Recent Paper Discussing Potential Quality Pitfalls with WSI in Breast Cases
Interesting paper recently published looking at potential quality issues in breast whole slide images across three scanners used. While it appears there may be tissue missing from an image due to faint staining and often times nearly translucent fatty tissue, the consequence of this seems to be of no diagnostic significance.
Laboratories may want to consider quality measures in terms of thickness of sections and staining protocols beyond fixation and processing to optimize slide quality for optimal image quality.
Abstract:
Using digitalized whole slide images (WSI) in routine histopathology practice is a revolutionary technology. This study aims to assess the clinical impacts of WSI quality and representation of the corresponding glass slides. 40,160 breast WSIs were examined and compared with their corresponding glass slides. The presence, frequency, location, tissue type, and the clinical impacts of missing tissue were assessed. Scanning time, type of the specimens, time to WSIs implementation, and quality control (QC) measures were also considered. The frequency of missing tissue ranged from 2% to 19%. The area size of the missed tissue ranged from 1–70%. In most cases (>75%), the missing tissue area size was <10% and peripherally located. In all cases the missed tissue was fat with or without small entrapped normal breast parenchyma. No missing tissue was identified in WSIs of the core biopsy
specimens. QC measures improved images quality and reduced WSI failure rates by seven-fold. A negative linear correlation s41379-021-01000-8between the frequency of missing tissue and both the scanning time and the image file size was observed (p < 0.05). None of the WSI with missing tissues resulted in a change in the final diagnosis. Missing tissue on breast WSI is observed but with variable frequency and little diagnostic consequence. Balancing between WSI quality and scanning time/image file size should be considered and pathology laboratories should undertake their own assessments of risk and provide the relevant mitigations with the appropriate level of caution.
Modern Pathology; https://doi.org/10.1038/s41379-021-01000-
