Re: Editorial Comment on Intraoperative pathology consultation during urological surgery: Impact on final margin status and pitfalls of frozen section diagnosis

2021 ◽  
Author(s):  
Toyonori Tsuzuki
Keyword(s):  
Editorial Comment ◽  
Frozen Section ◽  
Margin Status ◽  
Urological Surgery ◽  
Frozen Section Diagnosis

scholarly journals Systematic Review of the Use of Telepathology During Intraoperative Consultation

2019 ◽  
Vol 153 (2) ◽  
pp. 198-209 ◽  
Author(s):  
Robin L Dietz ◽  
Douglas J Hartman ◽  
Liron Pantanowitz
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Frozen Section ◽  
Strong Support ◽  
Risk Of Bias ◽  
Low Risk ◽  
Reference Standard ◽  
Weighted Mean ◽  
Frozen Section Diagnosis ◽  
Conventional Microscopy

Abstract Objective To compare studies that used telepathology systems vs conventional microscopy for intraoperative consultation (frozen-section) diagnosis. Methods A total of 56 telepathology studies with 13,996 cases in aggregate were identified through database searches. Results The concordance of telepathology with the reference standard was generally excellent, with a weighted mean of 96.9%. In comparison, we identified seven studies using conventional intraoperative consultation that showed a weighted mean concordance of 98.3%. Evaluation of the risk of bias showed that most of these studies were low risk. Conclusions Despite limitations such as variation in reporting and publication bias, this systematic review provides strong support for the safety of using telepathology for intraoperative consultations.

Intraosseous Epidermoid Inclusion Cyst in a Great Toe

2003 ◽  
Vol 127 (7) ◽  
pp. e298-e300 ◽  
Author(s):  
Beverly Y. Wang ◽  
Jesse Eisler ◽  
Dempsey Springfield ◽  
Michael J. Klein
Keyword(s):  
Frozen Section ◽  
Inclusion Cyst ◽  
Great Toe ◽  
Imaging Studies ◽  
Benign Lesions ◽  
Work Related ◽  
Frozen Section Diagnosis ◽  
History Of ◽  
Radiolucent Lesion ◽  
Epidermoid Inclusion Cyst

Abstract Epidermoid inclusion cysts are benign lesions that occasionally occur in the distal phalanges of the fingers but are less frequently identified and underreported in the toes. We describe a 55-year-old man with a history of work-related trauma followed by painful expansion of his right great toe, resulting in great anxiety. Imaging studies revealed a radiolucent lesion in the distal phalanx of his right hallux. Clinical differential diagnoses included the possibility of an intramedullary inclusion cyst and other various radiolucent lesions. During surgery, a cystic lesion that contained creamy material was discovered. Frozen section diagnosis of the lesion was an intraosseous epidermoid inclusion cyst. The lesion was removed and the patient recovered uneventfully. Although it has been reported that an unduly large number of phalangeal cysts have been treated by amputation, the judicious use of intraoperative frozen sections can prevent this scenario.

scholarly journals Evaluation of panoramic digital images using Panoptiq for frozen section diagnosis

2016 ◽  
Vol 7 (1) ◽  
pp. 26 ◽  
Author(s):  
Liron Pantanowitz ◽  
Dinesh Pradhan ◽  
SaraE Monaco ◽  
AnilV Parwani ◽  
Ishtiaque Ahmed ◽  
...  
Keyword(s):  
Digital Images ◽  
Frozen Section ◽  
Frozen Section Diagnosis

Accuracy of frozen section diagnosis in ovarian masses: experience at a tertiary oncology center

2008 ◽  
Vol 280 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Azadeh Rakhshan ◽  
Hanieh Zham ◽  
Mehdi Kazempour
Keyword(s):  
Frozen Section ◽  
Frozen Section Diagnosis ◽  
Oncology Center ◽  
Ovarian Masses

scholarly journals Experience with a Dynamic Inexpensive Video-Conferencing System for Frozen Section Telepathology

2000 ◽  
Vol 21 (3-4) ◽  
pp. 169-175 ◽  
Author(s):  
J. P. A. Baak ◽  
P. J. van Diest ◽  
G. A. Meijer
Keyword(s):  
Image Quality ◽  
Frozen Section ◽  
Video Conferencing ◽  
Final Diagnosis ◽  
Complete Agreement ◽  
Frozen Sections ◽  
Predictive Values ◽  
Video Conferencing System ◽  
Frozen Section Diagnosis ◽  
Conferencing System

