Digital pathology evaluation in the multicenter Nephrotic Syndrome Study Network (NEPTUNE)

Area of Science:

• Nephrology
• Digital Pathology
• Biomedical Imaging

Background:

• Traditional pathology review for clinical trials relies on manual microscopy, leading to variability, high costs, and delays.
• Manual methods present challenges in slide circulation, data integrity, and achieving consensus among pathologists.

Purpose of the Study:

• To implement and evaluate digital pathology using whole slide imaging (WSI) within the Nephrotic Syndrome Study Network (NEPTUNE) for multicenter clinical trials.
• To enhance the accuracy, efficiency, and reproducibility of renal biopsy review through a web-based digital pathology system.

Main Methods:

• Renal biopsy slides were digitized using whole slide imaging (WSI) and stored in a web-based information system.
• A systematic quality control process was established, including metadata and image quality review.
• Digital slides were annotated, with glomeruli uniquely identified and tracked across sections; analysis focused on injury patterns using "descriptors".

Main Results:

• Digital pathology enabled concurrent viewing and annotation of multiple slide sections, improving glomerular counting and lesion identification.
• The WSI approach facilitated independent review by multiple pathologists, enhancing intra- and inter-observer reproducibility.
• Implementation led to increased efficiency, reduced risks associated with slide mailing, and centralized data management.

Conclusions:

• Digital pathology with WSI offers a more accurate, reproducible, and efficient method for renal biopsy review in multicenter clinical trials.
• This technology streamlines pathology review, improves data integrity, and supports web-based consensus meetings, achieving a budget-neutral outcome.