A Validation Study Of WSI-based Primary Diagnosis For Malignant Lymphoma | 80456
Journal of Clinical & Experimental Pathology
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Background: The digital pathology is an emerging technology, and its usage on routine practices is spreading worldwide
rapidly. Very recently, FDA allowed marketing of first whole slide imaging (WSI) system for digital pathology, which enables
us use the system even for primary diagnosis. This epoch-making achievement owes a lot to scientific evidences indicated that
WSI is eligible for making accurate pathological diagnoses. However, those studies typically targeting small specimens alone
and the cases requiring immunohistochemistry or special staining, such as malignant lymphoma, were excluded in many
Objective: To provide an evidence of usability of WSI diagnosis for primary diagnosis of malignant lymphoma compared to
conventional glass slide diagnosis and optical microscope.
Design: The cases of malignant lymphoma were retrieved from our case collection. The all slide glasses, including H&E and
immunohistochemistry were digitized using a WSI scanner, NanoZoomer RS (Hamamatsu), with X40 magnification, and a
well-trained pathologist for lymphoma diagnosis had reviewed and made diagnosis for the digitized cases with more than
2 months of washout time interval. Discrepancies between microscope slide and WSI diagnosis were classified into three
categories; concordance, major discrepancy (defined as ones associated with significant difference in clinical treatment), and
minor discrepancy (defined as ones associated with no significant difference in clinical treatment).
Result: At the time of writing this abstract, the study was still ongoing. Tentative data showed excellent concordance rate, over
than 95%, and which was much better than we expected.
Conclusion: WSI is applicable for primary diagnosis of malignant lymphoma, if we make diagnoses with combination of
adequate clinical information, H&E morphology, and immunohistochemistries.
Tomoo Itoh has completed his PhD at Hokkaido University Graduate School of Medicine and presently he is a Professor and Deputy Director of Diagnostic Pathology at Kobe University Hospital, Japan. He is a Board Certified Member of the Japanese Society of Pathology and Board Certified Member of the Japanese Society of Clinical Cytology. He was President of 15th Annual Meeting of Japanese Society of Digital Pathology held in Kobe in 2016, and now one of the core members of the Society.
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