{
  "abstract": "Aim The digital transformation of the pathology laboratory is being continuously sustained by the introduction of innovative technologies promoting whole slide image (WSI)-based primary diagnosis. Here, we proposed a real-life benchmark of a pathology-dedicated medical monitor for the primary diagnosis of renal biopsies, evaluating the concordance between the ‘traditional’ microscope and commercial monitors using WSI from different scanners.Methods The College of American Pathologists WSI validation guidelines were used on 60 consecutive renal biopsies from three scanners (Aperio, 3DHISTECH and Hamamatsu) using pathology-dedicated medical grade (MG), professional grade (PG) and consumer-off-the-shelf (COTS) monitors, comparing results with the microscope diagnosis after a 2-week washout period.Results MG monitor was faster (1090 vs 1159 vs 1181 min, delta of 6–8%, p<0.01), with slightly better performances on the detection of concurrent diseases compared with COTS (κ=1 vs 0.96, 95% CI=0.87 to 1), but equal concordance to the commercial monitors on main diagnosis (κ =1). Minor discrepancies were noted on specific scores/classifications, with MG and PG monitors closer to the reference report (r=0.98, 95% CI=0.83 to 1 vs 0.98, 95% CI=0.83 to 1 vs 0.91, 95% CI=0.76 to 1, κ=0.93, 95% CI=077 to 1 vs 0.93, 95% CI=0.77 to 1 vs 0.86, 95% CI=0.64 to 1, κ=1 vs 0.50, 95% CI=0 to 1 vs 0.50, 95% CI=0 to 1, for IgA, antineutrophilic cytoplasmic antibody and lupus nephritis, respectively). Streamlined Pipeline for Amyloid detection through congo red fluorescence Digital Analysis detected amyloidosis on both monitors (4 of 30, 13% cases), allowing detection of minimal interstitial deposits with slight overestimation of the Amyloid Score (average 6 vs 7).Conclusions The digital transformation needs careful assessment of the hardware component to support a smart and safe diagnostic process. Choosing the display for WSI is critical in the process and requires adequate planning.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy"
      ],
      "name": "Giorgio Cazzaniga"
    },
    {
      "affiliations": [
        "Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy"
      ],
      "name": "Francesco Mascadri"
    },
    {
      "affiliations": [
        "Division of Pathology, Humanitas Cancer Center, Catania, Italy"
      ],
      "name": "Stefano Marletta"
    },
    {
      "affiliations": [
        "Department of Medicine, Surgery and Dentistry \"Scuola Medica Salernitana\", San Giovanni di Dio e Ruggi d'Aragona University Hospital, University of Salerno, Salerno, Italy"
      ],
      "name": "Alessandro Caputo"
    },
    {
      "affiliations": [
        "Medical Physics Unit, University Hospital of Modena, Modena, Italy"
      ],
      "name": "Gabriele Guidi"
    },
    {
      "affiliations": [
        "Division of Nephrology, Department of Medicine, University of Verona, Verona, Italy"
      ],
      "name": "Giovanni Gambaro"
    },
    {
      "affiliations": [
        "Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "Albino Eccher"
    },
    {
      "affiliations": [
        "Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua School of Medicine, Padua, Italy"
      ],
      "name": "Angelo Paolo Dei Tos"
    },
    {
      "affiliations": [
        "Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy"
      ],
      "name": "Fabio Pagni"
    },
    {
      "affiliations": [
        "Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Monza, Italy"
      ],
      "name": "Vincenzo L'Imperio"
    }
  ],
  "title": "Benchmarking digital displays (monitors) for histological diagnoses: the nephropathology use case",
  "uid": "64d61e73-7864-5efb-8eec-0782131b585d"
}