Automatisation of the Gleason Score, The End of the Dilemma? A Proposal to Increase Consensus

J Varinot, H Alshehhe, A Furudoi, F Soussaline, M Soussaline, R Renard-Penna, P Mozer, O Cussenot and E Compérat

Department of Pathology, Hôpital La-Pitié Salpêtrière, UPMC Paris VI, France
Imstar, France
Department of Radiology, Hôpital La-Pitié Salpêtrière, UPMC Paris VI, France
Department of Urology, Hôpital La-Pitié Salpêtrière, UPMC Paris VI, France
CeRePP, UPMC Paris VI, France

^*Correspondance to: E Comperat 

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Abstract:

Introduction: The updated Gleason score (GS) (WHO classification 2016) decreases interobserver variability, but discordance still exists. The aim was to apply an operator independent method by a computer system (IMSTAR) to give a GS via automated image analysis. Material and
Methods: Twenty-six prostate biopsies (PB) were evaluated by three pathologists. GS was reported, new slides of the same PB were double stained by immunofluorescence (Annexin-3, a marker of low GG and normal tissue, and p504s, a marker of Pca employed in routine) . The slides were scored using Pathfinder™ reader analyzer, for quantitative digital pathology automated scanning of the PB. Detection of different fluorescent signals allowed with a specific algorithm to give a GS by the computer.
Results: The interobserver consensus was 96%. When comparing pathologists and the computer analysis, we found a 100 % agreement in 13 cases (50%). In 8 (31%) cases, GS assigned by pathologists was lower than that assigned by the computer. In 5 cases (19%) pathologists attributed a higher GS than the computer. Discordance never exceeded 1 GG. Major discrepancy existed between the GS 6 and 7.
Conclusion: This study shows feasibility of GS standardization. Automated image analysis seems to be a promising operator independent technique to standardize GS and provide more homogeneous grading for PCa.

Keywords:

Prostate cancer; Gleason grade; prostate biopsy; Quantitative digital pathology

Cite the Article:

Varinot J, Alshehhe H, Furudoi A, Soussaline F, Soussaline M, RenardPenna R, et al. Automatisation of the Gleason Score, The End of the Dilemma? A Proposal to Increase Consensus. Clin Oncol. 2016;1: 1159.