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Li H, Du Z, Zhu L, Zhang C, Xiong J, Zhou B, Dong B, Zhang X, Alifu N. Ultrabright NIR-IIb Fluorescence Quantum Dots for Targeted Imaging-Guided Surgery. ACS APPLIED MATERIALS & INTERFACES 2024; 16:32045-32057. [PMID: 38861701 DOI: 10.1021/acsami.4c04748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Pioneering approaches for precise tumor removal involve fluorescence-guided surgery, while challenges persist, including the low fluorescence contrast observed at tumor boundaries and the potential for excessive damage to normal tissue at the edges. Lead/cadmium sulfide quantum dots (PbS@CdS QDs), boasting high quantum yields (QYs) and vivid fluorescence, have facilitated advancements in the second near-infrared window (NIR-II, 900-1700 nm). However, during fluorescent surgical navigation operations, hydrophilic coatings of these inorganic nanoparticles (NPs) guarantee biosafety; it also comes at the expense of losing a significant portion of QY and NIR-II fluorescence, causing heightened damage to normal tissues caused by cutting edges. Herein, we present hydrophilic core-shell PbS@CdS@PEG NPs with an exceptionally small diameter (∼8 nm) and a brilliant NIR-IIb (1500-1700 nm) emission at approximately 1600 nm. The mPEG-SH (MW: 2000) addresses the hydrophobicity and enhances the biosafety of PbS@CdS QDs. In vivo fluorescence-guided cervical tumor resection becomes achievable immediately upon injection of an aqueous solution of PbS@CdS@PEG NPs. Notably, this approach results in a significantly reduced thickness (100-500 μm) of damage to normal tissues at the margins of the resected tumors. With a high QY (∼30.2%) and robust resistance to photobleaching, NIR-IIb imaging is sustained throughout the imaging process.
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Affiliation(s)
- Hui Li
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi 830054, China
| | - Zhong Du
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 841100, China
| | - Lijun Zhu
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 841100, China
| | - Chi Zhang
- Department of Labor Hygiene and Environmental Hygiene, School of Public Health, Xinjiang Medical University, Urumqi 830054, China
| | - Jiabao Xiong
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 841100, China
| | - Bingshuai Zhou
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun 130012, China
| | - Biao Dong
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830054, China
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun 130012, China
| | - Xueliang Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi 830054, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830054, China
| | - Nuernisha Alifu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi 830054, China
- Department of Labor Hygiene and Environmental Hygiene, School of Public Health, Xinjiang Medical University, Urumqi 830054, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830054, China
- The Second Affiliated Hospital of Xinjiang Medical University, Urumqi 841100, China
- Engineering Research Center of Xinjiang and Central Asian Medicine Resources, Ministry of Education, Urumqi 830017, China
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Turashvili G, Gjeorgjievski SG, Wang Q, Ewaz A, Ai D, Li X, Badve SS. Intraoperative assessment of axillary sentinel lymph nodes by telepathology. Breast Cancer Res Treat 2023; 202:423-434. [PMID: 37688667 DOI: 10.1007/s10549-023-07101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 08/17/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE Although axillary dissection is no longer indicated for many breast cancer patients with 1-2 positive axillary sentinel lymph nodes (ASLN), intraoperative ASLN assessment is still performed in many institutions for patients undergoing mastectomy or neoadjuvant therapy. With recent advancements in digital pathology, pathologists increasingly evaluate ASLN via remote telepathology. We aimed to compare the performance characteristics of remote telepathology and conventional on-site intraoperative ASLN assessment. METHODS Data from ASLN evaluation for breast cancer patients performed at two sites between April 2021 and October 2022 was collated. Remote telepathology consultation was conducted via the Aperio eSlideManager system. RESULTS A total of 385 patients were identified during the study period (83 telepathology, 302 on-site evaluations). Although not statistically significant (P = 0.20), the overall discrepancy rate between intraoperative and final diagnoses was slightly higher at 9.6% (8/83) for telepathology compared with 5.3% (16/302) for on-site assessment. Further comparison of performance characteristics of ASLN assessment between telepathology and conventional on-site evaluation revealed no statistically significant differences between deferral rates, discrepancy rates, interpretive or sampling errors, major or minor disagreements, false negative or false positive results as well as clinical impact and turn-around time (P ≥ 0.12). CONCLUSION ASLN assessment via telepathology is not significantly different from conventional on-site evaluation, although it shows a slightly higher overall discrepancy rate between intraoperative and final diagnoses (9.6% vs. 5.3%). Further studies are warranted to ensure accuracy of ASLN assessment via telepathology.