Aim: To evaluate the feasibility of an inexpensive, generally applicable video‐conferencing system for frozen section telepathology (TP).Methods: A commercially widely available PC‐based dynamic video‐conferencing system (PictureTel LIVE, model PCS 100) has been evaluated, using two, four and six ISDN channels (128–384 kilobits per second (kbs)) bandwidths. 129 frozen sections have been analyzed which were classified by TP as benign, uncertain (the remark probably benign, or probably malignant was allowed), malignant, or not acceptable image quality. The TP results were compared with the original frozen section diagnosis and final paraffin diagnosis.Results: Only 384 kbs (3 ISDN‐2 lines) resulted in acceptable speed and quality of microscope images, and synchronous image/speech transfer. In one of the frozen section cases (0.7%), TP image quality was classified as not acceptable, leaving 128 frozen sections for the analysis. Five of these cases were uncertain by TP, and also deferred by frozen section procedure (FS). One more benign and three malignant FS cases were classified as uncertain by TP. Three additional cases were uncertain by FS, but benign according to TP (in agreement with the final diagnosis). In one case, FS diagnosis was uncertain but TP was malignant (in agreement with the final diagnosis). Thus, test efficiency (i.e., cases with complete agreement) was 120/128 (93.8%, Kappa = 0.88) between FS and TP. Sensitivity was 93.5%, specificity 98.6%, positive and negative predictive values were 97.7% and 96.0%. Between TP and final diagnosis agreement was even higher. More importantly, there was not a single discrepancy as to benign‐malignant. Moreover, there was a clear learning effect: 5 of the 8 FS/TP discrepancies occurred in the first 42 cases (5/42=11.9%), the remaining 3 in the following 86 cases (3/86=3.5%).Discussion: The results are encouraging. However, TP evaluation is time‐consuming (5–15 min for one case instead of 2–4 min although speed went up with more experience) and is more tiring. The system has the following technical drawbacks: no possibility to point at objects or areas of interest in the life image at the other end, resolution (rarely) may become suboptimal (blocky), storage of images evaluated (which is essential for legal reasons) is not easy and no direct control of a remote motorized microscope. Yet, all users were positive about the system both for telepathology and personal contact by video‐conferencing. Conclusion: With a relatively simple videoconferencing system, accurate dynamic telepathology frozen section diagnosis can be obtained without false positive or negative results, although a limited number of uncertain cases will have to be accepted.

Ovarian Frozen Section Diagnosis: Use of Whole-Slide Imaging Shows Excellent Correlation Between Virtual Slide and Original Interpretations in a Large Series of Cases

2010 ◽  
Vol 134 (7) ◽  
pp. 1020-1023 ◽  
Author(s):  
Margaret A. Fallon ◽  
David C. Wilbur ◽  
Manju Prasad
Keyword(s):  
Frozen Section ◽  
Virtual Slide ◽  
Granulosa Cell Tumor ◽  
Routine Practice ◽  
Corpora Lutea ◽  
Operating Characteristics ◽  
Frozen Section Diagnosis ◽  
Very High ◽  
Whole Slide Images

Abstract Context.—Whole-slide images (WSI) are a tool for remote interpretation, archiving, and teaching. Ovarian frozen sections (FS) are common and hence determination of the operating characteristics of the interpretation of these specimens using WSI is important. Objectives.—To test the reproducibility and accuracy of ovarian FS interpretation using WSI, as compared with routine analog interpretation, to understand the technology limits and unique interpretive pitfalls. Design.—A sequential series of ovarian FS slides, representative of routine practice, were converted to WSI. Whole-slide images were examined by 2 pathologists, masked to all prior results. Correlation characteristics among the WSI, the original, and the final interpretations were analyzed. Results.—A total of 52 cases, consisting of 71 FS slides, were included; 34 cases (65%) were benign, and 18 cases (35%) were malignant, borderline, and of uncertain potential (9 [17%], 7 [13%], and 2 [4%] of 52 cases, respectively). The correlation between WSI and FS interpretations was 96% (50 of 52) for each pathologist for benign versus malignant, borderline, and uncertain entities. Each pathologist undercalled 2 borderline malignant cases (4%) as benign cysts on WSI. There were no overcalls of benign cases. Specific issues within the benign and malignant groups involved endometriosis versus hemorrhagic corpora lutea, and granulosa cell tumor versus carcinoma, respectively. Conclusions.—The correlation between original FS and WSI interpretations was very high. The few discordant cases represent recognized differential diagnostic issues. Ability to examine gross pathology and real-time consultation with surgeons might be expected to improve performance. Ovarian FS diagnosis by WSI is accurate and reproducible, and thus, remote interpretation, teaching, and digital archiving of ovarian FS specimens by this method can be reliable.

scholarly journals Frozen-section Diagnosis

BMJ ◽  
1959 ◽  
Vol 1 (5133) ◽  
pp. 1321-1320 ◽  
Author(s):  
P. M. Peters
Keyword(s):  
Frozen Section ◽  
Frozen Section Diagnosis
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