![]() |
6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A140
In the malignancy grading of prostate carcinomas, the Gleason scoring
system is widely used, but recent studies have shown substantial
interobserver variations which may have serious clinical implications,
and could result in inappropriate treatment of the patient. Telepathology
potentially provides an ideal medium for consensus derivation, and this
experiment is aimed at collecting a grading consensus from a wide group
of pathologists on typical prostate images. The experiment involves
two stages. In Stage 1, expert prostate pathologists were asked to select
cases which they considered to contain clear example fields of each Gleason
grade (1-5). Images from these were placed on a web site, and participants
were invited to give a grade and confidence score for each set of images.
Images giving low confidence scores were removed from the set and replaced
by other images selected by the participant. When complete, the resulting
images will be loaded onto a designated area of the publicly-available
EUROPATH data base as consensual examples of prostate carcinoma fields
illustrating each Gleason grade. These images, together with information
on confidence scores and rejected images, give information on the stability
of the Gleason grading scheme. In the second stage, it is intended that
Gleason scores obtained by static-image Remote Consultation via interactive
telepathology using whole-slide low-power imaging and selected high-power
imaging will be compared with those obtained by direct microscopy on the
slide.
PROSTATE GRADING CONSENSUS USING TELEPATHOLOGY - A PROGRESS REPORT
Tucker J *, Grigor K *, Busch C +
* Pathology Dept. Edinburgh University, UK,
+ Dept. Pathology, University Hospital, Uppsala, Sweden