Whole slide imaging for rapid treatment decision-making and education in renal pathology

Abstract

Background: Whole slide imaging (WSI) is digital imaging technique that involves scanning glass slides. Although WSI is widely used in pathological diagnosis and education, its impact on nephrology education remains unknown. We clarified the usefulness of WSI in rapid treatment decision-making and education in renal pathology.

Methods: We included in patients undergoing renal biopsy at our facility and divided them into two groups: the WSI (-) group, underwent renal biopsy during (July, 2020-June, 2022), when WSI was not available, and the WSI (+) group (July, 2022-June, 2024), when WSI was available on electric medical record. The time from renal biopsy to the description of the pathological assessment, days to treatment initiation or modification, and the percentage of the assessment reported by nephrology trainees were compared between the two groups. Furthermore, this study included an inquiry about the usefulness of WSI from nephrologists who worked during these periods.

Results: The time until assessment description and treatment initiation or modification were shorter in the WSI (+) group (p < 0.001 for both). Multivariable Cox regression analysis showed that the use of WSI had the most significant impact on these outcomes (p < 0.001). Moreover, the percentage of first assessments reported by nephrology trainees increased from 25.8% to 53.2% (p < 0.001), and multivariable logistic analysis showed that WSI was the most associated factor (p < 0.001). In the questionnaire, most nephrologists cited the ease of access and sharing as the main advantages of WSI.

Conclusions: WSI is helpful for rapid treatment decision-making and education in renal pathology.

Keywords: Nephrology education; Nephrology trainees; Renal pathology; Virtual slide; Whole slide imaging.