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Affiliation(s)
- Gulisa Turashvili
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Sandra Gjorgova Gjeorgjievski
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Qun Wang
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Abdulwahab Ewaz
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Di Ai
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Sunil S Badve
- Department of Pathology and Laboratory Medicine, Emory University Hospital, 1364 Clifton Road NE, Atlanta, GA, 30322, USA
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Garavand A, Aslani N, Behmanesh A, Khara R, Ehsanzadeh SJ, Khodaveisi T. Features of teleoncology in lung cancer: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 114:107831. [PMID: 37295044 DOI: 10.1016/j.pec.2023.107831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 05/17/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES There are several challenges in providing healthcare services for lung cancer patients. Using teleoncology is an effective solution to meet such challenges. Given this, we in this study aimed to identify the features of teleoncology in lung cancer. METHODS We conducted this scoping review in 2023. We first searched scientific databases including PubMed, Scopus, ISI Web of Sciences, and Science Direct by combining related keywords for the past 12 years (2012-2023). RESULTS After reviewing 860 articles, we selected 39 studies for the purpose of this study. The interventions of teleoncology for lung cancer patients have four main categories, namely: monitoring of symptoms, monitoring the process of treatment and rehabilitation of patients, self-management and patient empowerment, and providing consultation for patients. CONCLUSION The appropriate implementation of teleoncology systems improves the patient's condition and reduces lung cancer complications by improving the availability of different health services. PRACTICE IMPLICATIONS More attention should be paid to the evaluation of telemedicine systems from the perspective of patients and health service providers. Also, the latest platforms, including mobile phone-based software, should be used to implement such systems.
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Affiliation(s)
- Ali Garavand
- Department of Health Information Technology, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nasim Aslani
- Department of Health Information Technology, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Behmanesh
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Jafar Ehsanzadeh
- English Language Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Taleb Khodaveisi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
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Kaushal RK, Yadav S, Sahay A, Karnik N, Agrawal T, Dave V, Singh N, Shah A, Desai SB. Validation of Remote Digital Pathology based diagnostic reporting of Frozen Sections from home. J Pathol Inform 2023; 14:100312. [PMID: 37214151 PMCID: PMC10192998 DOI: 10.1016/j.jpi.2023.100312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/24/2023] Open
Abstract
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.
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Affiliation(s)
- Rajiv Kumar Kaushal
- Corresponding author at: Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Dr Ernest Borges Marg, Parel, Mumbai 400 012, India.
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Kantasiripitak C, Laohawetwanit T, Apornvirat S, Niemnapa K. Validation of whole slide imaging for frozen section diagnosis of lymph node metastasis: A retrospective study from a tertiary care hospital in Thailand. Ann Diagn Pathol 2022; 60:151987. [PMID: 35700561 DOI: 10.1016/j.anndiagpath.2022.151987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/23/2022] [Accepted: 06/03/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The use of whole slide imaging (WSI) for frozen section (FS) diagnosis is helpful, particularly in the context of pathologist shortages. However, there is minimal data on such usage in resource-limited settings. This study aims to validate the use of WSI for FS diagnosis of lymph node metastasis using a low-cost virtual microscope scanner with consumer-grade laptops at a tertiary care hospital in Thailand. METHODS FS slides were retrieved for which the clinical query was to evaluate lymph node metastasis. They were digitized by a virtual microscope scanner (MoticEasyScan, Hong Kong) using up to 40× optical magnification. Three observers with different pathology experience levels diagnosed each slide, reviewing glass slides (GS) followed by digital slides (DS) after two weeks of a wash out period. WSI and GS diagnoses were compared. The time used for scanning and diagnosis of each slide was recorded. RESULTS 295 FS slides were retrieved and digitized. The first-time successful scanning rate was 93.6 %. The mean scanning time was 2 min per slide. Both intraobserver agreement and interobserver agreement of WSI and GS diagnoses were high (Cohen's K; kappa value >0.84). The time used for DS diagnosis decreased as the observer's experience with WSI increased. CONCLUSIONS Despite varying pathological experiences, observers using WSI provided accurate FS diagnoses of lymph node metastasis. The time required for DS diagnoses decreased with additional observer's experience with WSI. Therefore, a WSI system containing low-cost scanners and consumer-grade laptops could be used for FS services in hospital laboratories lacking pathologists.
