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Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?

BACKGROUND: Accurate diagnosis of melanocytic lesions is challenging, even for expert pathologists. Nowadays, whole-slide imaging (WSI) is used for routine clinical pathology diagnosis in several laboratories. One of the limitations of WSI, as it is most often used, is the lack of a multiplanar focu...

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Autores principales: Sturm, Bart, Creytens, David, Cook, Martin G., Smits, Jan, van Dijk, Marcory C. R. F., Eijken, Erik, Kurpershoek, Eline, Küsters-Vandevelde, Heidi V. N., Ooms, Ariadne H. A. G., Wauters, Carla, Blokx, Willeke A. M., van der Laak, Jeroen A. W. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415522/
https://www.ncbi.nlm.nih.gov/pubmed/30972225
http://dx.doi.org/10.4103/jpi.jpi_46_18
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author Sturm, Bart
Creytens, David
Cook, Martin G.
Smits, Jan
van Dijk, Marcory C. R. F.
Eijken, Erik
Kurpershoek, Eline
Küsters-Vandevelde, Heidi V. N.
Ooms, Ariadne H. A. G.
Wauters, Carla
Blokx, Willeke A. M.
van der Laak, Jeroen A. W. M.
author_facet Sturm, Bart
Creytens, David
Cook, Martin G.
Smits, Jan
van Dijk, Marcory C. R. F.
Eijken, Erik
Kurpershoek, Eline
Küsters-Vandevelde, Heidi V. N.
Ooms, Ariadne H. A. G.
Wauters, Carla
Blokx, Willeke A. M.
van der Laak, Jeroen A. W. M.
author_sort Sturm, Bart
collection PubMed
description BACKGROUND: Accurate diagnosis of melanocytic lesions is challenging, even for expert pathologists. Nowadays, whole-slide imaging (WSI) is used for routine clinical pathology diagnosis in several laboratories. One of the limitations of WSI, as it is most often used, is the lack of a multiplanar focusing option. In this study, we aim to establish the diagnostic accuracy of WSI for melanocytic lesions and investigate the potential accuracy increase of z-stack scanning. Z-stack enables pathologists to use a software focus adjustment, comparable to the fine-focus knob of a conventional light microscope. MATERIALS AND METHODS: Melanocytic lesions (n = 102) were selected from our pathology archives: 35 nevi, 5 spitzoid tumors of unknown malignant potential, and 62 malignant melanomas, including 10 nevoid melanomas. All slides were scanned at a magnification comparable to use of a ×40 objective, in z-stack mode. A ground truth diagnosis was established on the glass slides by four academic dermatopathologists with a special interest in the diagnosis of melanoma. Six nonacademic surgical pathologists subspecialized in dermatopathology examined the cases by WSI. RESULTS: An expert consensus diagnosis was achieved in 99 (97%) of cases. Concordance rates between surgical pathologists and the ground truth varied between 75% and 90%, excluding nevoid melanoma cases. Concordance rates of nevoid melanoma varied between 10% and 80%. Pathologists used the software focusing option in 7%–28% of cases, which in 1 case of nevoid melanoma resulted in correcting a misdiagnosis after finding a dermal mitosis. CONCLUSION: Diagnostic accuracy of melanocytic lesions based on glass slides and WSI is comparable with previous publications. A large variability in diagnostic accuracy of nevoid melanoma does exist. Our results show that z-stack scanning, in general, does not increase the diagnostic accuracy of melanocytic.
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spelling pubmed-64155222019-04-10 Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy? Sturm, Bart Creytens, David Cook, Martin G. Smits, Jan van Dijk, Marcory C. R. F. Eijken, Erik Kurpershoek, Eline Küsters-Vandevelde, Heidi V. N. Ooms, Ariadne H. A. G. Wauters, Carla Blokx, Willeke A. M. van der Laak, Jeroen A. W. M. J Pathol Inform Research Article BACKGROUND: Accurate diagnosis of melanocytic lesions is challenging, even for expert pathologists. Nowadays, whole-slide imaging (WSI) is used for routine clinical pathology diagnosis in several laboratories. One of the limitations of WSI, as it is most often used, is the lack of a multiplanar focusing option. In this study, we aim to establish the diagnostic accuracy of WSI for melanocytic lesions and investigate the potential accuracy increase of z-stack scanning. Z-stack enables pathologists to use a software focus adjustment, comparable to the fine-focus knob of a conventional light microscope. MATERIALS AND METHODS: Melanocytic lesions (n = 102) were selected from our pathology archives: 35 nevi, 5 spitzoid tumors of unknown malignant potential, and 62 malignant melanomas, including 10 nevoid melanomas. All slides were scanned at a magnification comparable to use of a ×40 objective, in z-stack mode. A ground truth diagnosis was established on the glass slides by four academic dermatopathologists with a special interest in the diagnosis of melanoma. Six nonacademic surgical pathologists subspecialized in dermatopathology examined the cases by WSI. RESULTS: An expert consensus diagnosis was achieved in 99 (97%) of cases. Concordance rates between surgical pathologists and the ground truth varied between 75% and 90%, excluding nevoid melanoma cases. Concordance rates of nevoid melanoma varied between 10% and 80%. Pathologists used the software focusing option in 7%–28% of cases, which in 1 case of nevoid melanoma resulted in correcting a misdiagnosis after finding a dermal mitosis. CONCLUSION: Diagnostic accuracy of melanocytic lesions based on glass slides and WSI is comparable with previous publications. A large variability in diagnostic accuracy of nevoid melanoma does exist. Our results show that z-stack scanning, in general, does not increase the diagnostic accuracy of melanocytic. Medknow Publications & Media Pvt Ltd 2019-02-21 /pmc/articles/PMC6415522/ /pubmed/30972225 http://dx.doi.org/10.4103/jpi.jpi_46_18 Text en Copyright: © 2019 Journal of Pathology Informatics http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Research Article
Sturm, Bart
Creytens, David
Cook, Martin G.
Smits, Jan
van Dijk, Marcory C. R. F.
Eijken, Erik
Kurpershoek, Eline
Küsters-Vandevelde, Heidi V. N.
Ooms, Ariadne H. A. G.
Wauters, Carla
Blokx, Willeke A. M.
van der Laak, Jeroen A. W. M.
Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title_full Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title_fullStr Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title_full_unstemmed Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title_short Validation of Whole-slide Digitally Imaged Melanocytic Lesions: Does Z-Stack Scanning Improve Diagnostic Accuracy?
title_sort validation of whole-slide digitally imaged melanocytic lesions: does z-stack scanning improve diagnostic accuracy?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415522/
https://www.ncbi.nlm.nih.gov/pubmed/30972225
http://dx.doi.org/10.4103/jpi.jpi_46_18
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