the appropriate level of caution.
在常规组织病理学实践中使用数字化全切片图像（WSI）是一项革命性的技术。本研究旨在评估 WSI 质量和相应玻璃切片代表性的临床影响。检查了 40160 例乳腺 WSI 并将其与相应的玻璃切片进行比较。评估了缺失组织的存在、频率、位置、组织类型以及对临床的影响。还考虑了扫描时间、标本类型、实施 WSI 的时间以及质量控制（QC）措施。缺失组织的频率范围为 2%至 19%。缺失组织的面积大小范围为 1-70%。在大多数情况下（>75%），缺失组织的面积<10%且位于周边。在所有情况下，缺失的组织都是脂肪，伴有或不伴有少量被包裹的正常乳腺实质。在核心活检标本的 WSI 中未发现缺失组织。QC 措施将图像质量提高了七倍，并将 WSI 故障的发生率降低了七倍。观察到缺失组织的频率与扫描时间和图像文件大小呈负线性相关（p<0.05）。所有缺失组织的 WSI 均未导致最终诊断发生变化。在乳腺 WSI 上观察到缺失组织，但频率不同，对诊断的影响也不大。应在 WSI 质量和扫描时间/图像文件大小之间取得平衡，病理实验室应自行评估风险，并在适当的谨慎程度下提供相关的缓解措施。
