Whole Slide Imaging (WSI) in Pathology: Current Perspectives and Future Directions
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REVIEW
Whole Slide Imaging (WSI) in Pathology: Current Perspectives and Future Directions Neeta Kumar 1 & Ruchika Gupta 2
&
Sanjay Gupta 2
# Society for Imaging Informatics in Medicine 2020
Abstract Whole slide imaging (WSI), ever since its first introduction about two decades ago, has been validated for a number of applications in the field of pathology. The recent approval of US FDA to a WSI system for use in primary surgical pathology diagnosis has opened avenues for wider acceptance and application of this technology in routine practice. The ongoing technological advances in digital scanners, image visualization methods, and the integration of artificial intelligence-derived algorithms with these systems provide opportunities of its newer applications. Its benefits are innumerable such as ease of access through internet, avoidance of physical storage space, and no risk of deterioration of staining quality or breakage of slides to name a few. Various barriers such as the high cost, technical glitches, and professional hesitation to adopt a new technology have hindered its use in pathology. This review article summarizes the technical aspects of WSI, its applications in diagnostic pathology, training, and research along with future perspectives. It highlights the benefits, limitations, and challenges delaying the use of this technology in routine practice. The review is targeted at students, residents, and budding pathologists to better acquaint them with the key aspects of state-of-the-art technology and enable them to implement WSI judiciously. Keywords Whole slide imaging . Cytopathology . Telepathology . Diagnosis . Education . Automated image analysis . Validation . Regulation
Introduction Digital imaging is widely used by pathologists for creation of static images using microscope-dedicated optical cameras and, more recently, using smartphones [1]. The introduction of whole slide imaging (WSI) in 1999 provided the opportunity of digitally converting the entire tissue on glass slide into a high-resolution virtual slide (VS). In the last two decades, we have witnessed an exponential growth in technology of acquiring virtual slide as well as its applications in various subspecialties of pathology [1].
Neeta Kumar and Ruchika Gupta contributed equally to this work. * Sanjay Gupta [email protected] 1
Department of Pathology, Faculty of Dentistry, Jamia Millia Islamia (Central University), New Delhi 110025, India
2
Division of Cytopathology, ICMR-National Institute of Cancer Prevention and Research, I-7, Sector-39, Noida 201301, India
Development and refinement of artificial intelligence (AI) and machine learning algorithms have been an area of intense research in both radiology and pathology for automated or computer-aided diagnosis. WSI is a promising tool to develop and utilize such algorithms to be used in diagnostic pathology. There has been an ever-increasing demand for telemedicine which surged remarkably in times of lockdowns of the current corona pandemic throughout the globe. As the countr
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