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Purpose: The recent findings from the DESTINY-Breast04 trial highlighted the clinical importance of distinguishing between HER2 immunohistochemistry (IHC) scores 0 and 1 + in metastatic breast cancer (BC). However, pathologist interpretation of HER2 IHC scoring is subjective, and standardized methodology is needed. We evaluated the consistency of HER2 IHC scoring among pathologists and the accuracy of digital image analysis (DIA) in interpreting HER2 IHC staining in cases of HER2-low BC. Methods: Fifty whole-slide biopsies of BC with HER2 IHC staining were evaluated, comprising 25 cases originally reported as IHC score 0 and 25 as 1 +. These slides were digitally scanned. Six pathologists with breast expertise independently reviewed and scored the scanned images, and DIA was applied. Agreement among pathologists and concordance between pathologist scores and DIA results were statistically analyzed using Kendall coefficient of concordance (W) tests. Results: Substantial agreement among at least five of the six pathologists was found for 18 of the score 0 cases (72%) and 15 of the score 1 + cases (60%), indicating excellent interobserver agreement (W = 0.828). DIA scores were highly concordant with pathologist scores in 96% of cases (47/49), indicating excellent concordance (W = 0.959). Conclusion: Although breast subspecialty pathologists were relatively consistent in evaluating BC with HER2 IHC scores of 0 and 1 +, DIA may be a reliable supplementary tool to enhance the standardization and quantification of HER2 IHC assessment, especially in challenging cases where results may be ambiguous (i.e., scores 0–1 +). These findings hold promise for improving the accuracy and consistency of HER2 testing. [ABSTRACT FROM AUTHOR]

Background: In 2018, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was published, defining a diagnostic categorization scheme. However, this system of classification was criticized due to its suboptimal diagnostic accuracy and low interobserver reliability. For these reasons, the modified Milan system was recently proposed by a few authors claiming it to be more clinically reliable. The present study aimed to analyze the interobserver reliability of MSRSGC and modified MSRSGC. Methods: A total of 100 salivary gland fine-needle aspirations were reviewed over a 1-year period and classified by two independent observers according to MSRSGC and modified MSRSGC. Interobserver reproducibility was estimated using observed agreement and chance-corrected agreement (Cohen's kappa). Results: An overall chance corrected agreement of 0.37 (fair) was obtained for the original Milan system and 0.41 (moderate) for the modified one. In addition, subcategories of modified MSRSGC performed better than the MSRSGC in terms of interobserver reliability. Conclusion: The present study suggests that modified MSRSGC should be accepted worldwide as the clinical relevance of any categorization scheme requires diagnostic accuracy along with excellent interobserver reproducibility. [ABSTRACT FROM AUTHOR]

Grade, based on proliferative activity and tumor necrosis, has recently been shown to be prognostic in medullary thyroid carcinoma (MTC) in multivariate analysis. The aim of this study was to evaluate the interobserver reproducibility of assessed grade in MTC. Three groups (each group included one resident/fellow and one attending pathologist) independently evaluated a cohort of 44 sporadic MTC. For each case, all available tumor slides were reviewed, and mitotic count and the presence of tumor necrosis were recorded. Ki-67 was performed, and the Ki-67 proliferative index was determined in the area of highest proliferative activity. Tumors were graded according to the recently published International Medullary Thyroid Carcinoma Grading System (IMTCGS). Kappa statistics were calculated for each individual criterion (mitotic count, Ki-67 proliferative index, and necrosis) and for assigned IMTCGS grade. For our cohort of 44 MTCs, the kappa statistic for mitotic count, Ki-67 proliferative index, and necrosis was 0.68, 0.86, and 0.89, respectively. The kappa statistic for assigned IMTCGS grade was 0.87. Our findings indicate that there was a strong level of agreement for assessment of grade in our cohort of MTC, indicating that grade as assessed by the IMTCGS is not only prognostic but also reproducible. [ABSTRACT FROM AUTHOR]

