scholarly journals Reliability of Telepathology for Frozen Section Service

2000 ◽  
Vol 21 (3-4) ◽  
pp. 213-222 ◽  
Author(s):  
Uwe Wellnitz ◽  
Bernd Binder ◽  
Peter Fritz ◽  
Godehard Friedel ◽  
Peter Schwarzmann
Keyword(s):  
Diagnostic Accuracy ◽  
Technological Development ◽  
Frozen Section ◽  
False Negative ◽  
Daily Practice ◽  
Histopathological Diagnosis ◽  
Time Saving ◽  
Surgical Interventions ◽  
Average Accuracy ◽  
Frozen Section Diagnosis

One of the most promising applications of telepathology (pathology at a distance by electronic transmission of images in pathology) is frozen section diagnosis, especially because by means of this tool operations requiring an intraoperative histopathological diagnosis are feasible at hospitals without a pathologist on‐site. For the introduction of this diagnostic tool into pathologist's daily practice the evidence of its diagnostic accuracy comparable to that of the conventional frozen section diagnosis is crucial.For this purpose the literature on the diagnostic accuracy of telepathological frozen section diagnosis was reviewed. In a metaanalysis these studies and reports, in which a total of more than 1290 cases had been examined, showed a slightly lower overall diagnostic accuracy (of the telepathological frozen section diagnosis) of about 0.91 than the conventional frozen section diagnosis with an average accuracy of about 0.98 found in an analysis of several studies (on frozen section diagnosis of different organs). This difference is at least predominantly caused by a higher rate of deferred and false negative frozen section diagnoses in the telepathological method, while the specificity of both methods, each more than 0.99 was not significantly different.In conclusion, the introduction of a telepathological frozen section diagnosis for hospitals without an acceptable access to a pathologist is justifiable already at the current state of the technological development especially when considering the advantages (time saving, reduction in costs) compared to the alternative of surgical interventions without access to an intraoperative diagnosis.

scholarly journals Correlation of Biomarkers and Frozen Section Diagnosis with Paraffin Histopathological Diagnosis in Suspected Ovarian Cancer

2019 ◽  
Vol 4 ◽  
pp. 67-71
Author(s):  
Tanushri Mukherjee ◽  
Soma Mukherjee ◽  
Parikshit Sanyal ◽  
Vikram Bharadwaj ◽  
S Sampath ◽  
...  
Keyword(s):  
Decision Making ◽  
Predictive Value ◽  
Frozen Section ◽  
False Negative ◽  
Paraffin Section ◽  
Histopathological Diagnosis ◽  
Diagnostic Dilemma ◽  
Ovarian Cancers ◽  
Frozen Section Diagnosis ◽  
Malignant Lesions

Introduction: Ovarian cancers pose diagnostic dilemma and is problematic for decision making for the gynecological oncologist as well as the pathologist. The use of intra-operative frozen section can aid significantly in decision making and assist in choosing the correct operative path once a mass lesion of ovaries is discovered. Materials and Methods: Over a two-year period, 50 cases of Suspected Ovarian cancers were examined by intra- operative frozen section as well as followed up with histopathology in paraffin sections. Results were categorized in two strata—benign and malignant. Results: A comparison between frozen-section diagnosis and findings on paraffin section showed that the sensitivity of frozen section in diagnosis of malignant lesions is 97.14%, with specificity 93.33%, positive predictive value 97.14% and negative predictive value 93.33%. Among 50 cases, one case was reported as false positive and one was reported as false negative. Conclusion: Intra-operative frozen section is a highly sensitive and specific modality for the diagnosis of malignant lesions of the ovary.

scholarly journals Comparison of Different Telepathology Solutions for Primary Frozen Section Diagnostic

2000 ◽  
Vol 21 (3-4) ◽  
pp. 161-167 ◽  
Author(s):  
P. Hufnagl ◽  
G. Bayer ◽  
P. Oberbarnscheidt ◽  
K. Wehrstedt ◽  
H. Guski ◽  
...  
Keyword(s):  
Retrospective Study ◽  
False Positive ◽  
Frozen Section ◽  
False Negative ◽  
Frozen Sections ◽  
Frozen Section Diagnosis

In a retrospective study on a set of 125 cases we compared the following three telepathology solutions for primary frozen section diagnosis: ATM‐TP (connection via ATM), TPS 1.0 (connection via LAN) and TELEMIC (connection via Internet), which represent different concepts of telepathological procedures.A set of 125 routine frozen sections (breast) was selected from the Charité cases of the year 1999. Four experienced pathologists diagnosed retrospectively all of these cases.Using the ATM‐TP and TPS systems and 53 of them with the TELEMIC system. Using the ATM‐TP we recorded no false positive (0%), 4 false negative (3.2%) and 4 deferred (3.2%) cases. Using the TPS we recorded no false positive (0%), 4 false negative (3.2%) and 4 deferred (3.2%) cases. Using the TELEMIC we recorded in 53 cases no false positive (0%), no false negative (0%) and 16 deferred (30.2%) cases.The average time of 2.2 minutes per case using ATM‐TP is also short enough for routine frozen section diagnostic. This is also true for the TPS system with 7.2 minutes per case.

