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

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.

scholarly journals Diagnostic accuracy of intraoperative frozen section in ovarian neoplasms: Experience in a tertiary oncology centre

2016 ◽  
Author(s):  
Anu Bajracharya ◽  
Rupinder Sekhon ◽  
Shweta Giri ◽  
Sudhir Rawal
Keyword(s):  
Diagnostic Accuracy ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Ovarian Neoplasm ◽  
Predictive Values ◽  
Intraoperative Frozen Section ◽  
The Mean ◽  
Oncology Centre ◽  
Line Of Therapy ◽  
Sensitivity Specificity

Aims and Objectives: This study is done to assess the accuracy of intraoperative frozen section in the diagnosis of various categories of ovarian neoplasm conducted in RGCI. Materials and Methods: Introperative frozen sections for suspected ovarian neoplasm that underwent surgery as primary line of therapy at this institution were analyzed retrospectively from Jan. 2014 - Dec. 2015. The results of frozen section were compared with the final histopathologic diagnosis on paraffin sections and the overall accuracy, sensitivity, specificity, positive and negative predictive values were determined. Results: The study included 159 cases and the mean age of patients was 44.72 ± 14.28 years (Range 19-75 years). The mean size of tumor was 12.5 ± 5.9 cm. Sensitivity of frozen section for benign, borderline and malignant tumors was 98.53%, 73.33% and 94.74% respectively. And the related specificities were 95.60%, 96.53% and 100% respectively. There were 150 concordant cases and 9 discordant cases. Overall diagnostic accuracy of frozen section was 94.33%. Conclusion: Intraoperative frozen section diagnosis appears to be an accurate and comparable technique for the histopathology diagnosis of ovarian tumours. It is a valuable tool to guide the surgical management of these patients.

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 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.

Intraoperative Frozen Section Performance for Thyroid Cancer Diagnosis

2021 ◽  
Author(s):  
Iuri Martin Goemann ◽  
Francisco Paixão ◽  
Alceu Migliavaca ◽  
José Ricardo Guimarães ◽  
Rafael Selbach Scheffel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Diagnosis ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Intraoperative Frozen Section ◽  
Indeterminate Nodules ◽  
Intraoperative Management ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard.Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n=96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy.Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be a reasonable option and should be specifically investigated.

Operative Decision-Making for Follicular Thyroid Lesions: A Community Hospital System Experience

2011 ◽  
Vol 77 (4) ◽  
pp. 443-446 ◽  
Author(s):  
Kevin Grannan ◽  
Jonathan Snyder ◽  
Sarah Mcdonough ◽  
Amy Engel ◽  
James Farnum
Keyword(s):  
Decision Making ◽  
Community Hospital ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Frozen Sections ◽  
Indication For Surgery ◽  
Hospital System ◽  
Reoperative Surgery ◽  
Intraoperative Frozen Section ◽  
Initial Surgery

Follicular neoplasms of the thyroid are a frequent indication for surgery of the thyroid gland. We evaluated the use of frozen sections on intraoperative decision-making, possible avoidance of reoperative surgery, and histologic findings in a retrospective cohort. A database was created of all thyroid operations from 2001 to 2007. Data collected included age, gender, preoperative cytology, indication for surgery, surgeon, intraoperative decision-making, and histologic findings. Of the 723 thyroidectomies, 203 were performed for follicular neoplasms diagnosed by fine needle aspiration. Of these, 135 had cytology reports available within our electronic medical record; 44 per cent (59 of 135) of these patients had an intraoperative frozen section. Only two of 59 (3.4%) were positive for carcinoma, both of which were papillary carcinomas. One was interpreted as “suspicious” for carcinoma by the pathologist. In these three cases, the surgeon proceeded with total thyroidectomy at the time of initial surgery. The results of frozen section altered the operation in only three of 59 cases (5.1%). Intraoperative frozen section rarely impacts the conduct of thyroidectomy for follicular neoplasms.

