VALIDATION OF DIGITAL MICROSCOPY IN THE HISTOPATHOLOGIC DIAGNOSES OF ORAL DISEASES

Objective This study aimed to provide information regarding the performance of whole slide imaging (WSI) and to validate its use in oral diseases diagnosis, using the intraobserver variability as the primary form of analysis. Study Design Seventy hematoxylin and eosin (H&E)-stained glass slides of oral biopsies were scanned using the Aperio Digital Pathology System at a magnification of 20 x. Two experienced oral pathologists blindly analyzed all H&E-stained sections with a conventional light microscope (CLM) and, after a 3-month washout, with WSI. Clinical information was provided along with the cases in both analyses. Results The intraobserver agreement between CLM and WSI was 97% (κ = 0.9) for both pathologists. The majority of preferred diagnoses were achieved by CLM. Both pathologists had the same discordances in different cases. Challenging cases, and cases with insufficient quantity of tissue for analyses, were considered the main reasons for disagreement rather than the diagnostic methods. Median time taken to make a diagnosis was higher only in CLM for 1 pathologist. Time outliers occurred in discordant cases and in other difficult cases. Conclusions We provide original evidence for the high-performance of WSI for diagnostic purposes in clinical practice, routine pathology, and primary diagnosis in the field of oral pathology.