scholarly journals Analysis of frozen section in correlation with surgical pathology diagnosis

2019 ◽  
Vol 7 (6) ◽  
pp. 2312
Author(s):  
Ashwini Tangde ◽  
Vaidik Shrivastava ◽  
Anil Joshi
Keyword(s):  
Frozen Section ◽  
Final Diagnosis ◽  
Surgical Pathology ◽  
Histopathological Diagnosis ◽  
Pathology Laboratory ◽  
Medical College ◽  
Incorrect Diagnosis ◽  
Frozen Section Diagnosis ◽  
Sensitivity Specificity ◽  
Suspected Lesion

Background: Frozen section (FS) is a rapid diagnostic procedure performed on tissues obtained intraoperatively. This method serves useful purposes, such as determining the malignancy or benignancy of a suspected lesion, determining the adequacy of a biopsy of a suspected lesion, confirming the presence or absence of metastasis, and identifying small structures. But it bears many disadvantages and limitations, the most of which is the danger of incorrect diagnosis. Therefore, it is critical to determine efficiency of frozen section performance periodically.  This study was performed to determine accuracy of frozen section by correlating the intra-operative frozen section diagnosis with final diagnosis on permanent sections.Methods: In this retrospective study, authors compared the results of frozen section with their final permanent section diagnosis in Government Medical College and Hospital, Aurangabad, Maharashtra, India during January 2017 to December 2018.Results: Study comprises 83 patients, of which 73 were female and 10 were male. Out of 83 cases, the diagnosis of 76 cases was concordant with conventional histopathology diagnosis while seven were discordant. This gave overall accuracy rate of 91.57% and discordant rate of 8.43%. The overall sensitivity was 85.71% and specificity was 97.92%. The positive predictive and negative predictive value was 96.77% and 90.38% respectively.Conclusions: The accuracy, sensitivity, specificity of frozen section diagnosis in this study  are comparable with most international quality control statistics for frozen sections. The results suggest that the correlation of intra-operative frozen section diagnosis with the final histopathological diagnosis on permanent sections forms an integral part of quality assurance activities in the surgical pathology laboratory and specific measures should be taken to reduce the number of discrepancies.

scholarly journals Borderline ovarian tumor frozen section diagnoses with features suspicious of invasive cancer: a retrospective study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Koen De Decker ◽  
Karina H. Jaroch ◽  
Joost Bart ◽  
Loes F. S. Kooreman ◽  
Roy F. P. M. Kruitwagen ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Invasive Carcinoma ◽  
Frozen Section ◽  
Paraffin Section ◽  
Final Diagnosis ◽  
Borderline Ovarian Tumor ◽  
Histopathological Diagnosis ◽  
Frozen Section Diagnosis ◽  
Histologic Subtypes ◽  
Section Evaluation

Abstract Background A frozen section diagnosis of a borderline ovarian tumor with suspicious features of invasive carcinoma (“at least borderline” or synonymous descriptions) presents us with the dilemma of whether or not to perform a full ovarian cancer staging procedure. Quantification of this dilemma may help us with the issue of this clinical decision. The present study assessed and compared both the prevalence of straightforward borderline and “at least borderline” frozen section diagnoses and the proportion of these women with a final histopathological diagnosis of invasive carcinoma, with a special interest in histologic subtypes. Methods A retrospective cohort study was performed in three hospitals in The Netherlands. All women that underwent ovarian surgery with perioperative frozen section evaluation in one of these hospitals between January 2007 and July 2018 were identified and included in case of a borderline or “at least borderline” frozen section diagnosis and a borderline ovarian tumor or invasive carcinoma as a final diagnosis. Results A total of 223 women were included, of which 41 women (18.4%) were diagnosed with “at least borderline” at frozen section. Thirteen of forty-one women (31.7%) following “at least borderline” frozen section diagnosis and 14 of 182 women (7.7%) following a straightforward borderline frozen section diagnosis were diagnosed with invasive carcinoma at paraffin section evaluation (p < 0.001). When compared to straightforward borderline frozen section diagnoses, the proportion of women diagnosed with invasive carcinoma increased from 3.1 to 35.7% for serous tumors (p = 0.001), 10.0 to 21.7% for mucinous tumors (p = 0.129) and 50.0 to 75.0% (p = 0.452) in case of other histologic subtypes following an “at least borderline” frozen section diagnosis. Conclusions Overall, when compared to women with a decisive borderline frozen section diagnosis, women diagnosed with “at least borderline” frozen section diagnoses were found to have a higher chance of carcinoma upon final diagnosis (7.7% vs 31.7%). Especially in the serous subtype, full staging during initial surgery might be considered after preoperative consent to prevent a second surgical procedure or chemotherapy in unstaged women. Further studies are needed to evaluate whether additional sampling in case of an “at least borderline” diagnosis may decrease the risk of surgical over-treatment.