scholarly journals Guiding significance of intraoperative frozen section for range of judging incisal edge of Esophageal Carcinoma

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Fei He ◽  
Chen Wang ◽  
Weichao Liu ◽  
Gongning Shi
Keyword(s):  
Esophageal Cancer ◽  
Esophageal Carcinoma ◽  
Original Work ◽  
Frozen Section ◽  
Frozen Sections ◽  
Intraoperative Frozen Section ◽  
Creative Commons ◽  
Descriptive Research ◽  
Incisal Edge ◽  
Open Access Article

Objective: To explore guiding significance of intraoperative frozen section for judging incisal edge range of esophageal carcinoma. Methods: A retrospective descriptive research design was used to collect the clinical and pathological data of 205 patients with esophageal cancer who were treated in Huaihe Hospital of Henan University from March 2012 to July 2015. Among them, 46 patients’ esophageal margins were made into intraoperative frozen sections. Results: In the 205 cases, nine cases were diagnoses with upper incisal edge cancerization, accounting for 4.39%, and five cases were diagnosed with lower incisal edge cancerization, accounting for 2.4%. There were 14 cases in total, accounting for 6.83%. four cases showed positive residual end of intraoperative frozen section. Conclusion: The cancerous focus residue of incisal edge in esophageal carcinoma is not uncommon. Intraoperative frozen section is helpful to judge the proper excision length of esophageal carcinoma. doi: https://doi.org/10.12669/pjms.37.5.3910 How to cite this:He F, Wang C, Liu W, Shi G. Guiding significance of intraoperative frozen section for range of judging incisal edge of Esophageal Carcinoma. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3910 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review

2005 ◽  
Vol 15 (2) ◽  
pp. 192-202 ◽  
Author(s):  
L. R. Medeiros ◽  
D. D. Rosa ◽  
M. I. Edelweiss ◽  
A. T. Stein ◽  
M. C. Bozzetti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Frozen Sections ◽  
Borderline Tumors ◽  
Frozen Section Analysis ◽  
Accuracy Rates ◽  
Section Result ◽  
Section Analysis

A quantitative systematic review was performed to estimate the diagnostic accuracy of frozen sections in ovarian tumors. Studies that compared frozen sections and paraffin sections within subjects for diagnosis of ovarian tumors were included. Fourteen primary studies were analyzed, which included 3 659 women. For benign ovarian vs borderline/malignant tumor cases, the occurrence of a positive frozen-section result for benignity (pooled likelihood ratio [LR], 8.7; 95% confidence interval [CI], 7.3–10.4) and posttest probability for benign diagnosis was 95% (95% CI, 94–96%). A positive frozen-section result for malignant vs benign diagnosis (pooled LR, 303; 95% CI, 101–605) increased the probability of ovarian cancer to 98% (95% CI, 97–99%). In borderline vs benign ovarian tumor cases, a positive frozen-section result (pooled LR, 69; 95% CI, 45–106) increased the probability of borderline tumors to 79% (95% CI, 71–85%). In borderline vs malignant ovarian tumor cases, a positive frozen-section result (pooled LR, 18; 95% CI, 13–26) increased the probability of borderline tumors to 51% (95% CI, 42–60%). We conclude that diagnostic accuracy rates for frozen-section analysis is high for malignant and benign ovarian tumors, but the accuracy rates in borderline tumors remain relatively low.

scholarly journals Current Evidence Does Not Warrant Frozen Section Evaluation for the Presence of Tumor Spread Through Alveolar Spaces

2017 ◽  
Vol 142 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Ann E. Walts ◽  
Alberto M. Marchevsky
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Frozen Section ◽  
Current Evidence ◽  
Sublobar Resection ◽  
Open Thoracotomy ◽  
Tumor Spread ◽  
Predictive Values ◽  
Video Assisted ◽  
Sensitivity Specificity

