Digital pathology in real-life conditions for daily cytopathological diagnosis: a feasibility study.

Background: Nowadays, there is an increasing adoption of digital pathology for diagnostic purposes.

Aim: Herein we study the feasibility of cytopathological diagnosis by whole slide imaging (WSI) in daily practice.

Material and methods: Hundred and ten consecutive non-gynecologic cytopathology cases, originally diagnosed under light microscopy (LM) by two pathologists, were scanned at X40. Then, cases were diagnosed on WSI, by the same pathologist who originally rendered the conventional diagnosis. The pathologists were blinded to the diagnosis made by light microscopy, but they had access to the same clinical information. The washout period was at least 3 months. WSI diagnoses were compared to the original LM diagnoses, and cases were considered concordant if the two types of diagnosis were identical.

Results and analysis: LM and the WSI diagnoses were concordant in 87.3% [95%CI: 79.6; 92.9] of cases. Intra-observer agreement was lowest for thyroid fine-needle aspiration cytology (FNAC) (only 1 case out of 5). After exclusion of thyroid cases, the concordance rate between WSI and LM was 90.5% [95%CI: 83.2%; 95.3%].

Conclusion: Primary cytological diagnosis can be done using our digital system.