Evaluation of Intraoperative Frozen Sections: Experience in a Tertiary Care Hospital (original) (raw)
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https://ijshr.com/IJSHR\_Vol.3\_Issue.3\_July2018/IJSHR\_Abstract.0011.html, 2018
Introduction: Intraoperative consultation by frozen section technique is an invaluable tool for immediate diagnosis. Its accuracy and limitations vary with different anatomical sites. Aim: Qualitative morphological comparison between frozen section and routine formalin fixed paraffin embedded sections and determine the diagnostic accuracy in various anatomical sites. Materials and Methods: 75 tissue specimens from 72 cases were studied over a period of 20 months. Diagnostic accuracy of frozen section and its morphological quality and reliability in comparison to histopathology was evaluated for overall morphology. The turnaround time and limitations in section preparation and problems encountered were assessed. Results: Diagnostic accuracy of frozen section was 90.7%with, false negative rate of 4% and 5.3% of inconsistent diagnosis.The nuclear details, cellular outline and overall morphological quality of frozen section was slightly inferior to that of routine histopathology section, however, staining and cytoplasmic details were comparable. Most common limitation was freezing artifact. The average turnaround time was within 30 minutes in 76% cases. Conclusion: Intra-operative frozen section diagnosis is very useful and highly accurate procedure but one needs to be aware of its indications and limitations. Avoiding technical errors in sectioning and staining, intimal cooperation with surgeon can avoid certain limitations and provide rapid, reliable, cost effective information necessary for optimum patient care.
Accuracy of frozen section analysis in correlation with surgical pathology diagnosis
International Journal of Research in Medical Sciences, 2015
Background: Intra-operative consultation by frozen section is a high risk procedure with important consequences. Therefore it is critical to determine efficiency of frozen section performance periodically. This study was performed to determine accuracy of frozen section. Methods: In this prospective study, we compared the results of 100 consecutive cases of frozen section with their final permanent section diagnosis in a teaching hospital of Jawaharlal Nehru Medical College, Wardha, Maharashtra during July 2012 to June 2014. Results: A total of 100 cases were studied on frozen section while one case was deferred for permanent paraffin section (deferral rate 01%). The overall accuracy of frozen section was 96.96% with false positive and false negative rates of 1.01% and 2.02% respectively. Sensitivity, specificity, positive predictive value and negative predictive value were 97.22%, 96.30%, 98.59% and 92.86% respectively. The turnaround time of 18 minutes was observed in the present study. Conclusions: The accuracy of frozen section diagnosis at our institute can be interpreted as comparable with most international quality control statistics for frozen sections. The overall error rate and deferral rates are within the range previously published studies. The results suggest specific measures should be taken to reduce the number of discrepancies.
Iranian journal of pathology, 2015
BACKGROUND The diagnostic accuracy of frozen section as an important source of information in surgical pathology is important not only in the management of surgical patients but also as a measure of quality control in surgical pathology. In this study, we evaluated the diagnostic accuracy of frozen sections over a 6-year period in a teaching hospital in Iran. METHODS We retrospectively reviewed frozen sections performed in the Pathology Department of Taleghani Hospital (Shahid Beheshti University of Medical Sciences), Tehran, Iran from 2007 to 2013. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity, of frozen section test. Discordant cases were reassessed to find the reasons for discrepancy. RESULTS A total of 306 frozen section specimens from 176 surgical cases were evaluated. In eleven specimens (3.59%) the diagnoses were deferred. Of the remaining 295 specimens, 6 (2.03%) were discordant and 289 (97.96%) were concorda...
Qualitative Comparative Study of Frozen Section with Routine Histological Technique
National Journal of Laboratory Medicine, 2016
Introduction: Intraoperative consultation by frozen section technique is an invaluable tool for immediate diagnosis. Its accuracy and limitations vary with different anatomical sites. Various studies comparing diagnostic accuracy are reported, however morphological quality of frozen section and its limitations have not been widely discussed. Aim: Qualitative morphological comparison between frozen section and routine formalin fixed paraffin embedded sections in different tissues, determine the diagnostic accuracy and study limitations of frozen section. Materials and Methods: 67 tissue specimens from 52 cases were studied over a period of 2 years. Diagnostic accuracy of frozen section and its morphological quality and reliability in comparison to histopathology was evaluated by 2 pathologists in a blinded fashion for the following parameters: cellular outline, nuclear and cytoplasmic features, staining pattern and overall morphology. The turnaround time and limitations in section preparation and problems encountered were assessed. Results: Diagnostic accuracy of frozen section was 96.2%. Statistical analysis showed that nuclear details, cellular outline and overall morphological quality of frozen section was slightly inferior to that of routine histopathology section, however, staining and cytoplasmic details were comparable. Most common limitation was freezing artifact. The average turnaround time was within 20 minutes in 76.9% cases. Conclusion: Frozen section is a reliable and accurate intra-operative consultation modality, but one needs to be aware of its indications and limitations. Avoiding technical errors in sectioning and staining, combination of knowledge about clinical presentation and experience in interpretation of morphological details can provide rapid diagnosis and subsequent patient management.
