Validation of Remote Digital Pathology based diagnostic reporting of Frozen Sections from home

• Main Authors: Rajiv Kumar Kaushal (Author), Subhash Yadav (Author), Ayushi Sahay (Author), Nupur Karnik (Author), Tushar Agrawal (Author), Vinayak Dave (Author), Nikhil Singh (Author), Ashish Shah (Author), Sangeeta B. Desai (Author)
• Format: Book
• Published: Elsevier, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2153-3539; 10.1016/j.jpi.2023.100312
• Keywords: Digital pathology; Frozen section; Primary diagnosis; Validation; Whole-slide imaging; Remote reporting; Computer applications to medicine. Medical informatics; R858-859.7; Pathology; RB1-214
• Source: Journal of Pathology Informatics, Vol 14, Iss , Pp 100312- (2023)

Background: Despite the promising applications of whole-slide imaging (WSI) for frozen section (FS) diagnosis, its adoption for remote reporting is limited. Objective: To assess the feasibility and performance of home-based remote digital consultation for FS diagnosis. Material & Method: Cases accessioned beyond regular working hours (5 pm-10 pm) were reported simultaneously using optical microscopy (OM) and WSI. Validation of WSI for FS diagnosis from a remote site, i.e. home, was performed by 5 pathologists. Cases were scanned using a portable scanner (Grundium Ocus®40) and previewed on consumer-grade computer devices through a web-based browser (http://grundium.net). Clinical data and diagnostic reports were shared through a google spreadsheet. The diagnostic concordance, inter- and intra-observer agreement for FS diagnosis by WSI versus OM, and turnaround time (TAT), were recorded. Results: The overall diagnostic accuracy for OM and WSI (from home) was 98.2% (range 97%-100%) and 97.6% (range 95%-99%), respectively, when compared with the reference standard. Almost perfect inter-observer (k = 0.993) and intra-observer (k = 0.987) agreement for WSI was observed by 4 pathologists. Pathologists used consumer-grade laptops/desktops with an average screen size of 14.58 inches (range = 12.3-17.7 inches) and a network speed of 64 megabits per second (range: 10-90 Mbps). The mean diagnostic assessment time per case for OM and WSI was 1:48 min and 5:54 min, respectively. Mean TAT of 27.27 min per case was observed using WSI from home. Seamless connectivity was observed in approximately 75% of cases. Conclusion: This study validates the role of WSI for remote FS diagnosis for its safe and efficient adoption in clinical use.