Glotsos Dimitris, Georgiadis Pantelis, Kostopoulos Spiros, Daskalakis Antonis, Kalatzis Ioannis, Ravazoula Panagiota, Cavouras Dionisis
Department of Medical Instruments Technology, Technological Educational Institute of Athens, Athens, Greece.
Anal Quant Cytol Histol. 2009 Oct;31(5):262-8.
To investigate the minimum requirements necessary for remote grading astrocytomas in terms of selected static images and descriptive histologic characteristics.
A histopathologist examined 106 formalin-fixed, paraffin-embedded tissue samples of low- and high-grade astrocytomas. Interobserver-checked cases were reviewed under a microscope to estimate the accuracy of the conventional glass slide diagnoses. Then cases based on 5 static-digitized images from each patient were diagnosed. Next, the grade of each tumor was assessed based on the set of 5 images and the World Health Organization (WHO) description of 8 histologic characteristics defined as crucial in grading astrocytomas. Finally, an evaluation was made using a custom-designed decision support system.
Conventional glass slide diagnosis was 93.9%. Diagnosis based only on the set of 5 images dropped to 81.6%. Diagnosis based on the set of 5 images and the WHO characteristics boosted accuracy to 88.8%. Accuracy improved to 91.8% with the addition of the decision support system.
Our findings suggest that a telepathology system might be valuable for accurate grade diagnosis of astrocytomas-providing a means for avoiding diagnostic errors-without blocks or slides having to leave the department. This could significantly reduce the overall time and cost of diagnosis.
根据选定的静态图像和描述性组织学特征，研究远程分级星形细胞瘤所需的最低要求。
一位组织病理学家检查了106份低级别和高级别星形细胞瘤的福尔马林固定、石蜡包埋组织样本。对观察者间检查的病例进行显微镜复查，以评估传统玻片诊断的准确性。然后根据每位患者的5张静态数字化图像进行病例诊断。接下来，根据这5张图像以及世界卫生组织（WHO）对8种组织学特征的描述（这些特征在星形细胞瘤分级中被定义为关键特征）对每个肿瘤的级别进行评估。最后，使用定制设计的决策支持系统进行评估。
传统玻片诊断的准确率为93.9%。仅基于5张图像集的诊断降至81.6%。基于5张图像集和WHO特征的诊断将准确率提高到88.8%。添加决策支持系统后，准确率提高到91.8%。
我们的研究结果表明，远程病理系统对于星形细胞瘤的准确分级诊断可能具有重要价值——提供一种避免诊断错误的方法——而无需将切片或玻片送出科室。这可以显著减少诊断的总体时间和成本。
