Lars Egevad1, Brett Delahunt2, Daniel M Berney3, David G Bostwick4, John Cheville5, Eva Comperat6, Andrew J Evans7, Samson W Fine8, David J Grignon9, Peter A Humphrey10, Jonas Hörnblad1, Kenneth A Iczkowski11, James G Kench12, Glen Kristiansen13, Katia R M Leite14, Cristina Magi-Galluzzi15, Jesse K McKenney16, Jon Oxley17, Chin-Chen Pan18, Hemamali Samaratunga19, John R Srigley20, Hiroyuki Takahashi21, Lawrence D True22, Toyonori Tsuzuki23, Theo van der Kwast7, Murali Varma24, Ming Zhou25, Mark Clements26. 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.
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.
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Authors: Geert J L H van Leenders; Theodorus H van der Kwast; David J Grignon; Andrew J Evans; Glen Kristiansen; Charlotte F Kweldam; Geert Litjens; Jesse K McKenney; Jonathan Melamed; Nicholas Mottet; Gladell P Paner; Hemamali Samaratunga; Ivo G Schoots; Jeffry P Simko; Toyonori Tsuzuki; Murali Varma; Anne Y Warren; Thomas M Wheeler; Sean R Williamson; Kenneth A Iczkowski Journal: Am J Surg Pathol Date: 2020-08 Impact factor: 6.298
Authors: Lars Egevad; Daniela Swanberg; Brett Delahunt; Peter Ström; Kimmo Kartasalo; Henrik Olsson; Dan M Berney; David G Bostwick; Andrew J Evans; Peter A Humphrey; Kenneth A Iczkowski; James G Kench; Glen Kristiansen; Katia R M Leite; Jesse K McKenney; Jon Oxley; Chin-Chen Pan; Hemamali Samaratunga; John R Srigley; Hiroyuki Takahashi; Toyonori Tsuzuki; Theo van der Kwast; Murali Varma; Ming Zhou; Mark Clements; Martin Eklund Journal: Virchows Arch Date: 2020-06-15 Impact factor: 4.064