title: Comparative Analysis Reveals Potential Utility of Digital Microscopy in the Evaluation of Peripheral Blood Smears With Some Barriers to Implementation.
abstract: OBJECTIVE
  Evaluation of the peripheral blood smear (PBS) is an essential diagnostic test in current medical practice. We aimed to evaluate the use of digital microscopy for the examination of PBS as an option to provide expert interpretation to remote sites and in "on-call" situations.
  
  
  METHODS
  We collected 100 Wright-Giemsa-stained PBS slides representing normal and abnormal findings seen at a community-based hospital. Four hematopathologists independently evaluated the cases using conventional light and digital microscopy.
  
  
  RESULTS
  When comparing digital vs light microscopy, most of the cellular features evaluated showed at least a moderate degree of agreement in at least three of the reviewers. Discrepancies in final diagnosis were identified in a minority of the cases, most of which were attributed to the poorer resolution of digital microscopy at high magnification (×400).
  
  
  CONCLUSIONS
  These results support the limited use of digital microscopy for evaluation and triage of peripheral blood smears as a practical option to obtain expert opinion in locations where experienced staff is not available on site. Our results indicate that while digital microscopy is well suited for basic triage of these blood smears, limitations in quality of imaging at higher magnification as well as large file size may limit its utility in certain settings and situations.
authors.affiliation: From the Department of Pathology, Henry Ford Hospital, Detroit, MI; Department of Pathology, University of Michigan, Ann Arbor;
authors.forename: Juan C
authors.initials: JC
authors.lastname: Gomez-Gelvez
authors.affiliation: From the Department of Pathology, Henry Ford Hospital, Detroit, MI; Departments of Pathology and Urology, University of Miami Miller School of Medicine, Miami, FL and.
authors.forename: Oleksandr N
authors.initials: ON
authors.lastname: Kryvenko
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque.
authors.forename: Devon S
authors.initials: DS
authors.lastname: Chabot-Richards
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Foucar
authors.affiliation: From the Department of Pathology, Henry Ford Hospital, Detroit, MI;
authors.forename: Kedar V
authors.initials: KV
authors.lastname: Inamdar
authors.affiliation: From the Department of Pathology, Henry Ford Hospital, Detroit, MI; kkarner1@hfhs.org.
authors.forename: Kristin H
authors.initials: KH
authors.lastname: Karner
mesh_terms: D001773:Blood Cells / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008853:Microscopy / Q000379:methods*
keywords: Digital microscopy; Interobserver agreement; Intraobserver agreement; Peripheral blood smear