Kaushal Rajiv Kumar, Yadav Subhash, Sahay Ayushi, Karnik Nupur, Agrawal Tushar, Dave Vinayak, Singh Nikhil, Shah Ashish, Desai Sangeeta B
Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
J Pathol Inform. 2023 Apr 15;14:100312. doi: 10.1016/j.jpi.2023.100312. eCollection 2023.
Despite the promising applications of whole-slide imaging (WSI) for frozen section (FS) diagnosis, its adoption for remote reporting is limited.
To assess the feasibility and performance of home-based remote digital consultation for FS diagnosis.
MATERIAL & METHOD: Cases accessioned beyond regular working hours (5 pm-10 pm) were reported simultaneously using optical microscopy (OM) and WSI. Validation of WSI for FS diagnosis from a remote site, i.e. home, was performed by 5 pathologists. Cases were scanned using a portable scanner (Grundium Ocus®40) and previewed on consumer-grade computer devices through a web-based browser (http://grundium.net). Clinical data and diagnostic reports were shared through a google spreadsheet. The diagnostic concordance, inter- and intra-observer agreement for FS diagnosis by WSI versus OM, and turnaround time (TAT), were recorded.
The overall diagnostic accuracy for OM and WSI (from home) was 98.2% (range 97%-100%) and 97.6% (range 95%-99%), respectively, when compared with the reference standard. Almost perfect inter-observer (k = 0.993) and intra-observer (k = 0.987) agreement for WSI was observed by 4 pathologists. Pathologists used consumer-grade laptops/desktops with an average screen size of 14.58 inches (range = 12.3-17.7 inches) and a network speed of 64 megabits per second (range: 10-90 Mbps). The mean diagnostic assessment time per case for OM and WSI was 1:48 min and 5:54 min, respectively. Mean TAT of 27.27 min per case was observed using WSI from home. Seamless connectivity was observed in approximately 75% of cases.
This study validates the role of WSI for remote FS diagnosis for its safe and efficient adoption in clinical use.
尽管全切片成像（WSI）在冰冻切片（FS）诊断方面有着广阔的应用前景，但其在远程报告中的应用却受到限制。
评估基于家庭的远程数字会诊用于FS诊断的可行性和性能。
对在正常工作时间（下午5点至晚上10点）之外接收的病例，同时使用光学显微镜（OM）和WSI进行报告。5位病理学家对从远程地点（即家中）进行的FS诊断的WSI进行了验证。使用便携式扫描仪（Grundium Ocus®40）对病例进行扫描，并通过基于网络的浏览器（http://grundium.net）在消费级计算机设备上进行预览。临床数据和诊断报告通过谷歌电子表格共享。记录了WSI与OM在FS诊断方面的诊断一致性、观察者间和观察者内一致性，以及周转时间（TAT）。
与参考标准相比，OM和（在家中进行的）WSI的总体诊断准确率分别为98.2%（范围97%-100%）和97.6%（范围95%-99%）。4位病理学家观察到WSI的观察者间一致性（k = 0.993）和观察者内一致性（k = 0.987）几乎完美。病理学家使用的消费级笔记本电脑/台式电脑平均屏幕尺寸为14.58英寸（范围 = 12.3 - 17.7英寸），网络速度为每秒64兆比特（范围：10 - 90 Mbps）。OM和WSI对每个病例的平均诊断评估时间分别为1分48秒和5分54秒。在家中使用WSI观察到每个病例的平均TAT为27.27分钟。在大约75%的病例中观察到无缝连接。
本研究验证了WSI在远程FS诊断中的作用，以便其在临床应用中安全有效地采用。
