Validation of whole-slide imaging in the primary diagnosis of liver biopsies in a University Hospital
Validation of whole-slide imaging in the primary diagnosis of liver biopsies in a University Hospital
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DOI：
10.1016/j.dld.2017.07.002
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发表时间：
2017-11-01
影响因子：
4.5
通讯作者：
Ordi, Jaume
中科院分区：
文献类型：
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作者：
Saco, Adela;Diaz, Alba;Ordi, Jaume
背景：使用全切片成像（WSI）进行初步诊断的经验有限，目前还没有全面的报告评估该技术在肝活检标本中的应用。目的：比较WSI与常规光镜（CLM）在肝穿刺活检诊断中的准确性。方法：两位经验丰富的肝脏病理学家对巴塞罗那医院门诊病理性部的176例连续活检进行了盲目分析。其中一名观察员用CLM进行首次评估，用WSI进行第二次评估，而另一名观察员用WSI进行第一次评估，用CLM进行第二次评估。所有的切片都在400倍的Ventana iScan HT中数字化，并使用Virtuoso查看器进行评估（罗氏诊断）。我们使用kappa统计（kappa）进行两次观察。结果：WSI和CLM评价之间的观察者内部一致性几乎是完美的（96.6%,kappa = 0.9； 95%置信区间[95% CI]：观察者1的0.9-1,90.3%,kappa = 0.9；观察者2的95% CI: 0.8-0.9）。原生活检和移植活检在诊断上几乎完全一致。结论：WSI对肝穿刺活检标本诊断准确。该技术可可靠地用于常规诊断。(C) 2017年由Elsevier Ltd代表Editrice gastroenteritaliana S.r.l出版。
Background: Experience in the use of whole slide imaging (WSI) for primary diagnosis is limited and there are no comprehensive reports evaluating this technology in liver biopsy specimens.Aims: To determine the accuracy of interpretation of WSI compared with conventional light microscopy (CLM) in the diagnosis of needle liver biopsies.Methods: Two experienced liver pathologists blindly analyzed 176 consecutive biopsies from the Pathology Department at the Hospital Clinic of Barcelona. One of the observers performed the initial evaluation with CLM, and the second evaluation with WSI, whereas the second observer performed the first evaluation with WSI and the second with CLM. All slides were digitized in a Ventana iScan HT at 400x and evaluated with the Virtuoso viewer (Roche diagnostics). We used kappa statistics (kappa) for two observations.Results: Intra-observer agreement between WSI and CLM evaluations was almost perfect (96.6%, kappa = 0.9; 95% confidence interval [95% CI]: 0.9-1 for observer 1, and 90.3%, kappa = 0.9; 95% CI: 0.8-0.9 for observer 2). Both native and transplantation biopsies showed an almost perfect concordance in the diagnosis.Conclusion: Diagnosis of needle liver biopsy specimens using WSI is accurate. This technology can reliably be introduced in routine diagnosis. (C) 2017 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.