ASSESSMENT OF DIAGNOSTIC CONCORDANCE BETWEEN WHOLE SLIDE MAGING AND CONVENTIONAL GLASS SLIDES IN SURGICAL PATHOLOGY AT UNIVERSITY MEDICAL CENTER HO CHI MINH CITY
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Abstract
Background: Whole Slide Imaging (WSI) is a high-resolution digital scanning technology for histopathological slides, increasingly implemented in surgical pathology worldwide, with diagnostic concordance rates ranging from 87% to 97.7% compared to glass slides. However, evidence validating the clinical utility of WSI in Vietnam remains limited.
Objectives: To evaluate the diagnostic concordance between digital slides and glass slides; classify discordances based on clinical significance; and identify technical and data entry errors in the digitization process.
Methods: A single-blind, non-inferiority study was conducted on 617 biopsy and surgical specimens at the University Medical Center Ho Chi Minh City from February 2024 to January 2025. Seven pathologists independently reviewed glass slides (phase 1) and digital slides (phase 2) after a washout period of at least four weeks. Slides were digitized using the Aperio GT450 DX scanner. Concordance rates, Cohen’s Kappa (κ), and levels of discordance were analyzed.
Results: The overall concordance rate was 95.8%. The Kappa coefficient was κ = 0.956 (95% CI: 0.939–0.972), indicating almost perfect agreement. Clinically significant discordance was very low (0.3%), lower than reported in international literature. Minor discordance accounted for 2.3%, while typographical/coding errors and technical/data errors each accounted for 0.8%.
Conclusions: WSI is non-inferior to conventional glass slides in surgical pathology diagnosis, demonstrating high concordance and minimal clinically significant discrepancies, supporting its routine implementation in Vietnam.
Keywords
Whole Slide Imaging, digital pathology, diagnostic concordance, Kappa coefficient, noninferiority.
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References
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