[1486] Telemicroscopy for the Evaluation of Donor Kidney Biopsies.

Evita Sadimin, Wenjin Chen, Adena Osband, William Reitsma, David Laskow, Jaworski Joseph, Billie Fyfe. UMDNJ – Robert Wood Johnson Medical School, New Brunswick, NJ; New Jersey Sharing Network, New Providence

Background: Pathologists play a vital role in the evaluation of kidney donor biopsies, largely related to accurate measurement of % global glomerulosclerosis (%GG). We have previously shown lack of correlation for %GG using light microscopy (LM) with manual slide manipulation. This study examines the correlation of %GG measurements using telemicroscopy (TM) enhanced with Computer Assisted Microscopy (CAM) software.
Design: Thirty-seven kidney donor biopsies with prior LM analysis performed at regional transplant centers and at our institution were studied with TM. The real time robotic TM incorporates an Olympus BX51 microscope with a robotic stage controlled by CAM software. The software provides the user an overview of the specimen that is used to select the region of interest (ROI). The ROI is overlaid with a grid map. Each grid cell corresponds to one non-overlapping screen of view. The user sets the desired objective and activates the program to advance from grid cell to grid cell. Analyzed cells are highlighted by a color change. The specimens were evaluated for %GG and total number of glomeruli using a 10x grid with full support for panning, zooming and focusing. The correlation coefficient is calculated using MedCalc.
Results: The correlation coefficient for %GG and total glomeruli measured by TM is significantly higher than LM.

	LM1	LM2	TM1	TM2
LM1	NA	0.6093	0.5504	0.5319
LM2	0.7421	NA	0.8744	0.8645
TM1	0.7707	0.8990	NA	0.9959
TM2	0.7582	0.8887	0.9944	NA

Table 1. Correlation coefficients between different measurements for total glomeruli (bottom left half) and %GG (top right half).

In most cases the numbers obtained by TM are higher than the numbers obtained by LM.
Conclusions: TM supported by sophisticated software (CAM) is a more accurate and reproducible technique than LM for assessing %GG in donor kidney biopsies. CAM software prevented review of overlapping fields, highlighted areas already viewed and was essential to the ease of use and reproducibility. TM also forms a foundation for more descriptive quantitative studies of donor kidney biopsies (e.g. density distribution of globally sclerosed glomeruli) potentially ultimately leading to increased utilization of this precious resource.
Category: Kidney (does not include tumors)

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 197, Monday Morning