PDF(Pubmed)
Abstract：
UNASSIGNED: Telepathology utilizing high-throughput static whole slide image scanners is proposed to address the challenge of limited pathology services in resource-restricted settings. However, the prohibitive equipment costs and sophisticated technologies coupled with large amounts of space to set up the devices make it impractical for use in resource-limited settings. Herein, we aimed to address this challenge by validating a portable whole slide imaging (WSI) device against glass slide microscopy (GSM) using lymph node biopsies from suspected lymphoma cases from Sub-Saharan Africa.
UNASSIGNED: This was part of a multicenter prospective case-control head-to-head comparison study of liquid biopsy against conventional pathology. For the portable WSI scanner validation, the study pathologists evaluated 105 surgical lymph node specimens initially confirmed by gold-standard pathology between February and December 2021. The tissues were processed according to standard protocols for Hematoxylin and Eosin (H&E) and Immunohistochemistry (IHC) staining by well-trained histotechnicians, then digitalized the H& E and IHC slides at each center. The digital images were anonymized and uploaded to a HIPAA-compliant server by the histotechnicians. Three study pathologists independently accessed and reviewed the images after a 6-week washout. The agreement between diagnoses established on GSM and WSI across the pathologists was described and measured using Cohens\' kappa coefficient (κ).
UNASSIGNED: On GSM, 65.5% (n=84) of specimens were lymphoma; 25% were classified as benign, while 9.5% were metastatic. Morphological quality assessment on GSM and WSI established that 79.8% and 53.6% of cases were of high quality, respectively. When diagnoses by GSM were compared to WSI, the overall concordance for various diagnostic categories was 93%, 100%, and 86% for lymphoma, metastases, and benign conditions respectively. The sensitivity and specificity of WSI for the detection of lymphoma were 95.2% and 85.7%, respectively, with an overall inter-observer agreement (κ) of 0.86; 95% CI (0.70-0.95).
UNASSIGNED: We demonstrate that mobile whole slide imaging (WSI) is non-inferior to conventional glass slide microscopy (GSM) for the primary diagnosis of malignant infiltration of lymph node specimens. Our results further provide proof of concept that mobile WSI can be adapted to resource-restricted settings for primary surgical pathology and would significantly improve patient outcomes.
UNASSIGNED: This was part of a multicenter prospective case-control head-to-head comparison study of liquid biopsy against conventional pathology. For the portable WSI scanner validation, the study pathologists evaluated 105 surgical lymph node specimens initially confirmed by gold-standard pathology between February and December 2021. The tissues were processed according to standard protocols for Hematoxylin and Eosin (H&E) and Immunohistochemistry (IHC) staining by well-trained histotechnicians, then digitalized the H& E and IHC slides at each center. The digital images were anonymized and uploaded to a HIPAA-compliant server by the histotechnicians. Three study pathologists independently accessed and reviewed the images after a 6-week washout. The agreement between diagnoses established on GSM and WSI across the pathologists was described and measured using Cohens\' kappa coefficient (κ).
UNASSIGNED: On GSM, 65.5% (n=84) of specimens were lymphoma; 25% were classified as benign, while 9.5% were metastatic. Morphological quality assessment on GSM and WSI established that 79.8% and 53.6% of cases were of high quality, respectively. When diagnoses by GSM were compared to WSI, the overall concordance for various diagnostic categories was 93%, 100%, and 86% for lymphoma, metastases, and benign conditions respectively. The sensitivity and specificity of WSI for the detection of lymphoma were 95.2% and 85.7%, respectively, with an overall inter-observer agreement (κ) of 0.86; 95% CI (0.70-0.95).
UNASSIGNED: We demonstrate that mobile whole slide imaging (WSI) is non-inferior to conventional glass slide microscopy (GSM) for the primary diagnosis of malignant infiltration of lymph node specimens. Our results further provide proof of concept that mobile WSI can be adapted to resource-restricted settings for primary surgical pathology and would significantly improve patient outcomes.
摘要：
UNASSIGNED：建议使用高通量静态全幻灯片图像扫描仪来解决资源受限环境中有限的病理学服务的挑战。然而,高昂的设备成本和先进的技术，加上大量的空间来设置设备，使其在资源有限的环境中使用不切实际。在这里，我们旨在通过使用来自撒哈拉以南非洲的疑似淋巴瘤病例的淋巴结活检,对照载玻片显微镜(GSM)验证便携式全载玻片成像(WSI)装置,来应对这一挑战.
UNASSIGNED：这是液体活检与常规病理的多中心前瞻性病例对照头对头比较研究的一部分。对于便携式WSI扫描仪验证，这项研究的病理学家评估了2021年2月至12月间经金标准病理学初步证实的105例手术淋巴结标本.由训练有素的组织技术人员根据苏木精和伊红（H＆E）和免疫组织化学（IHC）染色的标准方案处理组织。然后将每个中心的H&E和IHC幻灯片数字化。数字图像被匿名化并由组织技术人员上传到符合HIPAA的服务器。三名研究病理学家在6周的冲洗后独立访问并审查了图像。描述并使用Cohens'kappa系数（κ）测量了病理学家在GSM和WSI上建立的诊断之间的一致性。
未经评估：在GSM上，65.5％（n=84）的标本是淋巴瘤;25％被归类为良性，而9.5%为转移性。对GSM和WSI的形态学质量评估确定79.8%和53.6%的病例是高质量的，分别。当GSM的诊断与WSI进行比较时，各种诊断类别的总体一致性为93%，100%,淋巴瘤占86%,转移,和良性条件分别。WSI检测淋巴瘤的灵敏度和特异度分别为95.2%和85.7%,分别,观察者间的总体一致性(κ)为0.86；95%CI(0.70-0.95)。
UNASSIGNED：我们证明，移动全载玻片成像（WSI）在淋巴结标本恶性浸润的初步诊断中并不逊色于常规玻璃载玻片显微镜（GSM）。我们的结果进一步提供了概念证明，即移动WSI可以适应原发性手术病理的资源受限设置，并将显着改善患者预后。
UNASSIGNED：这是液体活检与常规病理的多中心前瞻性病例对照头对头比较研究的一部分。对于便携式WSI扫描仪验证，这项研究的病理学家评估了2021年2月至12月间经金标准病理学初步证实的105例手术淋巴结标本.由训练有素的组织技术人员根据苏木精和伊红（H＆E）和免疫组织化学（IHC）染色的标准方案处理组织。然后将每个中心的H&E和IHC幻灯片数字化。数字图像被匿名化并由组织技术人员上传到符合HIPAA的服务器。三名研究病理学家在6周的冲洗后独立访问并审查了图像。描述并使用Cohens'kappa系数（κ）测量了病理学家在GSM和WSI上建立的诊断之间的一致性。
未经评估：在GSM上，65.5％（n=84）的标本是淋巴瘤;25％被归类为良性，而9.5%为转移性。对GSM和WSI的形态学质量评估确定79.8%和53.6%的病例是高质量的，分别。当GSM的诊断与WSI进行比较时，各种诊断类别的总体一致性为93%，100%,淋巴瘤占86%,转移,和良性条件分别。WSI检测淋巴瘤的灵敏度和特异度分别为95.2%和85.7%,分别,观察者间的总体一致性(κ)为0.86；95%CI(0.70-0.95)。
UNASSIGNED：我们证明，移动全载玻片成像（WSI）在淋巴结标本恶性浸润的初步诊断中并不逊色于常规玻璃载玻片显微镜（GSM）。我们的结果进一步提供了概念证明，即移动WSI可以适应原发性手术病理的资源受限设置，并将显着改善患者预后。
