Department of Pathology, National Cancer Institute 'Giovanni Paolo II', Bari, Italy.
Histopathology. 2010 May;56(6):720-6. doi: 10.1111/j.1365-2559.2010.03548.x.
To conduct an internet-based study using virtual slides (VS) of sterotactic core biopsy specimens of non-palpable breast lesions in order to evaluate interobserver reproducibility between pathologists.
A total of 18 breast lesions, determined to be histologically complex by two pathologists, were selected. Digitized VSs were then created using QuickTime Virtual Reality technology (Apple, Cupertino, CA, USA) and posted on the world-wide web. In all, 10 pathologists completed the evaluations of 18 VSs using the five diagnostic categories (B1-B5) from the European guidelines for quality assurance in breast cancer screening and diagnosis. Their results were compared with those of every other participating pathologist, and were then individually compared with the results of a highly experienced breast pathologist (referee). Of the 18 cases, 10 (56%) were classified by the referee as borderline (B3 and B4). Comparisons with reference values showed a less than satisfactory level of reproducibility (median kappa(w) = 0.60). As regards interobserver reproducibility, results showed that, in general, the level of agreement was not satisfactory (median kappa(w) = 0.53).
Overall, the findings are comparable to those quality control studies using circulating slides when analysis is done on borderline cases.
通过对非触诊性乳腺病变的立体定向核心活检标本的虚拟切片（VS）进行基于互联网的研究，评估病理学家之间的观察者间可重复性。
选择了总共 18 个由两位病理学家确定为组织学复杂的乳腺病变。然后使用 QuickTime 虚拟现实技术（Apple，Cupertino，CA，USA）创建数字化 VS，并将其发布在万维网上。共有 10 位病理学家使用欧洲乳腺癌筛查和诊断质量保证指南中的五个诊断类别（B1-B5）对 18 个 VS 进行了评估。他们的结果与每位其他参与病理学家的结果进行了比较，然后与一位经验丰富的乳腺病理学家（裁判）的结果进行了单独比较。在 18 例中，裁判将 10 例（56%）分类为边界性（B3 和 B4）。与参考值相比，可重复性水平低于满意（中位数 kappa(w) = 0.60）。关于观察者间的可重复性，结果表明，总体而言，一致性水平并不令人满意（中位数 kappa(w) = 0.53）。
总体而言，当对边界病例进行分析时，研究结果与使用循环切片进行的质量控制研究相当。
