Validation of whole slide imaging for frozen section diagnosis of lymph node metastasis: A retrospective study from a tertiary care hospital in Thailand |
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| Institution: | 1. Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand;2. Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand;3. Advanced Digital Simulation Center, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand;1. Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Beijing 100730, China;2. Department of Pathology, Beijing Chuiyangliu Hospital, Beijing 100022, China;1. Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan;2. Genome Analysis Center, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu City, Yamanashi 400-8506, Japan;3. Department of Gastroenterology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu City, Yamanashi 400-8506, Japan;4. Department of Pathology, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu City, Yamanashi 400-8506, Japan;5. Department of Surgery, Yamanashi Central Hospital, 1-1-1 Fujimi, Kofu City, Yamanashi 400-8506, Japan;6. University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;1. Department of Pathology and Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China;2. Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China;3. Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100069, China;4. Department of Pathology and Key Laboratory for Xinjiang Endemic & Ethnic Diseases, The First Affiliated Hospital, Shihezi University School of Medicine, Shihezi, 832002, China;5. Department of Pathology, Shanghai PuDong GongLi Hospital, Shanghai, 200135, China;1. Department of Pathology, Consorci Sanitari Integral, Av. Josep Molins, 29, 08906, L''Hospitalet de Llobregat, Barcelona, Spain;2. University of Barcelona, Villarroel 170, 08036, Barcelona, Spain;3. Department of Pathology, Hospital Clinic of Barcelona, Villarroel 170, 08036, Spain;4. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Casanova 143, 08036 Barcelona, Spain;5. Department of Dermatology, Hospital Clínic of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain;6. Department of Oncology, Hospital Clínic of Barcelona, Villarroel 170, 08036 Barcelona, Spain |
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| Abstract: | BackgroundThe use of whole slide imaging (WSI) for frozen section (FS) diagnosis is helpful, particularly in the context of pathologist shortages. However, there is minimal data on such usage in resource-limited settings. This study aims to validate the use of WSI for FS diagnosis of lymph node metastasis using a low-cost virtual microscope scanner with consumer-grade laptops at a tertiary care hospital in Thailand.MethodsFS slides were retrieved for which the clinical query was to evaluate lymph node metastasis. They were digitized by a virtual microscope scanner (MoticEasyScan, Hong Kong) using up to 40× optical magnification. Three observers with different pathology experience levels diagnosed each slide, reviewing glass slides (GS) followed by digital slides (DS) after two weeks of a wash out period. WSI and GS diagnoses were compared. The time used for scanning and diagnosis of each slide was recorded.Results295 FS slides were retrieved and digitized. The first-time successful scanning rate was 93.6 %. The mean scanning time was 2 min per slide. Both intraobserver agreement and interobserver agreement of WSI and GS diagnoses were high (Cohen's K; kappa value >0.84). The time used for DS diagnosis decreased as the observer's experience with WSI increased.ConclusionsDespite varying pathological experiences, observers using WSI provided accurate FS diagnoses of lymph node metastasis. The time required for DS diagnoses decreased with additional observer's experience with WSI. Therefore, a WSI system containing low-cost scanners and consumer-grade laptops could be used for FS services in hospital laboratories lacking pathologists. |
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