Frozen Section Diagnosis of Pancreatic Lesions

2002 ◽  
Vol 126 (10) ◽  
pp. 1169-1173 ◽  
Author(s):  
Adina M. Cioc ◽  
E. Christopher Ellison ◽  
Daniela M. Proca ◽  
Joel G. Lucas ◽  
Wendy L. Frankel
Keyword(s):  
Frozen Section ◽  
Single Cells ◽  
Benign Lesion ◽  
False Negative ◽  
Resection Margins ◽  
Frozen Sections ◽  
Surgical Biopsy ◽  
Frozen Section Diagnosis ◽  
Metastatic Sites

Abstract Background.—The clinical and radiologic diagnosis of pancreatic cancer and the safety of pancreatic resections have improved. These improvements, together with the indication for resection in some cases of complicated chronic pancreatitis, have reduced the necessity for confirmed preoperative tissue diagnosis. We investigated the clinical use and accuracy of frozen section diagnosis for pancreatic lesions. Design.—We searched archival files for the years 1989–2000 for patients with pancreatic lesions who had received a diagnosis based on frozen section results. We compared the diagnosis of all frozen section slides with that of the permanent sections and reviewed the clinical follow-up notes. We evaluated histologic features useful in differentiating between malignant and benign pancreatic lesions. Results.—A total of 538 patients underwent surgical biopsy and/or resection for suspected pancreatic lesions. Frozen section was requested in 131 cases (284 frozen sections). Ninety cases had frozen section of the pancreatic lesions, 70 cases had frozen section of metastatic sites, and 29 cases had frozen section of surgical margins. Of the 90 cases in which frozen section of the pancreatic lesions was requested, malignancy was diagnosed in 44, a benign lesion was diagnosed in 37, and the diagnosis was atypical and deferred in 9. In total, 3 false-negative frozen sections and 1 false-positive frozen section were identified for respective rates of 1.2% and 0.3%. In all cases in which the frozen section diagnosis was deferred or was inconsistent with the operative impression, and the surgeon acted on his/her impression, the operative diagnoses were subsequently confirmed by additional permanent sections and/or clinical follow-up. The most useful histologic features for the diagnosis of pancreatic adenocarcinoma in frozen sections were variation in nuclear size of at least 4:1, disorganized duct distribution, incomplete duct lumen, and infiltrating single cells. Conclusions.—Frozen sections are useful in conjunction with the impression at surgery for the management of patients with pancreatic lesions. Frozen sections of resection margins were 100% accurate; frozen sections of pancreatic lesions or metastatic sites were accurate in 98.3% of cases. We found an acceptable rate of deferred frozen section (6.6%). The experienced surgeon's impression of malignancy is reliable in cases in which frozen section is deferred or has negative findings.

Diagnostic accuracy of frozen section diagnosis of the adnexal mass: a metaanalysis

2005 ◽  
Vol 96 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Peggy Geomini ◽  
Gérard Bremer ◽  
Roy Kruitwagen ◽  
Ben W.J. Mol
Keyword(s):  
Diagnostic Accuracy ◽  
Adnexal Mass ◽  
Frozen Section ◽  
Frozen Section Diagnosis

scholarly journals Diagnostic accuracy value of intraoperative frozen section for ovarian neoplasms

2020 ◽  
Author(s):  
Farinaz Shahmoradi ◽  
Maliheh Arab
Keyword(s):  
Diagnostic Accuracy ◽  
Medical Records ◽  
Ovarian Neoplasms ◽  
Frozen Section ◽  
Final Diagnosis ◽  
Intraoperative Frozen Section ◽  
Frozen Section Diagnosis ◽  
Accuracy Study ◽  
Extent Of Surgery ◽  
Histopathology Examination

