Journal of Pathology Informatics Journal of Pathology Informatics
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Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 46

The importance of eSlide macro images for primary diagnosis with whole slide imaging

1 Department of Pathology, Cannizzaro Hospital, Catania, Italy
2 Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
3 Department of Pathology, Hospital Universitario Puerta del Mar, Cádiz, Spain
4 Department of Pathology, University Health Network, Toronto, Canada
5 Department of Pathology, Henry Ford Health System, Detroit, Michigan, USA
6 Laboratory for Pathology East Netherlands, The Netherlands
7 Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
8 Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan

Correspondence Address:
Dr. Filippo Fraggetta
Department of Pathology, Ospedale Cannizzaro Via Messina 829, 95126 Catania
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpi.jpi_70_18

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Introduction: A whole slide image (WSI) is typically comprised of a macro image (low-power snapshot of the entire glass slide) and stacked tiles in a pyramid structure (with the lowest resolution thumbnail at the top). The macro image shows the label and all pieces of tissue on the slide. Many whole slide scanner vendors do not readily show the macro overview to pathologists. We demonstrate that failure to do so may result in a serious misdiagnosis. Materials and Methods: Various examples of errors were accumulated that occurred during the digitization of glass slides where the virtual slide differed from the macro image of the original glass slide. Such examples were retrieved from pathology laboratories using different types of scanners in the USA, Canada, Europe, and Asia. Results: The reasons for image errors were categorized into technical problems (e.g., automatic tissue finder failure, image mismatches, and poor scan coverage) and human operator mistakes (e.g., improper manual region of interest selection). These errors were all detected because they were highlighted in the macro image. Conclusion: Our experience indicates that WSI can be subject to inadvertent errors related to glitches in scanning slides, corrupt images, or mistakes made by humans when scanning slides. Displaying the macro image that accompanies WSIs is critical from a quality control perspective in digital pathology practice as this can help detect these serious image-related problems and avoid compromised diagnoses.

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