Background: Urine cytology remains to be the test of choice in the detection of high-grade urothelial carcinomas (HGUC) due to its favorable sensitivity. However, a significant rate of cases is reported under atypical/indeterminate categories, which result in a decrease in its specificity. Providing standardized cytologic criteria, one of the aims of The Paris System (TPS) is to reduce the use of indeterminate diagnoses and provide a higher predictive value in these categories. Aims: We compared the diagnostic performances of TPS and our original reporting system, and also investigated the interobserver reproducibility of the cytologic criteria used. Materials and Methods: A total of 386 urine samples were reviewed retrospectively. Original cytologic diagnoses have been made using similar cytologic features proposed by TPS. All slides were recategorized after the use of the cytologic criteria as described by TPS guideline. Results: After TPS, specificity of the test increased from 39.6% to 63.5, sensitivity decreased from 92.5% to 88.8%, and diagnostic accuracy increased from 63.6% to 75%. The use of negative category increased threefold. Frequencies of indeterminate categories of atypical urothelial cells (AUC) and suspicious for HGUC (SHGUC) decreased by 36% and 56.5%, respectively. A subsequent detection of HGUC after AUC and SHGUC categories increased by 38% and 64%, respectively. Interobserver agreement for TPS categorization was 39%. Conclusions: TPS improved diagnostic accuracy of urine cytology by reducing the use of indeterminate categories, and resulted in increase in their predictive value for subsequent diagnosis of HGUC. However, reproducibility of diagnostic categories seemed to be imperfect. [ABSTRACT FROM AUTHOR]

Background: Assessment of interobserver reproducibility and interocular symmetry using optical coherence tomography (OCT)-based measurements of the macular ganglion cell complex (GCC) in healthy children facilitates interpretation of OCT data. We assessed the interobserver reproducibility and interocular symmetry of GCC and evaluated candidate determinants.Methods: This was a cross-sectional study performed in a primary and tertiary health-care setting. A total of 126 healthy participants aged 5 to 18 years were eligible. GCC scans were performed by 4 operators using the Topcon 3D OCT-2000 device. Intraclass correlation coefficients (ICCs) were used to estimate reproducibility and symmetry. Cut-off points for symmetry were defined as the 95th percentile of the absolute interocular difference for 6 GCC parameters. Percentile distributions of interocular difference were generated based on age and difference in absolute interocular spherical equivalent (SE).Results: The reproducibility ICC ranged from 0.96 to 0.98 for all 6 GCC parameters. Cut-off points for interocular symmetry of the superior and inferior quadrants and total macular retinal nerve fibre layer thickness (mRNFL) and macular ganglion cell layer-inner plexiform layer thickness were 3.5, 4.5, 3.0, 3.0, 2.5, and 2.5 μm respectively. A positive association was observed between the absolute interocular difference of SE and superior and total mRNFL symmetry values (p = 0.047 and p = 0.040, respectively).Conclusions: OCT measurements of GCC in healthy children show excellent reproducibility. Interocular differences in SE should be assessed when mRNFL differences exceed the 95% cut-off. These findings can contribute to establish reference values for interocular symmetry in paediatric GCC parameters. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to determine the interobserver reproducibility in diagnosing low-grade ductal carcinoma in situ (DCIS). We also aimed to compare the interobserver variability using a proposed two-tiered grading system as opposed to the current three-tiered system.Methods: Three expert breast pathologists and one junior pathologist identified low-grade DCIS from a set of 300 DCIS slides. Months later, participants were asked to grade the 300 cases using the standard three-tiered system.Results: Using the two-tiered system, interobserver agreement among breast pathologists was considered moderate (κ = 0.575). The agreement was similar (κ = 0.532) with the junior pathologist included. Using the three-tiered system, pathologists' agreement was poor (κ = 0.235).Conclusions: Pathologists' reproducibility on diagnosing low-grade DCIS showed moderate agreement. Experience does not seem to influence reproducibility. Our proposed two-tiered system of low vs nonlow grade, where the intermediate grade is grouped in the nonlow category has shown improved concordance. [ABSTRACT FROM AUTHOR]

