Potential quality pitfalls of digitalized whole slide image of breast pathology in routine practice

Using digitalized whole slide images (WSI) in routine histopathology practice is a revolutionary technology. This study aims to assess the clinical impacts of WSI quality and representation of the corresponding glass slides. 40,160 breast WSIs were examined and compared with their corresponding glas...

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Bibliographic Details
Published in:Modern pathology Vol. 35; no. 7; pp. 903 - 910
Main Authors: Atallah, Nehal M., Toss, Michael S., Verrill, Clare, Salto-Tellez, Manuel, Snead, David, Rakha, Emad A.
Format: Journal Article
Language:English
Published: New York Elsevier Inc 01.07.2022
Nature Publishing Group US
Elsevier Limited
Subjects:
14/63
631/67/1347
692/699/67
Automation
Biopsy
Breast
Breast - pathology
COVID-19
Digitization
Histopathology
Humans
Laboratories
Laboratory Medicine
Medical research
Medicine
Medicine & Public Health
Parenchyma
Pathology
Quality control
Scanners
Scanning
ISSN:0893-3952, 1530-0285, 1530-0285
Online Access:Get full text
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Summary:Using digitalized whole slide images (WSI) in routine histopathology practice is a revolutionary technology. This study aims to assess the clinical impacts of WSI quality and representation of the corresponding glass slides. 40,160 breast WSIs were examined and compared with their corresponding glass slides. The presence, frequency, location, tissue type, and the clinical impacts of missing tissue were assessed. Scanning time, type of the specimens, time to WSIs implementation, and quality control (QC) measures were also considered. The frequency of missing tissue ranged from 2% to 19%. The area size of the missed tissue ranged from 1–70%. In most cases (>75%), the missing tissue area size was <10% and peripherally located. In all cases the missed tissue was fat with or without small entrapped normal breast parenchyma. No missing tissue was identified in WSIs of the core biopsy specimens. QC measures improved images quality and reduced WSI failure rates by seven-fold. A negative linear correlation between the frequency of missing tissue and both the scanning time and the image file size was observed (p < 0.05). None of the WSI with missing tissues resulted in a change in the final diagnosis. Missing tissue on breast WSI is observed but with variable frequency and little diagnostic consequence. Balancing between WSI quality and scanning time/image file size should be considered and pathology laboratories should undertake their own assessments of risk and provide the relevant mitigations with the appropriate level of caution.
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ISSN:0893-3952
1530-0285
1530-0285
DOI:10.1038/s41379-021-01000-8