Is Virtual Microscopy Ready for the Prime Time? A Comparison with Conventional Microscopy.
Carolina Reyes, Francis Ikpatt, Mehrdad Nadji, Richard J Cote. University of Miami Jackson Memorial Hospital and Sylvester Cancer Center, FL
Background: Automated whole slide imaging, also known as virtual microscopy (VM) is rapidly becoming an important tool in diagnostic pathology. Currently, the major utility of VM is for transmission of digital images for consultations and second opinions. The high resolution of images and refinement of technology now allows for VM to be used as an alternative to conventional microscopy (CM), as a first line diagnostic platform. We investigated that possibility by comparing the histologic diagnoses of breast biopsies by CM and VM.
Design: One hundred and three needle biopsies of breast were randomly selected for this study. Each slide was scanned at 20X by BioImagene iScan Coreo Au. Three board-certified pathologists with varying degrees of experience in breast pathology independently reviewed the glass slides by CM, VM and again by CM during periods of one week intervals. Diagnostic categories included fibrocystic disease with or without ductal hyperplasia (DH), atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC). The intra-pathologist reproducibility was recorded for CM vs VM and for CM vs CM, as control of the baseline. In those cases with inter-pathologist disagreement, the three observers jointly reviewed the glass slides by CM and agreed on a final diagnosis.
Results: Of the 103 core needle biopsies, 46 were malignant (22 DCIS, 24 IDC), 6 ADH and 51 fibrocystic disease (11 with DH). The intra-observer variability for CM vs VM was1% (observer 1), 4% (observer 2), and 1% (observer 3). The intra-observer variability for CM vs CM was 4%, 7% and 0% for observers 1, 2 and 3 respectively. All diagnostic disagreements were between DH and ADH. There were no intra- or inter-observer disagreement in the diagnosis of benign vs malignant disease.
Conclusions: Virtual microscopy using high resolution whole slide images compares favorably with conventional microscopy for the first line diagnosis of breast biopsies.
Monday, February 28, 2011 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 248, Monday Morning