Aims: The nuclear proliferation marker Ki67 assayed by immunohistochemistry has multiple potential uses in breast cancer, but an unacceptable level of interlaboratory variability has hampered its clinical utility. The International Ki67 in Breast Cancer Working Group has undertaken a systematic programme to determine whether Ki67 measurement can be analytically validated and standardised among laboratories. This study addresses whether acceptable scoring reproducibility can be achieved on excision whole sections. Methods and results: Adjacent sections from 30 primary ER+ breast cancers were centrally stained for Ki67 and sections were circulated among 23 pathologists in 12 countries. All pathologists scored Ki67 by two methods: (i) global: four fields of 100 tumour cells each were selected to reflect observed heterogeneity in nuclear staining; (ii) hot‐spot: the field with highest apparent Ki67 index was selected and up to 500 cells scored. The intraclass correlation coefficient (ICC) for the global method [confidence interval (CI) = 0.87; 95% CI = 0.799–0.93] marginally met the prespecified success criterion (lower 95% CI ≥ 0.8), while the ICC for the hot‐spot method (0.83; 95% CI = 0.74–0.90) did not. Visually, interobserver concordance in location of selected hot‐spots varies between cases. The median times for scoring were 9 and 6 min for global and hot‐spot methods, respectively. Conclusions: The global scoring method demonstrates adequate reproducibility to warrant next steps towards evaluation for technical and clinical validity in appropriate cohorts of cases. The time taken for scoring by either method is practical using counting software we are making publicly available. Establishment of external quality assessment schemes is likely to improve the reproducibility between laboratories further. [ABSTRACT FROM AUTHOR]

Objective: Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of "cervical intraepithelial neoplasia" (CIN) and "squamous intraepithelial lesion" (SIL) diagnoses. Material and Method: 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management. Results: We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic "styles" and gynecologists had management "styles". Conclusion: In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case. [ABSTRACT FROM AUTHOR]

Introduction Indeterminate diagnoses are rendered on 15%-30% of thyroid fine-needle aspirates ( FNA). Thus, a second diagnostic opinion given by an outside expert pathologist is a common practice that facilitates a more appropriate clinical management. Conversely, the role of an intra-institutional second opinion diagnosis ( iSOD), which is usually informally performed in-house, has not been well established. Methods To assess the contribution of iSOD, a retrospective series of 34 thyroid FNA diagnosed as follicular neoplasm/suspicious follicular neoplasm ( FN/ SFN) with matched histological follow-up and a malignancy rate of 17.6% was selected and independently reviewed by two cytopathologists ( CYT1 and 2). Cases with discrepant diagnoses were referred to a third in-house senior cytopathologist for the iSOD. The malignancy rates ( MR) obtained after single independent reviews and iSOD were compared. Results MR obtained after CYT1 and CYT2 re-screening was similar (14.28% and 19.04%, respectively) and did not improve the original MR (17.64%). Conversely, after the iSOD of discrepant diagnoses, the overall malignancy rate increased up to the 27.27%, potentially sparing unnecessary surgical procedures. Conclusions Intra-institutional second opinion practice for 'indeterminate' thyroid FNA avoids unnecessary surgeries and maximises the detection of malignant cases diagnosed as FN/ SFN. [ABSTRACT FROM AUTHOR]

