Whole-slide imaging digital pathology as a platform for teleconsultation: A pilot study using paired subspecialist correlations

David C. Wilbur, Kalil Madi, Robert B. Colvin, Lyn M. Duncan, William C. Faquin, Judith A. Ferry, Matthew P. Frosch, Stuart L. Houser, Richard L. Kradin, Gregory Y. Lauwers, David N. Louis, Eugene J. Mark, Mari Mino-Kenudson, Joseph Misdraji, Gunnlauger P. Nielsen, Martha B. Pitman, Andrew E. Rosenberg, R. Neal Smith, Aliyah R. Sohani, James R. StoneRosemary H. Tambouret, Chin Lee Wu, Robert H. Young, Artur Zembowicz, Wolfgang Klietmann

Research output: Contribution to journalArticlepeer-review

101 Scopus citations


Context. - Whole-slide imaging technology offers promise for rapid, Internet-based telepathology consultations between institutions. Before implementation, technical issues, pathologist adaptability, and morphologic pitfalls must be well characterized. Objective.-To determine whether interpretation of whole-slide images differed from glass-slide interpretation in difficult surgical pathology cases. Design.-Diagnostically challenging pathology slides from a variety of anatomic sites from an outside laboratory were scanned into whole digital format. Digital and glass slides were independently diagnosed by 2 subspecialty pathologists. Reference, digital, and glass-slide interpretations were compared. Operator comments on technical issues were gathered. Results.-Fifty-three case pairs were analyzed.There was agreement among digital, glass, and reference diagnoses in 45 cases (85%) and between digital and glass diagnoses in 48 (91%) cases. There were 5 digital cases (9%) discordant with both reference and glass diagnoses. Further review of each of these cases indicated an incorrect digital wholeslide interpretation. Neoplastic cases showed better correlation (93%) than did cases of nonneoplastic disease (88%). Comments on discordant cases related to digital whole technology focused on issues such as fine resolution and navigating ability at high magnification. Conclusions.-Overall concordance between digital whole-slide and standard glass-slide interpretations was good at 91%. Adjustments in technology, case selection, and technology familiarization should improve performance, making digital whole-slide review feasible for broader telepathology subspecialty consultation applications.

Original languageEnglish (US)
Pages (from-to)1949-1953
Number of pages5
JournalArchives of Pathology and Laboratory Medicine
Issue number12
StatePublished - Dec 2009
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology


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