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Can virtual microscope replace glass slide microscopy??

Dr. Mona Abdel-Halim



I came across a nice study in the Journal of Cutaneous Pathology* in which the authors compared diagnostic accuracy between virtual microscopy and traditional glass slide microscopy among dermatology residents. According to this study, the overall diagnostic accuracy was better with glass slides than virtual slides.

I remember in Graz in the Summer Academy of Dermatopathology 2011, I have attended several lectures prepared by the virtual microscope in which scanned slides were presented. I was impressed by the quality of the images and by the ability to magnify sections and navigate through them in a way simulating what one does on his own microscope with the glass slide.

However, I still believe that virtual microscopy is good in preparing lectures and presentations for conferences and for having instant opinions from others, but to me nothing replaces the glass slide microscopy in teaching juniors. If I am asked to choose between getting a virtual microscope system for teaching juniors in my department or getting a multi-observer microscope system. I will go for the multi-observer system without hesitation. I believe that the intimate relation between the observer and the glass slide is important in developing the required diagnostic skills. Juniors should learn using glass slide microscopy and then get introduced to virtual microscopy as a tool that helps them in their career later on. What do you think??

[center]*Comparison of virtual microscopy and glass slide microscopy among dermatology residents during a simulated in-training examination.[/center]
[center]Brick et al., Journal of Cutaneous Pathology, 2013, 40 (9): 807-811[/center]

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Mark A. Hurt MD



I don't know how all of this will play out eventually; perhaps there will be parallel dual systems. My sense of it, as we stand today, is that virtual microscopy is coming, and probably will replace using the glass, at least in part.

That said, virtual microscopy is an overlay system as it stands today. I am not aware of any technology that bypasses the formalin-fixed paraffin based preparation of tissue. This means -- as it stands today -- that virtual microscopy is an extra layer of time and expense. This will be a formidable obstacle to wide usage until or unless both time and expense of the virtual slide preparation can be minimized.

As a teaching and publishing tool, I think it is superb and eventually will become a standard method for teaching -- once the bugs are worked out and it becomes as cheap to use as a camera attached to a microscope. Today, I use a Nikon camera specifically for producing high quality photomicrographs. That system was about $7,000 a few years back. The last I heard of the virtual systems, they were in the hundreds of thousands of dollars -- hardly a cost that one practitioner or even a small department will want to bear in this day and age.

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