Papillary thyroid carcinomas (PTC) with BRAF mutation are morphologically distinctive. They are typically classic or tall cell variants, show infiltrative borders, and are associated with desmoplasia/fibrosis, psammoma bodies, and well-developed nuclear features of papillary carcinoma. We hypothesize that morphologic features of PTC can help in the prediction of BRAF mutation, and we evaluate the accuracy and the interobserver reproducibility of such prediction. Hematoxylin and eosin-stained sections from 50 PTCs comprising of 26 mutation-positive and 24 mutation-negative tumors were examined. BRAF mutation was predicted correctly in 42/50 tumors (accuracy, 84 %) with 96 % sensitivity, 71 % specificity, and 78 % positive and 94 % negative predictive values (NPV). Subtle nuclear features of PTC ( n = 10) had the highest (100 %) negative predictive value followed by well-circumscribed non-infiltrative tumor borders (17/22 mutation-negative tumors, 95 % NPV). The positive predictive value of infiltrative tumor borders (21/28 [75 %] mutation-positive), desmoplasia/fibrosis (23/31 [74 %] mutation-positive), and psammoma bodies (13/20 [65 %] mutation-positive) increased to 100 % when all three features were present ( n = 8/8 mutation-positive). To assess interobserver reproducibility, two pathologists blinded to the mutational status evaluated 30 PTCs (15 mutation-positive and 15 mutation-negative) after self-training on 10 PTCs with known BRAF mutational status (five mutation-positive and five mutation-negative). The prediction of the mutation was achieved with substantial agreement ( κ value, 0.79) and accuracy (25/30, 83 %). This study demonstrates that BRAF mutation in papillary thyroid carcinoma can be predicted on morphology with accuracy and with substantial interobserver agreement. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of radiologic images suggestive of urethral diverticula (UD) in men with spinal cord injury (SCI) and to study the interobserver diagnostic reproducibility. Methods: Radiological studies (i.e. voiding cystourethrography and retrograde urethrography) performed over 1 year on men with SCI were independently reviewed by 3 researchers (1 urologist and 2 radiologists). Results: The prevalence of UD was found to be between 4.2 and 9.8% of the patients, the higher figure obtained when including also the doubtful images. The kappa index of agreement between the researchers was low (between 0.15 and 0.40). The factors that significantly influenced agreement were localization in the prostatic urethra (p = 0.021), localization in the penile urethra (p = 0.000) and fusiform morphology (p = 0.004). Logistic regression analysis showed that the variables that independently influenced diagnostic agreement were the following: localization in the penile urethra (in favor of agreement) and fusiform morphology (against agreement). Conclusions: Radiologic images suggestive of UD constitute a frequent finding in men with SCI and raise important diagnostic problems. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

lntroduction:\Ne assessed the reproducibility and prognos-tic impact of the Broders' grading system (BGS) in a cohort of 147 patients with surgically treated penile squamous cell carcinomas. MaterialsandMethods:Corw/er\t\onaW)/ stained histology slides were graded according to the BGS In two rounds by two study pathologists. Reproducibility was as-sessed using K statistics. Multivariate analyses were calcu-lated to predict cancer-specific survival (CSS). The 'mean grade' per pathologist per round was calculated by allocat-ing grade points to each study case (G1-G4:1-4 points) and dividing the sum of all grade points by the number of cases examined. Results: The BGS showed substantial interob-server variation (59-87% with K = 0.38-0.69) but almost per-fect intraobserver reproducibility (91% with k = 0.86 and 96% with K = 0.94, respectively). The 'mean grade' per pathologist remained nearly constant In both rounds of exam-ination (differences <0.05 grade points) but differed be-tween the two pathologists (up to 0.4 grade points). In mul-tivariable analyses, the prognostic impact of the BGS in terms of CSS was strongly pathologist-dependent. Conclu-sions: Clinically and prognostically relevant interobserver discordance concerning the BGS seems, at least in part, to be attributable to inherent 'aggressive' versus 'reserved' grad-ing characteristics of individual pathologists. [ABSTRACT FROM AUTHOR]

