Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading

Lars Egevad; Ferran Algaba; Daniel M Berney; Liliane Boccon-Gibod; Eva Compérat; Andrew J Evans; Rainer Grobholz; Glen Kristiansen; Cord Langner; Gina Lockwood; Antonio Lopez-Beltran; Rodolfo Montironi; Pedro Oliveira; Matthias Schwenkglenks; Ben Vainer; Murali Varma; Vincent Verger; Philippe Camparo

doi:10.1007/s00428-011-1106-x

Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading

Lars Egevad, Ferran Algaba, Daniel M Berney, Liliane Boccon-Gibod, Eva Compérat, Andrew J Evans, Rainer Grobholz, Glen Kristiansen, Cord Langner, Gina Lockwood, Antonio Lopez-Beltran, Rodolfo Montironi, Pedro Oliveira, Matthias Schwenkglenks, Ben Vainer, Murali Varma, Vincent Verger, Philippe Camparo

53 Citations (Scopus)

Abstract

Our aims were to analyze reporting of Gleason pattern (GP) 3 and 4 prostate cancer with the ISUP 2005 Gleason grading and to collect consensus cases for standardization. We scanned 25 prostate biopsy cores diagnosed as Gleason score (GS) 6-7. Fifteen genitourinary pathologists graded the digital slides and circled GP 4 and 5 in a slide viewer. Grading difficulty was scored as 1-3. GP 4 components were classified as type 1 (cribriform), 2 (fused), or 3 (poorly formed glands). A GS of 5-6, 7 (3¿+¿4), 7 (4¿+¿3), and 8-9 was given in 29%, 41%, 19%, and 10% (mean GS 6.84, range 6.44-7.36). In 15 cases, at least 67% of observers agreed on GS groups (consensus cases). Mean interobserver weighted kappa for GS groups was 0.43. Mean difficulty scores in consensus and non-consensus cases were 1.44 and 1.66 (p¿=¿0.003). Pattern 4 types 1, 2, and 3 were seen in 28%, 86%, and 67% of GP 4. All three coexisted in 16% (11% and 23% in consensus and non-consensus cases, p¿=¿0.03). Average estimated and calculated %GP 4/5 were 29% and 16%. After individual review, the experts met to analyze diagnostic difficulties. Areas of GP 4 and 5 were displayed as heat maps, which were helpful for identifying contentious areas. A key problem was to agree on minimal criteria for small foci of GP 4. In summary, the detection threshold for GP 4 in NBX needs to be better defined. This set of consensus cases may be useful for standardization.

Original language	English
Journal	Virchows Archiv
Volume	459
Issue number	2
Pages (from-to)	175-82
Number of pages	8
ISSN	0945-6317
DOIs	https://doi.org/10.1007/s00428-011-1106-x
Publication status	Published - Aug 2011

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Egevad, L., Algaba, F., Berney, D. M., Boccon-Gibod, L., Compérat, E., Evans, A. J., Grobholz, R., Kristiansen, G., Langner, C., Lockwood, G., Lopez-Beltran, A., Montironi, R., Oliveira, P., Schwenkglenks, M., Vainer, B., Varma, M., Verger, V., & Camparo, P. (2011). Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading. Virchows Archiv, 459(2), 175-82. https://doi.org/10.1007/s00428-011-1106-x

Egevad, L, Algaba, F, Berney, DM, Boccon-Gibod, L, Compérat, E, Evans, AJ, Grobholz, R, Kristiansen, G, Langner, C, Lockwood, G, Lopez-Beltran, A, Montironi, R, Oliveira, P, Schwenkglenks, M, Vainer, B, Varma, M, Verger, V & Camparo, P 2011, 'Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading', Virchows Archiv, vol. 459, no. 2, pp. 175-82. https://doi.org/10.1007/s00428-011-1106-x

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title = "Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading",

abstract = "Our aims were to analyze reporting of Gleason pattern (GP) 3 and 4 prostate cancer with the ISUP 2005 Gleason grading and to collect consensus cases for standardization. We scanned 25 prostate biopsy cores diagnosed as Gleason score (GS) 6-7. Fifteen genitourinary pathologists graded the digital slides and circled GP 4 and 5 in a slide viewer. Grading difficulty was scored as 1-3. GP 4 components were classified as type 1 (cribriform), 2 (fused), or 3 (poorly formed glands). A GS of 5-6, 7 (3¿+¿4), 7 (4¿+¿3), and 8-9 was given in 29%, 41%, 19%, and 10% (mean GS 6.84, range 6.44-7.36). In 15 cases, at least 67% of observers agreed on GS groups (consensus cases). Mean interobserver weighted kappa for GS groups was 0.43. Mean difficulty scores in consensus and non-consensus cases were 1.44 and 1.66 (p¿=¿0.003). Pattern 4 types 1, 2, and 3 were seen in 28%, 86%, and 67% of GP 4. All three coexisted in 16% (11% and 23% in consensus and non-consensus cases, p¿=¿0.03). Average estimated and calculated %GP 4/5 were 29% and 16%. After individual review, the experts met to analyze diagnostic difficulties. Areas of GP 4 and 5 were displayed as heat maps, which were helpful for identifying contentious areas. A key problem was to agree on minimal criteria for small foci of GP 4. In summary, the detection threshold for GP 4 in NBX needs to be better defined. This set of consensus cases may be useful for standardization.",

