[2025] Validation of Remote Robotic Microscopy Using the iScan Coreo Au Platform

Michael J Thrall, Hidehiro Takei, Andreana L Rivera, Suzanne Z Powell. Methodist Hospital, Houston, TX

Background: Remote robotic microscopy (RRM) allows a remote pathologist to manipulate and view a slide via the internet. This technology is useful for intraoperative assessments (IA) when whole slide imaging (WSI) would be too time-consuming. Touch/squash preparations are especially difficult for WSI because of the widely dispersed and 3-dimensional diagnostic material.
Design: Our pathology department receives occasional requests for neuropathology IA from a branch hospital with no neuropathologist. We validated the iScan Coreo Au "Live Mode" RRM for touch/squash preparations to address this problem. 100 cases were selected, including 75 consecutive neuropathology cases with IA and 25 consecutive general surgical pathology cases with touch preparation IA. Three neuropathologists and one general surgical pathologist participated; each viewed 25 cases. Half of the cases were viewed on glass slides by conventional microscopy and half by RRM, followed by a delay of at least 3 weeks, after which the cases were viewed by the other modality. Diagnoses and times spent viewing were recorded. Intraobserver variation was analyzed.
Results: Of the 100 cases, 78 showed perfect intraobserver agreement and 10 more showed minor discrepancies (less specific diagnoses). There were 12 cases with significant discrepancies (listed below).

Intraobserver Discrepancies
Glass SlideRemote Robotic MicroscopyFinal Permanent Section Diagnosis
Consistent with meningiomaScant interpretable material - deferAtypical meningioma
Glial neoplasmMildly hypercellular glial tissueGlioblastoma
Gliotic brainPossible infarctConsistent with infarct
High grade astrocytomaEpendymomaEpendymoma
High grade astrocytomaNon-diagnostic - deferGlioblastoma
High grade gliomaSchwannomaLarge B-cell lymphoma
Infiltrating gliomaMildly hypercellular glial tissueGlioblastoma
Low grade gliomaHemorrhagic lesionPleomorphic xanthoastrocytoma
MeningiomaCannot focus - deferMeningioma
MeningiomaNecrotic neoplasmMeningioma
Metastatic carcinomaSmall round blue cell lesionMetastatic breast carcinoma
Spindle cell lesionNecrotic debrisSchwannoma

The average time to reach a diagnosis by RRM was 128 seconds versus 44 seconds for glass slides. Pathologists found RRM to be frustrating. It was difficult to decide what part of the slide to look at on high power using the RRM thumbnail images.
Conclusions: Overall, RRM performs well for touch/squash preps. RRM is cumbersome relative to glass slides, and is more challenging for the pathologist resulting in less decisive interpretations, but is still acceptable for remote IA.
Category: Quality Assurance

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 249, Tuesday Morning


Close Window