title: Diagnosing Pathological Prognostic Factors in Retinoblastoma: Correlation between Traditional Microscopy and Digital Slides.
abstract: OBJECTIVE
  It was the aim of this study to determine the diagnostic accuracy of high-risk prognostic factors and morphological characteristics of retinoblastomas using digital whole slide images (WSI) generated by a scanner.
  
  
  METHODS
  Forty-seven H&amp;E sections of glass slides with high-risk morphological features of retinoblastoma were analyzed. Slides were scanned as WSI and reviewed. The results were compared with those obtained after reviewing the slides using a regular microscope as the gold standard. McNemar's test (MT), the percentage of agreement (POA), and sensitivity (S) and specificity (Sp) were evaluated between WSI and conventional microscopy.
  
  
  RESULTS
  There were no differences with respect to multicentricity, growth type, rosette formation, choroidal invasion, anterior chamber invasion, extraocular extension, scleral extension, optic nerve invasion, necrosis, or Azzopardi effect between WSI analysis and light microscopy (MT, p = 1.0; POA = 100%; S = 100%, and Sp = 100%). Discordance was found in 1 case where calcification could not be found using WSI (MT, p = 1.00; POA = 97.9%; S = 100%, and Sp = 97.8%).
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first report using digital pathology (WSI) to evaluate prognostic factors in eyes containing retinoblastomas. Using WSI, the pathologist was able to detect high-risk morphological features in retinoblastoma. To date, WSI is an important tool, in particular for ophthalmic pathologists examining enucleation and exenteration specimens.
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada; Department of Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Zoroquiain
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Logan
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Vasco
authors.initials: V
authors.lastname: Bravo-Filho
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Natalia
authors.initials: N
authors.lastname: Vila
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Samir
authors.initials: S
authors.lastname: Jabbour
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Orellana
authors.affiliation: Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Que., Canada.
authors.forename: Miguel N
authors.initials: MN
authors.lastname: Burnier
keywords: Ocular pathology; Retinoblastoma; Virtual slides; Whole slide images