Journal of Clinical & Experimental Pathology
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Virtual microscopy is rapidly emerging as a key technology for managing archival material and sharing consultations
electronically. Recently, the College of American Pathologists (CAP) published their first guidelines for validating the
use of virtual microscopy for clinical cases. These guidelines do not include technical specifications for software or hardware
components. Therefore, we attempted to validate virtual microscopy for clinical evaluation of surgical pathology and
cytopathology specimens at our pediatric hospital using currently available standard slide scanning resources, and computer
resources currently available to the pathologists. To complete the validation according to the CAP guidelines of representing
our case material, we selected a combination of consecutive cases and select cases in specific less common diagnostic
categories. Our validation process included both surgical and cytopathology cases, divided among the nine pathologists
who had previously completed clinical evaluation of the glass slides. Overall, diagnostic correlation was high between glass
slide diagnoses and the corresponding virtual slide reviews. For surgical pathology specimens, small biopsies were scanned
at 40x objective magnification based on pathologist feedback of the virtual slide evaluation. Cytology specimen evaluation
was challenging due to the specimen thickness. Rarely, cytology slides which were extremely paucicellular were not able to
be imaged for evaluation. We believe that validation of virtual microscopy for clinical evaluation of most surgical pathology
specimens can be accomplished with current standard scanning and computer resources.
Michael Arnold completed his M.D. Ph.D. at the University of Texas Southwestern Medical Center at Dallas. He completed his Anatomic Pathology Residency at
the National Institutes of Health, and a fellowship in Pediatric Pathology at Nationwide Children?s Hospital. He is currently an Assistant Professor of Pathology at
Nationwide Children?s Hospital and The Ohio State University College of Medicine in Columbus, Ohio.
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