Comparison of a medical-grade monitor vs commercial off-the-shelf display for mitotic figure enumeration and small object (Helicobacter pylori) detection

Objectives: To examine the performance of a commercial off-the-shelf (COTS) monitor vs a medical-grade (MG) monitor for small object enumeration in standardized digital pathology images. Methods: Pathologists reviewed 35 melanoma or 35 gastric biopsy images using the MG and COTS displays, with a 2-week washout period. Mitotic figure or Helicobacter pylori burden enumerations were compared with reference values reported by an expert subspecialist pathologist using a light microscope. Subjective evaluations of image color, brightness, and overall quality were also obtained. Results: There was substantial agreement between the mitotic counts obtained by the evaluating pathologists between monitors and the reference mitotic figure or H pylori burden assessments. Six of the nine evaluating pathologists subjectively evaluated the monitors as substantially similar. Conclusions: These findings are consistent with previous studies demonstrating that color calibration has limited impact on diagnostic accuracy and suggest that noncalibrated displays could be considered for fine assessment tasks.