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Affiliation(s)
| | - Thiyaphat Laohawetwanit
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand; Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.
| | - Sompon Apornvirat
- Division of Pathology, Thammasat University Hospital, Pathum Thani, Thailand; Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Kongkot Niemnapa
- Advanced Digital Simulation Center, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
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Girolami I, Neri S, Eccher A, Brunelli M, Hanna M, Pantanowitz L, Hanspeter E, Mazzoleni G. Frozen section telepathology service: Efficiency and benefits of an e-health policy in South Tyrol. Digit Health 2022; 8:20552076221116776. [PMID: 35923756 PMCID: PMC9340333 DOI: 10.1177/20552076221116776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/13/2022] [Indexed: 12/03/2022] Open
Abstract
Objective/Background Telepathology has been widely adopted to allow intraoperative pathology
examinations to be performed remotely and for obtaining second opinion
teleconsultation. In the Italian northern region of South Tyrol, the
widespread geographical distances and consequent cost for the health system
of having a travelling pathologist cover intraoperative consultations in
peripheral hospitals was a key driver for the implementation of a
telepathology system. Methods In 2010, four Menarini D-Sight whole slide scanners to digitize entire
pathology slides were placed in the peripheral hospitals of Merano,
Bressanone, Brunico, and in the hub hospital of Bolzano. Digital
workstations were also installed to allow pathologists to remotely perform
intraoperative consultations with digital slides. This study reviews the
outcome after 12 years of telepathology for this intended clinical use. Results After an initial validation phase with 100 cases which yielded a sensitivity
of 65% (CI 43–84%) and specificity of 100% (CI 95–100%), there were 2058
intraoperative consultations handled by telepathology. The cases evaluated
were mainly breast sentinel lymph nodes, followed by urological,
gynecological and general surgical pathology frozen section specimens. There
were no false-positive cases and 165 (8%) false-negative cases, yielding an
overall sensitivity and specificity of 65% (CI 61–69%) and 100% (CI
99–100%), respectively. Conclusion Telepathology is reliable for remote intraoperative diagnosis and, despite
technical issues and initial acquaintance issues, proved beneficial for
patient care in satellite hospitals, improved standardization, promoted
innovation, and resulted in cost savings for the health system.
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Affiliation(s)
- Ilaria Girolami
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Stefania Neri
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Mattew Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Liron Pantanowitz
- Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, MI, USA
| | - Esther Hanspeter
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Guido Mazzoleni
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
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He X, Wang L, Wang L, Gao J, Cui F, Ma Q, Zhang W, Wang L, Zhai Y, Zhao J. Effectiveness of a Cloud-Based Telepathology System in China: Large-Sample Observational Study. J Med Internet Res 2021; 23:e23799. [PMID: 34326037 PMCID: PMC8367172 DOI: 10.2196/23799] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/18/2020] [Accepted: 05/24/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Whole-slide imaging allows the entire slide to be viewed in a manner that simulates microscopy; therefore, it is widely used in telepathology. However, managing the large digital files needed for whole-slide imaging is difficult. To solve this problem, we set up the Chinese National Cloud-Based Telepathology System (CNCTPS). CNCTPS has been running for more than 4 years and has accumulated a large amount of data. OBJECTIVE The main purpose of this study was to comprehensively evaluate the effectiveness of the CNCTPS based on a large sample. The evaluation indicators included service volume, turnaround time, diagnosis accuracy, and economic benefits. METHODS Details of 23,167 cases submitted to the CNCTPS from January 2016 to December 2019 were collected to analyze the service volume, turnaround time, and economic benefits. A