Comparison of the whole slide imaging and conventional light microscopy in the grading of oral epithelial dysplasia: a multi-institutional study

Author(s)

Diniz, Priscilla Barbosa ^[1] ; Sena-Filho, Marcondes ^[1] ; Graner, Karen Mendes ^[2] ; Linhares Almeida Mariz, Bruno Augusto ^[1] ; dos Reis, Leonardo Amaral ^[1] ; de Almeida, Oslei Paes ^[1] ; Jorge, Jacks ^[1]

Affiliation

^[1] Univ Campinas Unicamp, Piracicaba Dent Sch, Dept Oral Diag, 901 Limeira Av, Piracicaba, SP - Brazil

^[2] Sao Paulo State Univ UNESP, Botucatu Med Sch, Botucatu, SP - Brazil

• Document type: Journal article
• Source: MEDICINA ORAL PATOLOGIA ORAL Y CIRUGIA BUCAL; v. 26, n. 1, p. E8-E13, JAN 2021.
• Web of Science Citations: 0

Abstract

Background: Whole Slide Imaging (WSI) is an alternative method to light microscopy (LM). However, few studies have compared the diagnostic agreement between WSI and LM, especially to grade oral epithelial dysplasia (OED). The purpose of this study was to evaluate the variability in grading OED by the World Health Organization grading system, using WSI and conventional LM, and to investigate whether the access to clinical information, and psychologic or physical states of the pathologists could interfere with the diagnosis. Material and Methods: eleven experienced pathologists from seven Brazilian universities independently evaluated twenty-five OED cases. The analyses were performed in duplicate for each method, with an interval of at least 30 days, and the time consumed in each analysis was measured. Physical and psychologic states were evaluated by blood pressure levels, heart rate and two questionnaires: State-Trait Anxiety Inventory and Perceived Stress Scale. Clinical information was provided after the second evaluation using WSI and the pathologist could change their diagnostic decision or not. Results: LM showed a higher inter-examiner agreement (k=0.53) than WSI (k=0.45) and a smaller time consumed by the pathologists (mean of 65.53 seconds compared to 91.02 seconds in WSI). In the first analysis using conventional microscopy, there was a positive correlation between kappa values and anxiety (r=0.47, p=0.02), and stress (r=0.64, p<0.01), and an inverse correlation with heart rate (r=-0.48, p=0.02). In the digital analysis, there was also a positive correlation between kappa values and anxiety (r=0.75, p<0.001). After clinical information was given, there was a slight change in 11.3% of the cases, and a great discrepancy in 1.1% of the cases, mainly increasing the OED grade. Conclusions: both microscopy systems had similar results, although LM had slightly higher kappa values, and WSI was more time consuming. (AU)

• FAPESP's process: 18/24715-2 - FGF-2, FGFR-1, PI3K, Akt and COX-2 expression in Oral Leucoplakia, primary and metastatic Oral Squamous Cell Carcinoma
• Grantee: Bruno Augusto Linhares Almeida Mariz
• Support Opportunities: Scholarships in Brazil - Doctorate