title: Exploring virtual reality technology and the Oculus Rift for the examination of digital pathology slides.
abstract: BACKGROUND
  Digital slides obtained from whole slide imaging (WSI) platforms are typically viewed in two dimensions using desktop personal computer monitors or more recently on mobile devices. To the best of our knowledge, we are not aware of any studies viewing digital pathology slides in a virtual reality (VR) environment. VR technology enables users to be artificially immersed in and interact with a computer-simulated world. Oculus Rift is among the world's first consumer-targeted VR headsets, intended primarily for enhanced gaming. Our aim was to explore the use of the Oculus Rift for examining digital pathology slides in a VR environment.
  
  
  METHODS
  An Oculus Rift Development Kit 2 (DK2) was connected to a 64-bit computer running Virtual Desktop software. Glass slides from twenty randomly selected lymph node cases (ten with benign and ten malignant diagnoses) were digitized using a WSI scanner. Three pathologists reviewed these digital slides on a 27-inch 5K display and with the Oculus Rift after a 2-week washout period. Recorded endpoints included concordance of final diagnoses and time required to examine slides. The pathologists also rated their ease of navigation, image quality, and diagnostic confidence for both modalities.
  
  
  RESULTS
  There was 90% diagnostic concordance when reviewing WSI using a 5K display and Oculus Rift. The time required to examine digital pathology slides on the 5K display averaged 39 s (range 10-120 s), compared to 62 s with the Oculus Rift (range 15-270 s). All pathologists confirmed that digital pathology slides were easily viewable in a VR environment. The ratings for image quality and diagnostic confidence were higher when using the 5K display.
  
  
  CONCLUSIONS
  Using the Oculus Rift DK2 to view and navigate pathology whole slide images in a virtual environment is feasible for diagnostic purposes. However, image resolution using the Oculus Rift device was limited. Interactive VR technologies such as the Oculus Rift are novel tools that may be of use in digital pathology.
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Navid
authors.initials: N
authors.lastname: Farahani
authors.affiliation: Information Services Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Post
authors.affiliation: Information Services Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Duboy
authors.affiliation: Information Services Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Ishtiaque
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Enterprises Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Kolowitz
authors.affiliation: Enterprises Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Teppituk
authors.initials: T
authors.lastname: Krinchai
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Monaco
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Fine
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Hartman
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Liron
authors.initials: L
authors.lastname: Pantanowitz
keywords: Digital pathology; oculus rift; virtual reality; whole slide imaging