6th ESACP Congress, Heidelberg, April 7-11, 1999

A140
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

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.