Related Experiment Video
Updated: Jun 18, 2026
Introduction of an Integrated Pathology Image Management, Artificial Intelligence, and Reporting System
Published on: July 11, 2025
Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist
David C Wilbur1, Kalil Madi, Robert B Colvin
1Department of Pathology, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, and the Department of Pathology, Harvard Medical School, Boston, MA 02114, USA. dwilbur@partners.org
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 whole-slide 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.
