Complete Digital Pathology for Routine Histopathology Diagnosis in a Multicenter Hospital Network.

CONTEXT.— Complete digital pathology and whole slide imaging for routine histopathology diagnosis is currently in use in few laboratories worldwide. Granada University Hospitals, Spain, which comprises 4 hospitals, adopted full digital pathology for primary histopathology diagnosis in 2016. OBJECTIVE.— To describe the methodology adopted and the resulting experience at Granada University Hospitals in transitioning to full digital diagnosis. DESIGN.— All histopathology glass slides generated for routine diagnosis were digitized at ×40 using the Philips IntelliSite Pathology Solution, which includes an ultrafast scanner and an image management system. All hematoxylin-eosin-stained preparations and immunohistochemistry and histochemistry slides were digitized. The existing sample-tracking software and image management system were integrated to allow data interchange through the Health Level 7 protocol. RESULTS.— Circa 160 000 specimens have been signed out using digital pathology for primary diagnosis. This comprises more than 800 000 digitized glass slides. The scanning error rate during the implementation phase was below 1.5%, and subsequent workflow optimization rendered this rate negligible. Since implementation, Granada University Hospitals pathologists have signed out 21% more cases per year on average. CONCLUSIONS.— Digital pathology is an adequate medium for primary histopathology diagnosis. Successful digitization relies on existing sample tracking and integration of the information technology infrastructure. Rapid and reliable scanning at ×40 equivalent was key to the transition to a fully digital workflow. Digital pathology resulted in efficiency gains in the preanalytical and analytical phases, and created the basis for computational pathology: the use of computer-assisted tools to aid diagnosis.

[1]  K. Jenpanich,et al.  [Drug administration]. , 1976, Thai journal of nursing.

[2]  John R. Gilbertson,et al.  Computer aided diagnostic tools aim to empower rather than replace pathologists: Lessons learned from computational chess , 2011, Journal of pathology informatics.

[3]  Alexis B. Carter,et al.  Validating whole slide imaging for diagnostic purposes in pathology: guideline from the College of American Pathologists Pathology and Laboratory Quality Center. , 2013, Archives of pathology & laboratory medicine.

[4]  Adam Bagg,et al.  Development and implementation of a custom integrated database with dashboards to assist with hematopathology specimen triage and traffic , 2014, Journal of pathology informatics.

[5]  Jonas S. Almeida,et al.  Mining genome sequencing data to identify the genomic features linked to breast cancer histopathology , 2014, Journal of pathology informatics.

[6]  A. Evans,et al.  Implementation of Whole Slide Imaging for Clinical Purposes: Issues to Consider From the Perspective of Early Adopters. , 2017, Archives of pathology & laboratory medicine.

[7]  Liron Pantanowitz,et al.  Routine Digital Pathology Workflow: The Catania Experience , 2017, Journal of pathology informatics.

[8]  Jon Griffin,et al.  Digital pathology in clinical use: where are we now and what is holding us back? , 2017, Histopathology.

[9]  Anca Bucur,et al.  Evaluating the benefits of digital pathology implementation: time savings in laboratory logistics , 2018, Histopathology.

[10]  Clive R. Taylor,et al.  Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology , 2017, The American journal of surgical pathology.

[11]  M. Salto‐Tellez,et al.  Artificial intelligence—the third revolution in pathology , 2019, Histopathology.