Context.— Tumor spread through alveolar spaces (STAS) has been correlated with unfavorable prognosis in lung adenocarcinomas treated with sublobar resection, but it is unknown whether STAS can be reliably identified in frozen section (FS) to help stratify patients for lobectomy or sublobar resection. Objective.— To evaluate STAS in FS. Design.— Tumor spread through alveolar spaces was evaluated in hematoxylin-eosin–stained FS, FS control slides, and all additional slides with lung tissue adjacent to tumor (AdLT) from 48 pT1–2 adenocarcinomas operated on using video-assisted thoracotomy (n = 25) or open thoracotomy (n = 23). The samples included lobectomies (n = 27) and sublobar resections (n = 21). The STAS incidences were compared by FS versus FS control versus AdLT, video-assisted thoracotomy versus open thoracotomy, and lobectomy versus sublobar resection. Sensitivity, specificity, and positive and negative predictive values of STAS+ findings were calculated. The literature was queried for best evidence regarding incidence and predictive value of STAS in FS. Results.— Tumor spread through alveolar spaces positivity was identified in 46 of 48 cases (95.8%), including 23 FS (47.9%), 32 FS control (66.7%), and 43 AdLT (89.6%). The STAS incidence was significantly higher in AdLT than in FS or FS control. Only 2 of the 25 cases that were STAS− in FS were true negatives. Frozen section sensitivity to detect STAS positivity was 50%, with a 100% positive predictive value and 8% negative predictive value. Systematic literature review identified no evidence regarding STAS identification in FS. Conclusions.— The sensitivity and negative predictive value of FS for STAS detection are unacceptably low. There are insufficient data to support intraoperative detection of STAS as a useful predictive feature to help stratify patients for lobectomy or sublobar resections.

Development and Evaluation of Perl-Based Algorithms to Classify Neoplasms From Pathology Records in Synoptic Report Format

2021 ◽  
pp. 295-303
Author(s):  
Kristen R. Rossi ◽  
Diana Echeverria ◽  
Anna Carroll ◽  
Tina Luse ◽  
Christopher Rennix
Keyword(s):  
Hodgkin Lymphoma ◽  
Malignant Neoplasm ◽  
Malignant Neoplasms ◽  
Predictive Values ◽  
Software Application ◽  
Non Hodgkin Lymphoma ◽  
Institutional Variation ◽  
Sensitivity Specificity ◽  
Synoptic Reporting

PURPOSE Synoptic reporting provides a mechanism for uniform and structured pathology diagnostics. This paper demonstrates the functionality of Perl alternation and grouping expressions to classify electronic pathology reports generated from military treatment facilities. Eight Perl-based algorithms are validated to classify malignant melanoma, Hodgkin lymphoma, non-Hodgkin lymphoma, leukemia, and malignant neoplasms of the breast, ovary, testis, and thyroid. METHODS Case finding cohorts were developed using diagnostic codes for neoplasm groups and matched by unique identifiers to obtain pathology records. Preprocessing techniques and Perl-based algorithms were applied to classify records as malignant, in situ, suspect, or nonapplicable, followed by a hand-review process to determine the accuracy of the algorithm classifications. Interrater reliability, sensitivity, specificity, positive predictive values, and negative predictive values were computed following abstractor adjudication. RESULTS The specificity of the Perl-based algorithms was consistently high, over 98%. Very few benign results were classified as malignant or in situ by the Perl-based algorithms; the leukemia algorithm classification was the only group to demonstrate a positive predictive value below 95%, at 91.9%. Three algorithm classification groups demonstrated a sensitivity of < 80%, including malignant neoplasm of the ovary (33.3%), leukemia (52.8%), and non-Hodgkin lymphoma (62.9%). The pathology records for these results included substantial linguistic variation. CONCLUSION This paper contextualizes the utility and value of an algorithm logic built around synoptic reporting to identify neoplasms from electronic pathology results. The major strength includes the application of Perl-based coding in SAS, an accessible software application, to develop highly specific algorithms across institutional variation in diagnostic documentation.

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