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Delphi expert consensus for whole slide imaging in thyroid cytopathology
Stefano Marletta1,2, Maria Salatiello3, Liron Pantanowitz4
1Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy.
Summary
Digital pathology using whole slide imaging (WSI) is reliable for primary diagnosis of thyroid fine needle aspirations (FNAs). Expert consensus confirms WSI
Area of Science:
- Digital pathology
- Cytopathology
- Medical imaging
Background:
- Thyroid fine needle aspiration (FNA) procedures are increasingly common.
- Whole slide imaging (WSI) adoption is growing in digital pathology.
- Current digital pathology use is often considered insufficient for primary diagnosis in thyroid FNAs.
Purpose of the Study:
- To validate the diagnostic utility of WSI for thyroid FNAs.
- To employ the Delphi method for expert consensus building.
Main Methods:
- Recruited a panel of experts from seven reference cytology centers.
- Conducted a two-round Delphi process: initial questionnaire and consensus analysis.
- Six investigators evaluated 80 shared WSIs from 80 cases using a 1-5 Likert scale on six morphological questions.
Main Results:
- Achieved high consensus with an average score of 4.27.
- 84% of items were ranked 4 or 5 by physicians.
- Over 95.2% of cases showed good to excellent diagnostic confidence; 78% had no technical limitations.
Conclusions:
- The Delphi study demonstrates broad physician consensus on using digital pathology for thyroid cytopathology.
- Results support the reliability and safety of WSI for primary diagnostic purposes in thyroid FNAs.
