Abstract
Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation; however, little is known about pathologists’ practice patterns or perceptions regarding WSI. A national sample (N = 252) of pathologists from New Hampshire, Vermont, Washington, Oregon, Arizona, Alaska, Maine, and Minnesota were surveyed in this cross-sectional study (2011–2013). The survey included questions on pathologists’ experience, WSI practice patterns, and perceptions using a six-point Likert scale. Agreement was summarized with descriptive statistics to characterize pathologists’ use and perceptions of WSI. The majority of participating pathologists were males (63 %) between 40 and 59 years of age (70 %) and not affiliated with an academic medical center (72 %). Experience with WSI was reported by 49 %. Types of use reported included CME/board exams/teaching (28 %), tumor board/clinical conference (22 %), archival purposes (6 %), consultative diagnosis (4 %), research (4 %), and other uses (12 %). Most respondents (79 %) agreed that accurate diagnoses can be made with this technology, and that WSI is useful for obtaining a second opinion (88 %). However, 78 % of pathologists agreed that digital slides are too slow for routine clinical interpretation. Fifty-nine percent agreed that the benefits of WSI outweigh concerns. The respondents were equally split as to whether they would like to adopt WSI (51 %) or not (49 %). About half of pathologists reported experience with the WSI technology, largely for CME, licensure/board exams, and teaching. Positive perceptions regarding WSI slightly outweigh negative perceptions. Understanding practice patterns with WSI as dissemination advances may facilitate concordance of perceptions with adoption of the technology.
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References
May M. A better lens on disease. Scientific American. May 1, 2010. https://www.scientificamerican.com/article.cfm?id=a-better-lens-on-disease
Al-Janabi S, Huisman A, Vink A, Leguit RJ, Offerhaus JA, ten Kate FJW, et al: Whole slide images for primary diagnostics in dermatopathology: a feasibility study. J Clin Pathol 65:152–158, 2012
Al-Janabi S, Huisman A, Van Diest PJ: Digital pathology; current status and future perspectives. Histopathology 61:1–9, 2012
Joel F, Leong WM, Leong ASY: Digital imaging in pathology: theoretical and practical considerations, and applications. Pathology 36(3):234–241, 2004
Dangott B, Parwani A: Whole slide imaging for teleconsultation and clinical use. J Pathol Inform 1:7, 2010
Hedvat CV: Digital microscopy: past, present, and future. Arch Pathol Lab Med 134:1666–1670, 2010
Brachtel E, Yagi Y: Digital imaging in pathology—current applications and challenges. J Biophotonics 5:327–335, 2012
Pantanowitz L, Valenstein PN, Evans AJ, Kaplan KJ, Pfeifer JD, Wilbur DC: Review of the current state of whole slide imaging in pathology. J Pathol Inform. 2:36, 2011
Patterson ES, Rayo M, Gil C, Gurcan MN: Barriers and facilitators to adoption of soft copy interpretation from the user perspective: lessons learned from filmless radiology for slideless pathology. J Pathol Inform. 2:1, 2011
Rocha R, Vassallo J, Soares F, Miller K, Gobbi H: Digital slides: present status of a tool for consultation, teaching, and quality control in pathology. Pathol Res Pract 205(11):73–741, 2009
College of American Pathologists. http://www.cap.org/apps/cap.portal?_nfpb=true&cntvwrPtlt_actionOverride=%2Fportlets%2FcontentViewer%2Fshow&_windowLabel=cntvwrPtlt&cntvwrPtlt%7BactionForm.contentReference%7D=cap_today%2F0112%2F0112a_regulators.html&_state=maximized&_pageLabel=cntvwr, last accessed 2/14/14.
U.S. Food and Drug Administration. http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/ClassifyYourDevice/. Last accessed: 06/14/13.
Allen TC. Digital pathology and federalism. Archives of Pathology and Laboratory Medicine. 2012. 0.5858/arpa.2013-0258-ED
Wilbur DC, Madi K, Colvin RB, Duncan LM, Faquin WC, Ferry JA, et al: Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations. Arch Pathol Lab Med. 133:1949–1953, 2009
Krenacs T, Zsakovics I, Diczhazi L, Ficsor VS, Varga VS, Molnar B: The potential of digital microscopy in breast pathology. Pathol Oncol Res 15:55–58, 2009
Rossing HH, Møller Talman M-L, Lænkholm A-V, Wielenga VT: Implementation of TMA and digitalization in routine diagnostics of breast pathology. APMIS Acta Pathol Microbiol Immunol Scand 120:341–347, 2012
Fung KM, Hassell LA, Talbert ML, Wiechmann AF, Chaser BE, Ramey J: Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience. Anal Cell Pathol 35:37–40, 2012
Cornish TC, Swapp RE, Kaplan KJ: Whole-slide imaging: routine pathologic diagnosis. Adv Anat Pathol. 19:152–159, 2012
Henricks WH: Evaluation of whole slide imaging for routine surgical pathology: looking through a broader scope. J Pathol Inform. 3:39, 2012
Hashimoto N, Bautista PA, Yamaguchi M, Ohyama N, Yagi Y: Referenceless image quality evaluation for whole slide imaging. J Pathol Inform. 3:9, 2012
Oster NV, Carney PA, Allison KH, Weaver D, Reisch L, Longton G, Onega T, Pepe M, Geller BM, Nelson H, Ross T, Tosteson AN, Elmore JG: Development of a diagnostic test set to assess agreement in breast pathology: practical application of the guidelines for reporting reliability and agreement studies (GRRAS). BMC Womens Health 13:3, 2013
Jara-Lazaro AR, Thamboo TB, The M, Tan PH: Digital pathology: exploring its applications in diagnostic surgical pathology practice. Pathology. 42:512–518, 2010
Shaw EC, Hanby AM, Wheeler K, et al: Observer agreement comparing the use of virtual slides with glass slides in the pathology review component of the POSH breast cancer cohort study. J Clin Pathol 65:403–408, 2012
Ho J, Parwani AV, Jukic CM, et al: Use of whole slide imaging in surgical pathology quality assurance: design and pilot validation studies. Hum Pathol 37:322–331, 2006
Campbell WS, Lele SM, West WW, Lazenby AJ, Smith LM, Hinrichs SH: Concordance between whole-slide imaging and light microscopy for routine surgical pathology. Hum Pathol 43:1739–1744, 2012
Al-Janabi S, Hulsman A, Willems SM, Van Diest PJ: Digital slide images for primary diagnostics in breast pathology: a feasibility study. Hum Pathol 43:2318–2325, 2012
Mea VD, Demichelis F, Viel F, Palma PD, Betlrami CA: User attitudes in analyzing digital slides in a quality control test bed: a preliminary study. Comput Meth Prog Bio 82:177–186, 2006
Bellis M, Metias S, Naugler C, Pollett A, Jothy S, Yousef GM: Digital pathology: attitudes and practices in the Canadian pathology community. J Pathol Inform. 4:3, 2013. doi:10.4103/2153-3539.108540. Print 2013
Acknowledgments
Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number R01 CA140560 and KO5 CA104699. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Cancer Institute or the National Institutes of Health. We would also like to acknowledge Thomas Morgan at the University of Washington, Seattle WA and Paul Litwin of the Fred Hutchinson Cancer Center, Seattle, WA for valuable assistance with data preparation and transfer.
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Onega, T., Weaver, D., Geller, B. et al. Digitized Whole Slides for Breast Pathology Interpretation: Current Practices and Perceptions. J Digit Imaging 27, 642–648 (2014). https://doi.org/10.1007/s10278-014-9683-2
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DOI: https://doi.org/10.1007/s10278-014-9683-2