Abstract Background Accuracy of intraoperative frozen section diagnosis is extremely important in the evaluation of ovarian tumors so that suitable surgical procedures can be chosen. Methods This retrospective diagnostic accuracy study was conducted in the Department of Obstetrics and Gynecology, Emam Hossein Hospital. The case records of patients with ovarian mass who underwent surgery and intraoperatively frozen section assessments between September 2006 and December 2014 were analyzed. Demographic and clinical data, operative details, frozen section and final histopathology Examination (HPE) were reviewed from the medical records. Results one hundred and ninety three patients with ovarian masses undergoing surgery and frozen section were included. The frozen section diagnoses were benign in 155 (80.31%), borderline in 10 (5.18%), and malignant in 28 (14.51%), whereas the final diagnosis was benign in 154 (79.80%), borderline in 9 (4.66%), and malignant in 30 (15.54%). The overall accuracy of intra-operative frozen section diagnosis was 98.9%. The sensitivity for frozen section diagnosis was 100% for benign, 89% for borderline and 93.3% for malignant category, whereas the specificity was 97%, 99%, and 100%, respectively. There were 3 cases with discordance between the frozen section diagnoses and the final diagnoses, all of which were under diagnosed by frozen section. Conclusion Frozen section was found to be accurate and useful in the intraoperative assessment of patients with ovarian neoplasm. The results may help to determine the type and extent of surgery.

scholarly journals Frozen Section Diagnosis: Accuracy and Errors; with Emphasis on Reasons for Discordance

2021 ◽  
Vol 8 (2) ◽  
pp. A33-38
Author(s):  
Roopam Kishore Gidwani ◽  
Falguni Jay Goswami ◽  
Arpan Mehta ◽  
Nirali V Shah ◽  
Shobhana Ashok Prajapati ◽  
...  
Keyword(s):  
Sampling Error ◽  
Frozen Section ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Paraffin Section ◽  
Cost Effective ◽  
Final Diagnosis ◽  
Frozen Section Diagnosis ◽  
Final Histological Diagnosis

Background: Frozen section is a multistep process involving surgical resection, intraoperative preparation of slides and their microscopic examination.  It is important to   assess concordant, discordant and deferred diagnosis rates from intra-operative frozen section diagnosis with final diagnosis on paraffin section and to determine the reasons for discordance. An integral part of quality assurance in surgical pathology entails the correlation of intra-operative frozen section diagnosis with final diagnosis on permanent section.  Methods:  A retrospective analysis of 117 cases of frozen section biopsy was carried out which were reported in the Histopathology department between July 2007 to June 2012.  The correlation between the frozen section diagnosis with final histological diagnosis was performed in order to check the accuracy of the technique.  The number and type of discrepancies were compared, causes for the discrepancies were analyzed in order to decrease the avoidable errors and improve on the frozen section diagnoses.   Results:  The overall accuracy of frozen section diagnoses over 5years was 90.60% with false positive rate of 0.85%, false negative rate of 6.84% and 1.71% of deferred diagnosis. Sensitivity was 87.69% and Specificity was 98%.  The discrepancies were mainly due to the interpretation error, sampling error and technical artefacts. Conclusions:  Gross inspection, sampling by pathologist, frozen section complemented with cytological and histological review and cooperation between consultants can avoid certain limitations and provide rapid, reliable, cost effective information necessary for optimum patient care.

Accuracy of frozen section diagnosis in ovarian tumors: Is there a change in the course of time?

2003 ◽  
Vol 13 (5) ◽  
pp. 593-597 ◽  
Author(s):  
M. Gol ◽  
A. Baloglu ◽  
S. Yigit ◽  
M. Dogan ◽  
Ç. Aydin ◽  
...  
Keyword(s):  
Frozen Section ◽  
Correct Diagnosis ◽  
False Negative ◽  
Ovarian Tumors ◽  
Borderline Ovarian Tumors ◽  
Frozen Section Examination ◽  
Benign Ovarian Tumor ◽  
Frozen Section Diagnosis ◽  
Accuracy Rates ◽  
Higher Sensitivity

A retrospective study of 222 ovarian biopsy results between January 1, 2000 and August 31, 2002 was examined to determine the accuracy of frozen section diagnosis. In addition we reviewed all previous studies that examined the accuracy rates of frozen section diagnosis in ovarian tumors. Histopathologic examination results of frozen section biopsies were concordant with paraffin diagnosis in 92% of all cases. The sensitivity rates for benign, malignant, and borderline ovarian tumors were 98%, 88.7%, and 61%, respectively. There were five (2.2%) false-positive (overdiagnosed), and 13 (5.4%) false-negative (underdiagnosed) patients in frozen section examination. Frozen section examination of mucinous tumors showed higher underdiagnosis rates (20%). Review of previous studies showed no significant variation in accuracy rates of frozen section diagnosis for benign and malignant ovarian tumors, in relation with time. We found low accuracy rates for borderline ovarian tumors which was similar with the previous studies. Hovewer, there were consistent and relatively higher sensitivity rates for borderline ovarian tumors in the recent studies. As a result, we conclude that frozen section evaluation in identifying a malignant or benign ovarian tumor is accurate enough for the correct diagnosis. Since accuracy rates for borderline ovarian tumors are low, we should have more improvement in the correct diagnosis.

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