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Perceived image quality and diagnostic sufficiency of whole slide imaging scanners: a pathologist-centred evaluation
Jonas Bäcker1,2,3, Christoph Wengenmayr1, Lukas Borcherding4
1Digital Medicine, University Hospital of Augsburg, Augsburg, Germany.
Aim:
Whole slide imaging (WSI) scanners are fundamental to digital pathology, providing high-resolution digitized histology slides. While scanner models vary in throughput, usability and image quality, the impact of these differences on pathologists' diagnostic performance remains insufficiently understood. This study evaluates the perceived image quality and diagnostic sufficiency of four commonly used high-throughput WSI scanners.
Methods And Results:
We selected four bright-field WSI scanners: Leica's Aperio GT 450 DX, Hamamatsu's NanoZoomer S360, 3DHISTECH's Pannoramic 1000 DX and Philips' IntelliSite Ultra Fast Scanner (first generation). A set of 601 slides was digitized on each scanner, and 96 representative slides were selected for evaluation. Fourteen pathologists from the University Hospital of Augsburg's Institute of Pathology assessed sharpness, brightness, contrast, colour realism and artefact frequency. To evaluate diagnostic sufficiency, pathologists were asked whether each scanned image was adequate for making a precise diagnosis when considering brightness/contrast/colour realism, sharpness and artefact frequency. Significant differences in perceived quality were observed across scanners, yet diagnostic sufficiency was rated more positively overall. Here, the Aperio GT 450 DX and NanoZoomer S360 scanners were ranked equally, each achieving the highest median rating for all image quality aspects. The Pannoramic 1000 DX and IntelliSite UFS scanners closely followed with deficits in colour realism and sharpness, respectively. Depending on the scanner model, 4.2% to 22.2% of images were deemed insufficient for diagnosis, with performance varying by tissue type and staining method.
Conclusion:
Scanner differences in diagnostic sufficiency ratings were less pronounced than differences in perceived image quality. These findings highlight the importance of selecting appropriate scanning solutions based on workload and tissue characteristics.
