Lauwers, Gregory Y.Wilbur, DavidMadi, KalilColvin, RobertDuncan, LynFaquin, WilliamFerry, JudithFrosch, MatthewHouser, Stuart L.Kradin, RichardLouis, DavidMark, EugeneMino-Kenudson, MariMisdraji, JosephNielsen, Gunnlauger P.Pitman, MarthaRosenberg, Andrew EricSmith, R. NealSohani, AliyahStone, JamesTambouret, RosemaryWu, Chin-LeeYoung, RobertZembowicz, ArturWlietmann, Wolfgang2017-10-202009Wilbur, David C., Kalil Madi, Robert B. Colvin, Lyn M. Duncan, William C. Faquin, Judith A. Ferry, Matthew P. Frosch, et al. 2009. Whole-slide imaging digital pathology as a platform for teleconsultation: A pilot study using paired subspecialist correlations. Archives of Pathology & Laboratory Medicine 133, no. 12: 1949-1953.0003-9985http://nrs.harvard.edu/urn-3:HUL.InstRepos:34268573Context.—Whole-slide imaging technology offers promise for rapid, Internet-based telepathology consultations between institutions. Before implementation, technical issues, pathologist adaptability, and morphologic pitfalls must be well characterized. Objective.—To determine whether interpretation of whole-slide images differed from glass-slide interpretation in difficult surgical pathology cases. Design.—Diagnostically challenging pathology slides from a variety of anatomic sites from an outside laboratory were scanned into whole digital format. Digital and glass slides were independently diagnosed by 2 subspecialty pathologists. Reference, digital, and glass-slide interpretations were compared. Operator comments on technical issues were gathered. Results.—Fifty-three case pairs were analyzed. There was agreement among digital, glass, and reference diagnoses in 45 cases (85%) and between digital and glass diagnoses in 48 (91%) cases. There were 5 digital cases (9%) discordant with both reference and glass diagnoses. Further review of each of these cases indicated an incorrect digital whole-slide interpretation. Neoplastic cases showed better correlation (93%) than did cases of nonneoplastic disease (88%). Comments on discordant cases related to digital whole technology focused on issues such as fine resolution and navigating ability at high magnification. Conclusions.—Overall concordance between digital whole-slide and standard glass-slide interpretations was good at 91%. Adjustments in technology, case selection, and technology familiarization should improve performance, making digital whole-slide review feasible for broader telepathology subspecialty consultation applications.en-USJournal Article10.1043/1543-2165-133.12.1949