Accuracy of Frozen Section with Histopathological Report in an Institute
Journal of Nepal Medical Association
Introduction: Frozen section helps in rapid intra-operative diagnosis. It is commonly used during surgical procedures to detect malignancy so that modifications of surgery can be decided at the time of surgery on the table. Frozen section is also performed for evaluation of surgical margins and detection of lymph node metastasis. In addition it is applied for detection of unknown pathological processes.The objective of this study was to assess the accuracy of frozen section diagnosis in comparison to gold standard histopathological diagnosis and to find concordance and discordance rate of frozen section with histopathological report.Methods: This was a cross sectional study of 41 frozen section samples done in the department of pathology of BP Koirala Institute of Health Sciences from September 2014 to August 2015. All frozen section samples with their permanent tissue samples sent for final histopathological evaluation were included in the study.Results: The overall accuracy of fro...
Study of intra operative frozen sections in an Oncopathology depa rtment
Intraoperative consultation with the Pathologist is required in oncological surgeries in deciding abo ut the margin status, nodal deposits and sometimes to establish the primary diagnosis. This is done with the use of Cryostat , commonly known as Frozen section where tissue is frozen in a refrigerated chamber and sections a re cut and stained and reports can be communicated to the surgeon within 20 minutes of receiving the specimen. In our study we have analysed retrospectively such material received during a period of one year in the Oncopa thology Department and the results are compared to permanent sections prepared using conventional methods to look for any discrepancy. The study also included the type of tissue received for frozen section and the variou s types of reports requested during a surgical procedure.
Intraoperative frozen section consultation: an analysis of accuracy in a teaching hospital
1993
This is a retrospective quality assurance study of all frozen sections done at The Aga Khan University Hospital during a six year period (1986 to 1991). There were 1,031 frozen sections out of a cumulative total of 42,985 surgical specimens (2.39%). Nine hundred and severity-six (94.66%) were concordant. In 92 (8.9%) fresh specimens were brought from other hospitals of Karachi, in 37 cases (3.58%) the diagnosis was deferred till the evaluation of permanent paraffin sections and 18 (1.74%) were discordant with 7 (0.67%) false positive and 11 (1.06%) false negative. Among the discordant cases, 9 were attributed to misinterpretation, 7 due to sampling errors and 2 due to technical reasons. Some of these errors might have been avoided, but appear to be an irreducible minimum.
Surgical Pathology and Intraoperative Consultation: An Audit
Background: While intraoperative consultation has been used in Bangladesh for a long period of time, to date, there has been no published reporting on the performance of frozen sections. The current audit evaluates the performance of frozen sections in a well reputed medical center in Bangladesh, Anowara Medical Services.
American Journal of Clinical Pathology
Objectives Monitoring of frozen section diagnostic performance provides an important quality improvement measure. Methods Surgical specimens involving a frozen section diagnosis over a 3-year period were retrospectively reviewed. Glass slides were reviewed on cases with discordance. Discordance and deferral rates were calculated. Results Of 3,675 frozen section diagnoses included, 96 (2.7%) were discordant with the final diagnosis. Additionally, 114 frozen section diagnoses (3.1%) were deferred. The organ-specific discordance rates were lowest in breast and genitourinary specimens and highest for pancreas, lymph node, and gynecologic specimens. Deferral rates were highest in musculoskeletal, breast, and hepatobiliary cases and lowest in thyroid, parathyroid, and neuropathology cases. Discordance was explained by block-sampling error (45%), specimen-sampling error (27%), or interpretation error (27%). Discordant frozen section diagnoses from gynecologic specimens were responsible for...
2020
Background and Objective: Intraoperative consultation by frozen section is a high -risk procedure with important consequences. Therefore, it is critical to determine efficiency of frozen section performance periodically. This study was performed to determine the accuracy of frozen section in Urmia University of Medical Sciences. Results: A total of 155 neoplastic and 45 nonneoplastic specimens were studied. The overall accuracy of frozen sections was 96.5%. In diagnosis of neoplastic lesions, sensitivity, specificity, positive and negative predictive values and accuracy were 93.1%, 97.7%, 96%, 95% and 95.9%, respectively. Conclusion: In this university interpretation of frozen sections is done with high accuracy and is valuable to help surgeons to plan the best management of the operation.