scholarly journals Utility of Intraoperative Frozen Sections during Thyroid Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Russel Kahmke ◽  
Walter T. Lee ◽  
Liana Puscas ◽  
Richard L. Scher ◽  
Michael J. Shealy ◽  
...  
Keyword(s):  
Predictive Value ◽  
Frozen Section ◽  
Case Series ◽  
Follicular Neoplasm ◽  
Frozen Sections ◽  
Fine Needle Aspirate ◽  
Retrospective Case ◽  
Predictive Values ◽  
Fine Needle ◽  
Intraoperative Frozen Section

Objective. To describe the usefulness of intraoperative frozen section in the diagnosis and treatment of thyroid nodules where fine needle aspirate biopsies have evidence of follicular neoplasm.Study Design. Retrospective case series.Methods. All patients have a fine needle aspirate biopsy, an intraoperative frozen section, and final pathology performed on a thyroid nodule after initiation of the Bethesda System for Reporting Thyroid Cytopathology in 2009 at a single tertiary referral center. Sensitivity, specificity, positive predictive value, and negative predictive value are calculated in order to determine added benefit of frozen section to original fine needle aspirate data.Results. The sensitivity and specificity of the frozen section were 76.9% and 67.9%, respectively, while for the fine needle aspirate were 53.8% and 74.1%, respectively. The positive and negative predictive values for the fine needle aspirates were 25% and 90.9%, respectively, while for the frozen sections were 27.8% and 94.8%, respectively. There were no changes in the operative course as a consequence of the frozen sections.Conclusion. Our data does not support the clinical usefulness of intraoperative frozen section when the fine needle aspirate yields a Bethesda Criteria diagnosis of follicular neoplasm, suspicious for follicular neoplasm, or suspicious for malignancy at our institution.

The Accuracy of Intraoperative Frozen Sections in Epithelial Ovarian Tumor

2021 ◽  
Vol 104 (2) ◽  
pp. 214-218
Keyword(s):  
Ovarian Tumor ◽  
Frozen Section ◽  
High Accuracy ◽  
Malignant Neoplasms ◽  
Frozen Sections ◽  
Predictive Values ◽  
Intraoperative Frozen Section ◽  
Epithelial Ovarian Tumor ◽  
Sensitivity Specificity ◽  
Epithelial Neoplasm

Objective: To evaluate the accuracy of the intraoperative frozen section in the diagnosis of epithelial ovarian tumor. Materials and Methods: An observational study of epithelial ovarian tumor reports from patients that underwent surgery with intraoperative consultation at Ramathibodi Hospital, Thailand between 2013 and 2017 was done. The frozen section diagnoses were compared with the final surgical diagnoses and the overall accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) were studied. Results: One hundred sixteen ovarian specimen reports were reviewed, comprised of 74 (63.8%) benign, 21 (18.1%) borderline, and 21 (18.1%) malignant neoplasms. Nine cases (7.7%) were discordant diagnoses. The overall accuracy was 92.2%. The sensitivity and specificity for benign, borderline, and malignant neoplasms were 100%, 80.9%, and 76.2%, and 88.1%, 95.8%, and 100%, respectively. The PPV and NPV for benign, borderline, and malignant neoplasms were 93.7%, 80.9%, and 100%, and 100%, 95.8%, and 95.0%, respectively. Conclusion: The intraoperative frozen section has high accuracy in the diagnosis of ovarian epithelial neoplasm. The results can be used in guidance on the extent and type of surgical management. Keywords: Frozen section, Accuracy, Epithelial ovarian tumor

RESEARCH ON VALUE OF INTRAOPERATIVE FROZEN SECTION EXAMINATION OF THE COMMON TUMORS AT HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 67-73
Author(s):  
Cong Thuan Dang ◽  
Thi Thu Thao Le
Keyword(s):  
Sensitivity And Specificity ◽  
Frozen Section ◽  
Analysis Data ◽  
Poor Quality ◽  
University Hospital ◽  
Frozen Sections ◽  
Intraoperative Frozen Section ◽  
Frozen Section Examination ◽  
Incorrect Diagnosis ◽  
The Common

Background: To evaluate the accuracy and the pitfalls of frozen section examination in diagnosis the common tumors at Hue University Hospital. Materials and method: A retrospective analysis data of 99 consecutive patients from 2007 to 2009 were evaluated and analyzed the major pitfalls. In our 99 patients, 100% cases we compared histological diagnosis on frozen sections with those on paraffin sections. Results: The majority of frozen section examinations were the thyroid lesions 37.4%, breast lesions 25.2%, lymph nodes 16.1%, ovary 9.1% and less common in other diseases (12.1%). The accuracy, sensitivity and specificity of the intraoperative frozen section examination were 93.9%, 89.1% and 98.1% respectively. The main factors causing incorrect diagnosis in frozen section are: Misinterpretation, poor quality of frozen sections, improper sampling in sectioning and difficult to result interpretation. Conclusion: The frozen section analysis of suspect lesions displays good sensitivity and specificity characteristics.

scholarly journals Intraoperative Frozen Section May Reduce the Need for Reoperative Thyroid Surgery in Patients with Follicular Neoplasm

2016 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Dena Arumugam ◽  
Carlos A. Macias ◽  
Renee L. Arlow ◽  
Sumana Narayanan ◽  
Shou-En Lu ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Frozen Section ◽  
Follicular Neoplasm ◽  
Intraoperative Frozen Section ◽  
Reoperative Thyroid Surgery

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.