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doi = "10.1007/s00428-011-1106-x",

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T1 - Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading

AU - Egevad, Lars

AU - Algaba, Ferran

AU - Berney, Daniel M

AU - Boccon-Gibod, Liliane

AU - Compérat, Eva

AU - Evans, Andrew J

AU - Grobholz, Rainer

AU - Kristiansen, Glen

AU - Langner, Cord

AU - Lockwood, Gina

AU - Lopez-Beltran, Antonio

AU - Montironi, Rodolfo

AU - Oliveira, Pedro

AU - Schwenkglenks, Matthias

AU - Vainer, Ben

AU - Varma, Murali

AU - Verger, Vincent

AU - Camparo, Philippe

PY - 2011/8

Y1 - 2011/8

N2 - Our aims were to analyze reporting of Gleason pattern (GP) 3 and 4 prostate cancer with the ISUP 2005 Gleason grading and to collect consensus cases for standardization. We scanned 25 prostate biopsy cores diagnosed as Gleason score (GS) 6-7. Fifteen genitourinary pathologists graded the digital slides and circled GP 4 and 5 in a slide viewer. Grading difficulty was scored as 1-3. GP 4 components were classified as type 1 (cribriform), 2 (fused), or 3 (poorly formed glands). A GS of 5-6, 7 (3¿+¿4), 7 (4¿+¿3), and 8-9 was given in 29%, 41%, 19%, and 10% (mean GS 6.84, range 6.44-7.36). In 15 cases, at least 67% of observers agreed on GS groups (consensus cases). Mean interobserver weighted kappa for GS groups was 0.43. Mean difficulty scores in consensus and non-consensus cases were 1.44 and 1.66 (p¿=¿0.003). Pattern 4 types 1, 2, and 3 were seen in 28%, 86%, and 67% of GP 4. All three coexisted in 16% (11% and 23% in consensus and non-consensus cases, p¿=¿0.03). Average estimated and calculated %GP 4/5 were 29% and 16%. After individual review, the experts met to analyze diagnostic difficulties. Areas of GP 4 and 5 were displayed as heat maps, which were helpful for identifying contentious areas. A key problem was to agree on minimal criteria for small foci of GP 4. In summary, the detection threshold for GP 4 in NBX needs to be better defined. This set of consensus cases may be useful for standardization.

AB - Our aims were to analyze reporting of Gleason pattern (GP) 3 and 4 prostate cancer with the ISUP 2005 Gleason grading and to collect consensus cases for standardization. We scanned 25 prostate biopsy cores diagnosed as Gleason score (GS) 6-7. Fifteen genitourinary pathologists graded the digital slides and circled GP 4 and 5 in a slide viewer. Grading difficulty was scored as 1-3. GP 4 components were classified as type 1 (cribriform), 2 (fused), or 3 (poorly formed glands). A GS of 5-6, 7 (3¿+¿4), 7 (4¿+¿3), and 8-9 was given in 29%, 41%, 19%, and 10% (mean GS 6.84, range 6.44-7.36). In 15 cases, at least 67% of observers agreed on GS groups (consensus cases). Mean interobserver weighted kappa for GS groups was 0.43. Mean difficulty scores in consensus and non-consensus cases were 1.44 and 1.66 (p¿=¿0.003). Pattern 4 types 1, 2, and 3 were seen in 28%, 86%, and 67% of GP 4. All three coexisted in 16% (11% and 23% in consensus and non-consensus cases, p¿=¿0.03). Average estimated and calculated %GP 4/5 were 29% and 16%. After individual review, the experts met to analyze diagnostic difficulties. Areas of GP 4 and 5 were displayed as heat maps, which were helpful for identifying contentious areas. A key problem was to agree on minimal criteria for small foci of GP 4. In summary, the detection threshold for GP 4 in NBX needs to be better defined. This set of consensus cases may be useful for standardization.

U2 - 10.1007/s00428-011-1106-x

DO - 10.1007/s00428-011-1106-x

M3 - Journal article

C2 - 21698392

SN - 0945-6317

VL - 459

SP - 175

EP - 182

JO - Virchows Archiv

JF - Virchows Archiv

IS - 2

ER -

Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading

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