total of 564 patients who visited the First Affiliated Hospital of Zhengzhou University and obtained final diagnoses were followed up to analyze the diagnostic accuracy of the CNCTPS. RESULTS From 2016 to 2019, the service volume of the CNCTPS increased from 2335 to 9240, and the number of participating hospitals increased from 60 to 74. Consultation requests from county-level hospitals accounted for 86.57% (20,287/23,167). A total of 17,495 of 23,167 cases (75.52%) were confirmed, including 12,088 benign lesions, 5217 malignant lesions, and 190 borderline lesions. Of the cases, 3.85% (893/23,167) failed to be diagnosed for reasons such as poor slice quality and incomplete sampling. The median turnaround time was 16.93 hours and was shortened yearly (between 2018 and 2019: adjusted P=.01; other groups: adjusted P<.001); 82.88% cases were diagnosed in 48 hours. There was a discrepancy between the diagnosis and final diagnosis for 11 cases, including 4 false-positive cases and 7 false-negative cases. The sensitivity and specificity were 97.66% and 98.49%, respectively. The diagnostic accuracy of the system was 98.05%, with no statistical difference from the final diagnosis in the hospital (P=.55). By using this system, a total of US $300,000 was saved for patients every year. CONCLUSIONS The novel cloud-based telepathology system has the potential to relieve the shortage of pathologists in primary hospitals. It can also simultaneously reduce medical costs for patients in China. It should, therefore, be further promoted to enhance the efficiency, quantity, and quality of telepathology diagnoses.
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Affiliation(s)
- Xianying He
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linlin Wang
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Li Wang
- Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinghong Gao
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,National Engineering Laboratory for Internet Medical Systems and Applications, Zhengzhou, China
| | - Fangfang Cui
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianqian Ma
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenjie Zhang
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,National Engineering Laboratory for Internet Medical Systems and Applications, Zhengzhou, China
| | - Lin Wang
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunkai Zhai
- School of Management Engineering, Zhengzhou University, Zhengzhou, China
| | - Jie Zhao
- National Telemedicine Center of China, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,National Engineering Laboratory for Internet Medical Systems and Applications, Zhengzhou, China
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Laurent-Bellue A, Poullier E, Pomerol JF, Adnet E, Redon MJ, Posseme K, Trassard O, Cherqui D, Zarca K, Guettier C. Four-Year Experience of Digital Slide Telepathology for Intraoperative Frozen Section Consultations in a Two-Site French Academic Department of Pathology. Am J Clin Pathol 2020; 154:414-423. [PMID: 32459303 DOI: 10.1093/ajcp/aqaa055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To share our experience with digital slide telepathology for intraoperative frozen section consultations (IOCs) and to describe its evolution over time by reporting performance metrics and addressing organizational and economic aspects. METHODS Since 2013, a technician has been alone at the surgical site. At the other site, the pathologist opens the digital slide from a local server via the intranet. Three periods were compared: a 6-month period of conventional IOC (period 1), a 24-month period of telepathology at 6 months after implementation (period 2), and a 12-month period of telepathology at 3.5 years after implementation (period 3). RESULTS In total, 87 conventional IOCs and 464 and 313 IOCs on digital slides were performed respectively during periods 1, 2, and 3; mean turnaround time was 27, 36, and 38 minutes, respectively, and there were a mean number of 1.1, 1.1, and 1.3 slides, respectively, per IOC. Diagnostic accuracy was achieved in 95.4%, 92.7%, and 93.9%, respectively, of IOCs (not significant). The additional cost is in the same range as the cost of urgent transport by courier. CONCLUSIONS Developing IOC with digital slides is a challenge but is necessary to optimize medical time in the current context of pathologist shortage and budget restrictions.
