Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug;115(4):221-226.
doi: 10.32074/1591-951X-896.

Diagnostic concordance between traditional and digital workflows. A study on 1427 prostate biopsies

Evelin Torresani  1 , Maria Adalgisa Gentilini  2 , Stefano Grassi  3 , Luca Cima  1 , Irene Pedrolli  1 , Tommaso Cai  4 , Marco Puglisi  4 , Valentino Vattovani  4 , Bianca Guadin  5 , Matteo Brunelli  6 , Claudio Doglioni  3 , Mattia Barbareschi  1   7
Affiliations

Diagnostic concordance between traditional and digital workflows. A study on 1427 prostate biopsies

Evelin Torresani et al. Pathologica. 2023 Aug.

Abstract

Objective: To evaluate intra-observer diagnostic reproducibility using traditional slides (TS) versus whole slide images (WSI).

Methods: TS and WSI of 1427 prostatic biopsies (107 consecutive patients) were evaluated by a single pathologist. Agreement between readings was evaluated with Gwet's Agreement coefficient (AC) and Landis and Koch benchmark scale.

Results: The positive/negative agreement between the readings was almost perfect (AC1= 0.962; 95% CI[0.949,0.974]), with method independent distribution of discrepancies. Among positive biopsies, 212 had identical Gleason score (GS) on TS and WSI and discordant GS in 69 cases (AC2 = 0.932; 95% CI[0.907, 0.956]). Concordant negative and positive patient classification was observed in 39 and 64 cases, respectively; two cases were assigned to the positive group on TS and 2 on WSI configuring an almost perfect agreement (AC1=0.929; 95% C1[0.860, 0.998]). ISUP Grade group (ISUP GG) agreement was evaluated in the 60 concordantly positive cases: in 45 cases it was identical on TS and WSI; in 10 biopsies the discrepancy implied a modification of the assigned ISUP GG of ≤ 1 class and in 5 the discrepancy implied a modification of 2 classes. Gwet's agreement coefficient was (95% CI [0.834, 0.962]), i.e.: almost perfect agreement.

Conclusions: Our data show almost perfect agreement between digital and traditional diagnostic activity in a routine setting, confirming that digital pathology can be safely introduced into routine workflows.

Keywords: digital pathology; histopathology; human; prostate; prostatic neoplasms.

PubMed Disclaimer

Conflict of interest statement

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Diagnostic agreement for all 1427 slides. In ordinate are WSI paired with TS on abscissa, subdivided as positive or negative; dark blue squares represent perfectly concordant diagnoses.
Figure 2.
Figure 2.
Gleason score diagnostic agreement for 281 slides. In ordinate are WSI data paired with TS on abscissa, subdivided on the basis of increasing Gleason score; dark blue squares represent perfectly concordant diagnoses.
Figure 3.
Figure 3.
Perineural invasion diagnostic agreement for 282 slides. In ordinate are WSI data paired with TS on abscissa, subdivided as positive or negative; dark blue squares represent perfectly concordant diagnoses.
Figure 4.
Figure 4.
Diagnostic agreement for all 107 patients. In ordinate are WSI paired with TS on abscissa, subdivided as positive or negative; dark blue squares represent perfectly concordant diagnoses.
Figure 5.
Figure 5.
ISUP Grade group diagnostic agreement for all 107 patients. In ordinate are WSI paired with TS on abscissa, subdivided on the basis of increasing ISUP Grade group; dark blue squares represent perfectly concordant diagnoses.
See this image and copyright information in PMC

References

    1. Barbareschi M, Demichelis F, Forti S, et al. Digital pathology: science fiction? Int J Surg Pathol 2000;8:261-263. https://doi.org/10.1177/106689690000800401 10.1177/106689690000800401 - DOI - PubMed
    1. Fraggetta F, Pantanowitz L. Going fully digital: utopia or reality? Pathologica 2018;110:1-2. - PubMed
    1. Flach RN, Willemse PM, Suelmann BBM, et al. Significant inter- and intralaboratory variation in gleason grading of prostate cancer: a nationwide study of 35,258 patients in the Netherlands. Cancers (Basel) 2021;13:5378. https://doi.org/10.3390/cancers13215378 10.3390/cancers13215378 - DOI - PMC - PubMed
    1. Surintrspanont J, Zhou M. Prostate Pathology: What is New in the 2022 WHO Classification of Urinary and Male Genital Tumors? Pathologica. 2022;115:41-56. https://doi.org/10.32074/1591-951X-822 10.32074/1591-951X-822 - DOI - PMC - PubMed
    1. Board WCoTE. Urinary and Male Genital Tumours. 5th Edition. Lyon (France): International Agency for Research on Cancer; 2022.

LinkOut - more resources