The morphology of focal segmental glomerulosclerosis (FSGS) includes collapsing, cellular, and sclerosing forms. The Columbia Working Classification of FSGS divides these into collapsing (COLL), cellular (CELL), tip lesion (TIP), perihilar (PH), and not otherwise specified (NOS) morphologic forms. This study examined the ability of renal pathologists to classify FSGS using single light microscopic images of glomeruli as a uniform data set. Sixty-one digital images of individual glomeruli with FSGS, stained by periodic acid-Schiff or Jones methenamine silver methods, were classified independently by six specialist renal pathologists. Diagnostic consistency was quantified using the kappa statistic for nominal categories. Agreement for 366 diagnoses by six observers was 75.2 % with a kappa value of 0.676. Six of six observers agreed in 31 of 61 cases (50.8 %) and four or more in 53 cases (86.9 %). Respective kappa values ranged from moderate to good: COLL 0.77, CELL 0.53, TIP 0.76, PH 0.84, and NOS 0.60. Capillary retraction with lobular expansion, hypercellularity, and sclerosis in the same glomerular segments, and the location of segmental lesions were sources of diagnostic inconsistency. The morphologic forms of FSGS defined by the Columbia system are reproducible between observers and have a low probability of confusion between forms. Individual glomeruli may have overlapping features of more than one form of FSGS. [ABSTRACT FROM AUTHOR]

Nishi S. Polyomavirus nephropathy - recent pathological diagnostic problems and the report from the 2011 Banff meeting. Abstract: Polyomavirus nephropathy (PVN) is a cause of renal allograft dysfunction. Early detection of pathological abnormalities is not easy even in cases with urine decoy cells or polyomavirus viremia. A pathological classification for PVN was proposed by the Banff PVN working group, although the availability of the proposed schema has not been extensively evaluated in the clinical field. At the Banff meeting in 2011, the PVN working group reported the results of the evaluation on interobserver reproducibility and a clinicopathological study of PVN stages and renal outcome. Fair or good reproducibility was noted, although the PVN classification required further modification. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the interobserver reproducibility of quantitative measures of meniscus size and position, and to compare the interobserver reproducibility and agreement between a double echo steady state water excitation and an intermediately-weighted turbo spin-echo sequence. Eight knees (four healthy, four with radiographic knee osteoarthritis) from the Osteoarthritis Initiative cohort were studied. Manual segmentation of the menisci was performed by three observers and quantitative measures of meniscus size and position (i.e., extrusion) computed using image analysis software. The root mean square interobserver reproducibility error (e.g., 5.4% for medial meniscus volume with double echo steady state and 8.4% with intermediately-weighted turbo spin-echo) was found considerably smaller than the intersubject variability (average ratio ∼1:3). The lowest interobserver reproducibility error for meniscus extrusion was obtained for the central five coronal slices across the tibial surface. Quantitative meniscus measures from double echo steady state and intermediately-weighted turbo spin-echo were highly correlated ( r = 0.71 to 0.99 for the medial meniscus). Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

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CONTEXT: Gleason grade is the most widely used grading system for prostatic carcinoma and is recommended by World Health Organization. It is essential that there should be good interobserver reproducibility of this grading system as it has important implications in patient management. AIM: To assess interobserver reproducibility of Gleason grading of prostatic adenocarcinoma. DESIGN: A total of 20 cases of prostatic adenocarcinoma were scored using Gleason grade by 21 general pathologists. The scores were then compared using κ-coefficient and consensus score. RESULTS: For Gleason score groups (2-4, 5-6, 7 and 8-10) overall agreement with consensus score was 68%. Exact agreement for Gleason scores with consensus score was 43.3% and 92.3% within ±1 of the consensus score. κ coefficient for primary grade ranged from -0.32 to 0.92 with 60% of the readings in fair to moderate agreement range; and for secondary grade κ ranged from -0.30 to 0.62 with 78% of the readings in slight to fair agreement range. Kappa for Gleason scores ranged from -0.13 to 0.55 with 80% of the readings in slight to fair agreement range; and for Gleason score groups κ ranged from -0.11 to 0.82 with 68.5% of the readings in fair to moderate agreement range. CONCLUSIONS: In our study interobserver reproducibility of Gleason scores among general pathologists was at lower level and it highlights the need to improve the observer reproducibility by continuous educational sessions and taking second opinion in cases where grade could significantly influence management. [ABSTRACT FROM AUTHOR]