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Affiliation(s)
- Astrid Laurent-Bellue
- Department of Pathology, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
| | - Eric Poullier
- Information System Department, AP-HP, Campus Picpus, Paris, France
| | | | - Eric Adnet
- Information System Department, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Marie-José Redon
- Department of Pathology, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Katia Posseme
- Department of Pathology, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Olivier Trassard
- Department of Pathology, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Daniel Cherqui
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
- Department of Surgery, Centre Hépato-Biliaire, AP-HP-Université Paris Saclay, Hôpital Paul Brousse, Villejuif, France
| | - Kevin Zarca
- URC eco Ile-de-France, AP-HP-Université Paris V, Paris, France
| | - Catherine Guettier
- Department of Pathology, AP-HP-Université Paris Saclay, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France
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Dietz RL, Hartman DJ, Pantanowitz L. Systematic Review of the Use of Telepathology During Intraoperative Consultation. Am J Clin Pathol 2020; 153:198-209. [PMID: 31618416 PMCID: PMC7317083 DOI: 10.1093/ajcp/aqz155] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To compare studies that used telepathology systems vs conventional microscopy for intraoperative consultation (frozen-section) diagnosis. METHODS A total of 56 telepathology studies with 13,996 cases in aggregate were identified through database searches. RESULTS The concordance of telepathology with the reference standard was generally excellent, with a weighted mean of 96.9%. In comparison, we identified seven studies using conventional intraoperative consultation that showed a weighted mean concordance of 98.3%. Evaluation of the risk of bias showed that most of these studies were low risk. CONCLUSIONS Despite limitations such as variation in reporting and publication bias, this systematic review provides strong support for the safety of using telepathology for intraoperative consultations.
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Griffin J, Kitsanta P, Perunovic B, Suvarna SK, Bury J. Digital pathology for intraoperative frozen section diagnosis of thoracic specimens: an evaluation of a system using remote sampling and whole slide imaging diagnosis. J Clin Pathol 2019; 73:503-506. [PMID: 31806732 DOI: 10.1136/jclinpath-2019-206236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/12/2019] [Accepted: 11/19/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Digital pathology is now used for primary diagnostic work as well as teaching, research and consultation. In our multisite institution service reorganisation led to histopathology being located in a separate hospital from some surgical specialities. We implemented remotely supervised specimen sampling and frozen section diagnosis using digital pathology. In this study we assessed the concordance of glass and digital slide diagnosis using this system. METHODS We reviewed cases from the first 2 years of digital frozen section reporting at our institution. Cases with potential digital to glass slide discordance were reviewed by three experienced thoracic histopathologists. The reasons for discordance were determined and common themes identified. We also reviewed critical incidents relating to digital pathology during the study period. RESULTS The study population comprised 211 cases. Frozen section to final diagnosis concordance between digital and glass slide diagnosis was found in 196 (92.6%) cases. The 15 potentially discordant cases were reviewed. Intraobserver concordance between glass and digital slide review ranged from 9/15 to 12/15 cases across the three pathologists. Glass slide review diagnosis showed better concordance with ground truth in two cases; digital slide review was more accurate in two cases. One relevant critical incident was identified during the study period. DISCUSSION This is the largest study to examine digital pathology for thoracic frozen section diagnosis and shows that this is a safe and feasible alternative to glass slide diagnosis. Discordance between digital and glass slide diagnoses were unrelated to the processes of whole slide imaging and digital microscopy.
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Affiliation(s)
- Jon Griffin
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Panagiota Kitsanta
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Branko Perunovic
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - S Kim Suvarna
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jonathan Bury
- Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Menter T, Nicolet S, Baumhoer D, Tolnay M, Tzankov A. Intraoperative frozen section consultation by remote whole-slide imaging analysis -validation and comparison to robotic remote microscopy. J Clin Pathol 2019; 73:350-352. [PMID: 31719106 PMCID: PMC7279565 DOI: 10.1136/jclinpath-2019-206261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 11/10/2022]
Abstract
Digital pathology including whole slide image (WSI) acquisition is a promising tool for histopathologic teleconsultation. To test and validate the use of WSI in comparison with robotic microscopy for intraoperative frozen section consultation of peripheral hospitals serviced by our department, we compared the VENTANA DP 200 slide scanner with an established remote-controlled digital microscope. Thirty cases were retrospectively analysed. In comparison with a median specimen handling time of 19 min using remote-controlled microscopy, the WSI handling was significantly shorter (11 min, p=0.0089) and offered better image quality, for example, allowing to detect a positive resection margin by a malignant melanoma that had been missed using the former system. Prospectively assessed on 12 cases, the median handling time was 6 min. Here, we demonstrate the applicability and the advantages of WSI for intraoperative frozen section teleconsultation. WSI-based telepathology prooves to be an efficient and reliable tool providing superior turn-around time and image resolution.
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Affiliation(s)
- Thomas Menter
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Stefan Nicolet
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Daniel Baumhoer
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Markus Tolnay
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
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