WSI validation studies in breast and gynecological pathology

Area of Science:

• Pathology
• Digital Pathology
• Medical Imaging

Background:

• Virtual slide technology, including whole slide imaging (WSI), has advanced significantly in pathology over the last two decades.
• Studies have explored WSI's utility in breast and gynecological pathology, with this review focusing on validation evidence for the female genital tract and breast.

Approach:

• A systematic literature search was conducted in PubMed and Embase databases for WSI validation studies in breast and gynecological pathology.
• Evaluated topics included pathologist expertise, specimen types, scanners, washout periods, WSI viewing experience, and diagnostic concordance with traditional microscopy.

Key Points:

• 23 studies were included, predominantly focusing on breast pathology.
• Most studies adhered to College of American Pathologists validation guidelines, including dataset size and intra-observer variability.
• Challenges identified include interpreting high-grade nuclear atypia, mitotic counts in ovarian tumors, cervical cytology, and breast cancer grading.

Conclusions:

• Published evidence supports the value of WSI in breast and gynecological pathology.
• Technical issues with WSI systems involve focus, resolution, and immunohistochemical staining contrast/brightness.
• Grading breast cancer and mitotic counting present challenges in WSI, mirroring difficulties in conventional microscopy.