• Ali Alassiri, Amna Almutrafi, Fahd Alsufiani, Atheer Al Nehkilan, Alaa Al Salim, Hesham Musleh, Mohammad Aziz, and Walid Khalbuss.
• From the Pathology and Laboratory Medicine Department, College of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2020 Jan 1; 40 (1): 36-41.

BackgroundDigital pathology practice is rapidly gaining popularity among practicing anatomic pathologists. Acceptance is higher among the newer generation of pathologists who are willing to adapt to this new diagnostic method due to the advantages offered by whole slide imaging (WSI) compared to traditional light microscopy (TLM). We performed this validation study because we plan to implement the WSI system for diagnostic services.ObjectivesDetermine the feasibility of using digital pathology for diagnostic services by assessing the equivalency of WSI and TLM.DesignA laboratory-based cross-sectional study.SettingCentral laboratory at a tertiary health care center.Materials And MethodsFour practicing surgical pathologists participated in this study. Each pathologist blindly reviewed 60 surgical neuropathology cases with a minimum 8-week washout-period between the two diagnostic modalities (WSI vs. TLM). Intraobserver concordance rates between WSI and TLM diagnoses as compared to the original diagnosis were calculated.Main Outcome MeasuresOverall intraobserver concordance rates between each diagnostic method (WSI and TLM) and original diagnosis.Sample Size60 in-house surgical neuropathology cases.ResultsThe overall intraobserver concordance rate between TLM and original diagnosis was 86.3% (range 76.7%-91.7%) versus 80.8% for WSI (range 68.3%-88.3%). These findings are suggestive of the superiority of TLM, but the Fleiss' Kappa statistic indicated that the two methods are equivalent, despite the low level of the K value.ConclusionWSI is not inferior to the light microscopy and is feasible for primary diagnosis in surgical neuropathology. However, to ensure the best results, only formally trained neuropathologists should handle the digital neuropathology service.LimitationsOnly one diagnostic slide per case rather than the whole set of slides, sample size was relatively small, and there was an insufficient number of participating neuropathologists.Conflict Of InterestNone.

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