@-Pathology and Prostate Cancer: The Experience of the French Uropathology Club
V Moline, H Baumert, W Majoub, A Balaton, E Brunet. Hopital Saint Joseph, Paris, France; CCITI, Dijon, France
Background: Use of virtual slides system and web based technologies in pathology is promising, but many pathologists remain sceptical about the feasibility or reproducibility of diagnosis based on analysis of digitally scanned slides. Sending slides from difficult cases to a panel of expert is time-consuming with a risk of loss, damage or breakage of the slides. We conducted an evaluation on digitally scanned slides of prostate biopsies to assess reproducibility of the diagnosis of prostate cancer and different histological predictive features such as Gleason's score, length of tumor, nervous invasion.
Design: 650 slides from 50 prostate biopsies were prospectively retrieved from the files of 10 French pathology databases. Each pathologist retrieved the 5 first cases of June 2008, and sent all the slides to the centralization laboratory. All the slides were scanned on Zeiss scan system and digital images were retrieved on a server based in Dijon France. Each pathologist received an electronic copy of the program file, with a prostate biopsy user manual to download the CCITI system. The experts had access to clinical information before they blindy reviewed the virtual slides. For each case they had to fill out a score sheet and select a list of Gleason's score on which the diagnosis was based. Each expert had to justify the Gleason's score on which he or she make the diagnosis by selecting region of interest (ROI) using a drawing tool. Interobserver agreement on the diagnosis was calculated according to the Kappa test.
Results: 90% of the analyses were performed at time. There was a general good agreement on the diagnosis of prostate cancer. The exact agreement of Gleason's score was observed in 78% of the cases. Problems encountered with the software and the slides review system was evaluated. The ROI was extremely useful to understand discrepancy between the experts.
Conclusions: Our results showed that @-web based pathology is extremely useful tool and promising for the interpretation of prostate cancer on biopsies and in case of difficulty the CCITI system is a useful start for the creation of virtual slide library for a group of expert in uropathology.
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 213, Wednesday Morning