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Histopathology. 2018 Jul;73(1):8-18. doi: 10.1111/his.13471. Epub 2018 Mar 5.

Utility of Pathology Imagebase for standardisation of prostate cancer grading.

Author information

1
Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
2
Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
3
Barts Cancer Institute, Queen Mary University of London, London, UK.
4
Bostwick Laboratories, Orlando, FL, USA.
5
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
6
Hôpital Tenon, HUEP, AP-HP, UPMC Paris VI, Sorbonne Universities, Paris, France.
7
Laboratory Medicine Program, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
8
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
9
Department of Pathology and Molecular Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
10
Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
11
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA.
12
Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and Central Clinical School, University of Sydney, Sydney, NSW, Australia.
13
Institute of Pathology, University Hospital Bonn, Bonn, Germany.
14
Department of Urology, Laboratory of Medical Research, University of São Paulo Medical School, São Paulo, Brazil.
15
Department of Anatomic Pathology, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.
16
Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
17
Department of Cellular Pathology, Southmead Hospital, Bristol, UK.
18
Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan.
19
Aquesta Uropathology and University of Queensland, Brisbane, Qld, Australia.
20
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
21
Department of Pathology, Jikei University School of Medicine, Tokyo, Japan.
22
Department of Pathology, University of Washington Medical Center, Seattle, WA, USA.
23
Department of Surgical Pathology, School of Medicine, Aichi Medical University, Nagoya, Japan.
24
Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK.
25
Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA.
26
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Abstract

AIMS:

Despite efforts to standardise grading of prostate cancer, even among experts there is still a considerable variation in grading practices. In this study we describe the use of Pathology Imagebase, a novel reference image library, for setting an international standard in prostate cancer grading.

METHODS AND RESULTS:

The International Society of Urological Pathology (ISUP) recently launched a reference image database supervised by experts. A panel of 24 international experts in prostate pathology reviewed independently microphotographs of 90 cases of prostate needle biopsies with cancer. A linear weighted kappa of 0.67 (95% confidence interval = 0.62-0.72) and consensus was reached in 50 cases. The interobserver weighted kappa varied from 0.48 to 0.89. The highest level of agreement was seen for Gleason score (GS) 3 + 3 = 6 (ISUP grade 1), while higher grades and particularly GS 4 + 3 = 7 (ISUP grade 3) showed considerable disagreement. Once a two-thirds majority was reached, images were moved automatically into a public database available for all ISUP members at www.isupweb.org. Non-members are able to access a limited number of cases.

CONCLUSIONS:

It is anticipated that the database will assist pathologists to calibrate their grading and, hence, decrease interobserver variability. It will also help to identify instances where definitions of grades need to be clarified.

KEYWORDS:

International Society of Urological Pathology; database; grading; prostate; standardisation

PMID:
29359484
DOI:
10.1111/his.13471
[Indexed for MEDLINE]

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