Applications de l'imagerie virtuelle au diagnostic de routine en anatomie pathologique : état des lieux à partir de l'expérience d'une organisation en réseau au sein de l'ensemble hospitalo-militaire parisien

In order to evaluate feasibility and accuracy of web-based diagnosis of virtual slide as a routine procedure in pathologic laboratories, three french military hospitals experienced this procedure using a intranet system (4MB/s). Slides were digitized using MiraxScan® DotSLide® and Nanozoomer® scanners. Virtual images were stored and analyzed using the Aurora-mScope-wed-based-image platform. Quality of virtual images was assessed independently by 6 pathologists and compared to conventional slides. Virtual slides characteristics (size in mm2, size in megabites, time for acquisition and time for visualization) were measured during routine examination, expertise procedures, frozen section examinations and large series (200 slides) of scanning. Virtual slides confirm to be an adequate tool for histological examination with 87% of slides with either good or very good quality. Mean time of scanning was 10 to 14 mn (according to the scanner used) and mean size of virtual slides as 433 to 647 MB. Time for visualization was less than 1 mn in an expertise procedure that was considered acceptable by the pathologists. No impact on the hospitals' network could be observed. Time of acquisition remains the main critical aspect of virtual slides analysis either in a frozen section examination and large series of scanning (routine procedure). Acceptance of virtual slide analysis by pathologists is another crucial point for the success of this promising tool.