The following on the natural history of Barrett's esophagus (BE) includes commentary on histological sequences of the development of Barrett mucosa; the transformation of esophageal cells from squamous to columnar phenotype; the stages of natural history of dysplasia; the difficulties of predicting progression of dysplasia to adenocarcinoma; the preferable biopsy protocols; the role of Helicobacter pylori infection and gastric atrophy in the risk of BE; the value of decrease of proton pump inhibitor efficacy following eradication of H. pylori; the place of antireflux surgery in the natural history of BE; the newest procedures for the endoscopic detection of early neoplasia; and the essential importance of a good understanding of the natural history for the best management of high-grade dysplasia. [ABSTRACT FROM AUTHOR]

The overall interobserver reproducibility of thyroid fine-needle aspiration (FNA) has not been comprehensively assessed. A blinded 6-rater interobserver reproducibility study was conducted of 200 thyroid FNA cases using the UK System, which is similar to The Bethesda System for Reporting Thyroid Cytology: Thy1, nondiagnostic; Thy2, nonneoplastic; Thy3a, atypia, probably benign; Thy3f, follicular lesion; Thy4, suspicious of malignancy; and Thy5, malignant. There was good interobserver agreement for the Thy1 (κ = 0.69) and Thy5 (κ = 0.61), moderate agreement for Thy2 (κ = 0.55) and Thy3f (κ = 0.51), and poor agreement for Thy3a (κ = 0.11) and Thy4 (κ = 0.17) categories. Combining categories implying surgical management (Thy3f, Thy4, and Thy5) achieved good agreement (κ = 0.72), as did combining categories implying medical management (Thy1, Thy2, and Thy3a; κ = 0.72). The UK thyroid FNA terminology is a reproducible and clinically relevant system for thyroid FNA reporting. This study demonstrates that international efforts to harmonize and refine thyroid cytology classification systems can improve consistency in the clinical management of thyroid nodules. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The study aims were to evaluate (1) the interobserver and (2) the interdisciplinary repeatability of levator hiatus, urethral thickness, and anorectal angle measurements using three-dimensional endovaginal ultrasound (3D-EVUS). Methods: Twenty-seven nulliparous asymptomatic females were imaged with 3D-EVUS. Analyses were conducted off-line from stored 3D volumes by six readers (two radiologists, two urogynecologists, and two colorectal surgeons) using a standardized technique. Reproducibility was determined using the interclass correlation coefficients (ICC). Results: The overall interobserver repeatability for levator hiatus dimensions was good to excellent (ICC, 0.655-0.889), for urethral thickness was good (ICC, 0.624), and for anorectal angle was moderate (ICC, 0472). The interdisciplinary repeatability for levator hiatus indices was good to excellent (ICC, 0.639-0.915), for urethral thickness was moderate to good (ICC, 0.565-0.671), and for anorectal angle was fair to moderate (ICC, 0.204-0.434). Conclusions: 3D-EVUS yields reproducible measurements of levator hiatus dimensions and urethral thickness in asymptomatic nulliparous women. [ABSTRACT FROM AUTHOR]

Background: Tumour necrosis reflects the presence of hypoxia, which can be indicative of an aggressive tumour phenotype. The aim of this study was to investigate whether histological necrosis is a useful predictor of outcome in patients with pancreatic ductal carcinoma (PDC).Methods: We reviewed histopathological findings in 348 cases of PDC in comparison with clinicopathological information. We counted small necrotic foci (micronecrosis) as necrosis, in addition to massive necrosis that had been only defined as necrosis in previous studies. The reproducibility of identifying histological parameters was tested by asking five independent observers to blindly review 51 examples of PDC.Results: Both micronecrosis and massive necrosis corresponded to hypoxic foci expressing carbonic anhydrase IX detected by immunohistochemistry. Multivariate survival analysis showed that histological necrosis was an independent predictor of poor outcome in terms of both disease-free survival (DFS) and disease-specific survival (DSS) of PDC patients. In addition, metastatic status, and lymphatic, venous, and intrapancreatic neural invasion were independent prognostic factors for shorter DFS and metastatic status, margin status, lymphatic invasion, and intrapancreatic neural invasion were independent prognostic factors for DSS. The interobserver reproducibility of necrosis identification among the five independent observers was 'almost perfect' (κ-value of 0.87).Conclusion: Histological necrosis is a simple, accurate, and reproducible predictor of postoperative outcome in PDC patients. [ABSTRACT FROM AUTHOR]