Venous Flow Coupler in Head and Neck Free Flap Reconstruction

2020 ◽  
pp. 019459982095309
Author(s):  
Scott H. Troob ◽  
Quinn Self ◽  
Deniz Gerecci ◽  
Macgregor Hodgson ◽  
Javier González-Castro ◽  
...  
Keyword(s):  
Free Flap ◽  
Predictive Value ◽  
False Positive ◽  
False Positive Rate ◽  
Case Series ◽  
Arterial Flow ◽  
Retrospective Case ◽  
Venous Flow ◽  
Retrospective Case Series ◽  
Positive Rate

Objective To describe the utility of venous flow couplers in monitoring free tissue flaps in the immediate postoperative setting. Study Design Retrospective case series. Setting Otolaryngology department at a single tertiary care institution. Methods A retrospective case series of free flap reconstructions in which venous flow couplers were employed to supplement flap monitoring. All free flap cases performed over the past 4 years were reviewed. Inclusion criteria were venous flow coupler and arterial flow Doppler monitored for 5 days postoperatively. Results From July 2014 through May 2018, the venous flow coupler was used with the arterial flow Doppler and clinical monitoring in 228 cases. Eleven cases did not meet criteria for inclusion; thus, 217 cases were analyzed. Twenty cases (9.2%) returned to the operating room with concern for flap compromise, and 16 were salvaged. The combination of venous flow coupler and arterial flow Doppler identified 19 of these flaps. Venous flow couplers identified 5 compromised flaps before there was an arterial signal change, and all were salvaged. Additionally, there was a 24.1% false-positive rate when 2 venous flow couplers were used in parallel. For the venous flow coupler, the positive predictive value was 64.3% and the negative predictive value, 98.9%. The false-positive rate in the series was 5.1%. The sensitivity was 90% and the specificity, 94.9%. Conclusion The venous flow coupler is able to detect venous thrombosis in the absence of arterial thrombosis and may contribute to improved flap salvage rates.

Management of Thyroid Nodules in Deceased Donors With Comparison Between Fine Needle Aspiration and Intraoperative Frozen Section in the Setting of Transplantation

2019 ◽  
Vol 29 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Albino Eccher ◽  
Ilaria Girolami ◽  
Antonia D’Errico ◽  
Gianluigi Zaza ◽  
Amedeo Carraro ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Clinical History ◽  
Needle Aspiration ◽  
Transmission Risk ◽  
Fine Needle ◽  
Intraoperative Frozen Section ◽  
History Of ◽  
Deceased Donors

Introduction: Newly discovered thyroid nodules in deceased donors are investigated to rule out cancer that can be transmitted, but there are no established protocols. The aim of the study was to compare fine needle aspiration versus intraoperative frozen section in the donor management with limited time. Methods: Data were extracted only from the records of Italian second opinion consultation service in the years 2016 to 2017 and included donor details, pathology diagnoses, complications, transmission risk profile, and impact on transplantation. Results: Among 31 deceased donors with thyroid nodules, we documented 4 with a clinical history of cancer and 27 with a newly discovered nodule. The latter was evaluated by thyroidectomy with frozen section in 22 and fine needle aspiration in 5. Among all donors, 7 had papillary thyroid carcinoma with negligible transmission risk, whereas 8 with unacceptable risk. Two donors presented major bleeding after thyroidectomy, with organ discard in 1 case. Transplantation was delayed in 4 cases that were evaluated with frozen section. Discussion: There was no uniform approach for the investigation of thyroid nodules. Our results showed that fine needle aspiration was more accurate and useful than frozen section. Fine needle aspiration had minor economic impact and a far less rate of bleeding/hemodynamic complications, potentially delaying and compromising organ recovery. Our results suggested considering fine needle aspiration as a first step in the evaluation of thyroid nodules in donors.

Intraoperative frozen section histopathology for the diagnosis of periprosthetic joint infection in hip revision surgery: the influence of recent dislocation and/or periprosthetic fracture

2020 ◽  
pp. 112070002093399
Author(s):  
Lucas Luyckx ◽  
Jan F A Somers ◽  
Kristof Cokelaere ◽  
Stijn Deloose ◽  
Gaétan Delrue ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Predictive Value ◽  
Periprosthetic Fracture ◽  
Frozen Section ◽  
Joint Infection ◽  
Hip Revision ◽  
Intraoperative Frozen Section ◽  
Hip Revision Surgery ◽  
Group A ◽  
Group B

Aims: To evaluate the accuracy of intraoperative frozen section histopathology for diagnosing periprosthetic joint infection (PJI) during hip revision surgery, both for patients with and without recent trauma to the hip. Patients and methods: The study included all revision total hip replacement procedures where intraoperative frozen section histopathology had been used for the evaluation of infection in a single institution between 2008 and 2015. Musculoskeletal Infection Society criteria were used to define infection. 210 hips were included for evaluation. Prior to revision surgery, 36 hips had a dislocation or a periprosthetic fracture (group A), and 174 did not (group B). Results: The prevalence of infection was 14.3% (5.6% in group A and 16.1% in group B). Using Feldman criteria, the sensitivity of histopathology was 50.0%, specificity 47.1%, positive predictive value 5.3% and negative predictive value 94.1% in group A. The sensitivity of frozen section histopathology was 75.0%, specificity 96.5%, positive predictive value 85% and negative predictive value 95.3% in group B. Conclusions: Intraoperative frozen section histopathology is reliable for the diagnosis of PJI if no dislocation or periprosthetic fracture has occurred prior to hip revision surgery.

Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules

1998 ◽  
Vol 187 (5) ◽  
pp. 494-502 ◽  
Author(s):  
Loretta A Boyd ◽  
Richard C Earnhardt ◽  
John T Dunn ◽  
Henry F Frierson ◽  
John B Hanks
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Preoperative Evaluation ◽  
Needle Aspiration ◽  
Fine Needle
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