Alpha Omega Alpha Honor Medical Society

2014 Research Abstract

Comparing Whole Slide Digital Images versus Traditional Glass Slides in the Detection of Common Microscopic Features Seen in Dermatitis

Investigator: Nikki Vyas, USF Health Morsani College of Medicine

Mentor: Drazen M. Jukic, MD, PhD


BACKGROUND: The quality and limitations of digital slides are not completely known and need to be fully investigated. We aimed to estimate intrapathologist discrepancy when detecting specific microscopic features on glass slides and digital slides created by scanning at 20X. We examined differences between both media in the detection of certain microscopic features, the power of objective magnification needed, and the time needed assess each case.

METHODS: Hematoxylin and eosin and periodic acid–Schiff glass slides were scanned into DS using the Mirax Scan (Carl Zeiss Inc., Germany). Six dermatopathologists were assigned a set of 50-71 digital slides. We recorded objective magnification total time, and observation of the following: eosinophils; plasma cells; pigmented macrophages; epidermal melanin; fungal bodies; neutrophils; Civatte bodies; foamy cells; parakeratosis; sebocytes; and mast cells. This process was repeated for corresponding glass slides after 3 weeks. Diagnosis was not required.

RESULTS: The mean time to assess digital slides was 176.77 seconds and 137.61 seconds for glass slides (p<0.001, 99% CI). The average objective magnification used to detect features using digital slides was 18.28 and 14.07 for glass slides (p<0.001, 99.99% CI, see Table 6). Parakeratosis, Civatte bodies, pigmented macrophages, melanin at the epidermis, foamy cells, mast cells, eosinophils, plasma cells, and PMNs, were identified at lower objectives on glass slides (p = 0.023-0.001, 95% CI. Overall average intraobserver concordance ranged from κ = 0.30 – 0.78. The individual features with poor to fair average concordance were: melanin at the epidermis (κ = 0.15-0.58); foamy cells (κ = 0.26-0.46); plasma cells (κ = 0.15-0.49); and PMNs (κ = 0.12-0.48). Features with moderate average intrapathologist concordance were: parakeratosis (κ = 0.21-0.61); Civatte bodies (κ = 0.21-0.71); pigment-laden macrophages (κ = 0.34-0.66); mast cells (κ = 0.29-0.78); and eosinophils (κ = 0.31-0.79). The average intrapathologist concordance was good for sebocytes (κ = 0.51-1.00) and fungal bodies (κ = 0.47-0.76).

CONCLUSIONS: Telepathology using digital slides scanned at 20X is sufficient, but less efficient than traditional glass slides. Digital slides may have higher sensitivity for identifying sebocytes.

Last modified: 10/20/15

Updated on October 20, 2015.

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