The article discusses the study on the interobserver reproducibility of histologic parameters of melanoma deposits in picket lymph nodes (SLNs) in the U.S. The study showed that tumor deposits location within SLNs and extracapsular spread assessment was less reproducible, however, some quantitative parameter assessments were highly reproducible between pathologists. The study also examined the histologic sections of 44 SLNs with metastatic melanoma and assesed histologic parameters.

Two commonly used adhesion scoring systems were compared and the interobserver variability was assessed in 30 Wistar albino rats. Thirty-five milligrams per kilogram leflunomide was administered orally and intraperitoneally. Two weeks later, adhesion formation was assessed using the two scoring systems. The results showed that the two currently used adhesion scoring systems are subjective and the final results change depending on the observer and the type of the scoring system that has been used. [ABSTRACT FROM AUTHOR]

In the present study, the aim has been to investigate the interobserver reproducibility of DNA‐image‐cytometry (DNA‐ICM) applied to routine Pap smears classified as Atypical Squamous Cells of Undetermined Significance (ASCUS) or higher lesions (ASCUS+). 202 Pap smears diagnosed as ASCUS or higher were included in the study. After cytological assessment, smears underwent restaining according to Feulgen. First measurements were performed as routine workup. The second measurements were blinded to the result of the first and consecutively performed. DNA‐ICM met the consensus statements of the European Society of Analytical Cellular Pathology (ESACP). Interobserver agreement was assessed by calculating Kappa statistics. The diagnosis of DNA‐aneuploidy in the first measurements was confirmed in all cases. Second measurement detected 12 additional cases with aneuploidy. Nine out of these cases were classified as aneuploidy by detection of 9c Exceeding Events (9cEE). In three cases stemline‐aneuploidy was disclosed. The overall proportion of observed agreement was 94.1%, κ=0.87, 95% CI=0.74–0.99. Our study shows a good interobserver reproducibility of DNA‐ICM performed on cervical smears with ASCUS or higher lesions. DNA‐ICM thus represents a highly reproducible diagnostic procedure. [ABSTRACT FROM AUTHOR]

Abstract Objective To assess the inter- and intraobserver reproducibilities of pulsed Doppler measurements of the maternal renal circulation in normal pregnancies and those affected by pregnancy-induced hypertension. Materials and methods Color and pulsed Doppler ultrasound was used to measure acceleration time and resistance index in the renal segmental and interlobar arteries. For the investigation of interobserver reproducibility, two sonographers performed measurements blindly in six normal pregnant women and 14 women with pregnancy-induced hypertension between 28 and 36 weeks’ gestation. A second group of 10 patients between 30 and 35 weeks’ gestation were examined by one sonographer to assess the level of intraobserver reproducibility of measurements. For each patient in this group, the flow waveform was measured three times in succession. Calculations of the intraclass correlation coefficient Ri were used to determine the level of reproducibility. Results The interobserver Ri and intraobserver Ri for acceleration time in the segmental artery were 0.95 and 0.96 and for the interlobar artery they were 0.97 and 0.98, respectively. For the resistance index, these values were 0.01 and 0.01 in the segmental artery and 0.52 and 0.29 in the interlobar artery. Conclusion Both the inter- and intraobserver reproducibility of acceleration time measurements in the renal segmental and interlobar arteries were clinically acceptable but the equivalent reproducibilities of resistance index measurements were poor. [ABSTRACT FROM AUTHOR]