Histopathology最新文献

{"title":"Accuracy of the LaserSAFE technique for detecting positive surgical margins during robot-assisted radical prostatectomy: blind assessment and inter-rater agreement analysis","authors":"Ricardo Almeida-Magana,&nbsp;Matthew Au,&nbsp;Tarek Al-Hammouri,&nbsp;Manju Mathew,&nbsp;Kate Dinneen,&nbsp;Larissa S T Mendes,&nbsp;Eoin Dinneen,&nbsp;Willem Vreuls,&nbsp;Greg Shaw,&nbsp;Alex Freeman,&nbsp;Aiman Haider","doi":"10.1111/his.15336","DOIUrl":"10.1111/his.15336","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction and objectives</h3>\u0000 \u0000 <p>Fluorescence confocal microscopy (FCM) is a new imaging modality capable of generating digital microscopic resolution scans of fresh surgical specimens, and holds potential as an alternative to frozen section (FS) analysis for intra-operative assessment of surgical margins. Previously, we described the LaserSAFE technique as an application of FCM for margin assessment in robot-assisted radical prostatectomy (RARP) using the Histolog® scanner. This study describes the accuracy and inter-rater agreement of FCM imaging compared to corresponding paraffin-embedded analysis (PA) among four blinded pathologists for the presence of positive surgical margins (PSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>RARP specimens from patients enrolled in the control arm of the NeuroSAFE PROOF study (NCT03317990) were analysed from April 2022 to February 2023. Prostate specimens were imaged using the Histolog® scanner before formalin fixation and PA. Four trained assessors, blinded to PA, reviewed and analysed FCM images of the posterolateral prostatic surface.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 31 prostate specimens were included in the study. PA per lateral side of the prostate identified 11 instances of positive margins. Among the four histopathologists included in our study, FCM achieved a sensitivity of 73–91 and specificity of 94–100% for the presence of PSM. Fleiss’ Kappa for inter-rater agreement on PSM was 0.78 (95% confidence interval = 0.64–0.92), indicating substantial agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This blinded analysis of FCM versus PA among histopathologists with different experience levels demonstrated high accuracy and substantial inter-rater agreement for diagnosing PSM. This supports the role of the FCM as an alternative to FS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 3","pages":"433-440"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular techniques in haematopathology: what and how?","authors":"Gaurav Chatterjee,&nbsp;Rong He,&nbsp;Nikhil Patkar,&nbsp;David Viswanatha,&nbsp;Anton W Langerak","doi":"10.1111/his.15332","DOIUrl":"10.1111/his.15332","url":null,"abstract":"<p>Here we review the ‘what and how’ of molecular techniques used in the context of haematopathological diagnostics of both lymphoid and myeloid neoplasms. Keeping in mind that the required resources for molecular testing are not universally available, we will not only discuss novel and emerging techniques that allow more high-throughput and sophisticated analyses of lymphoid and myeloid neoplasms, but also the more classical, low-cost alternatives and even some workarounds for molecular testing approaches. In this review we also address other key aspects around molecular techniques for haematopatholgy diagnostics, including preanalytics, data interpretation, and data management, bioinformatics, and interlaboratory precision and performance evaluation.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 1","pages":"38-57"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/his.15332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of acute lymphoblastic leukaemia: an overview of the current genomic classification, diagnostic approaches, and future directions","authors":"Wencke Walter,&nbsp;Ilaria Iacobucci,&nbsp;Manja Meggendorfer","doi":"10.1111/his.15338","DOIUrl":"10.1111/his.15338","url":null,"abstract":"<p>B-acute lymphoblastic leukaemia (B-ALL) is a haematological disease resulting from haematopoietic system dysfunction, leading to the unchecked growth of immature B lymphoblasts. The disease's complexity is underscored by the spectrum of genetic aberrations that underlie B-ALL entities, necessitating advanced genetic analyses for precise classification and risk determination. Prior to the adoption of next-generation sequencing into standard diagnostic practices, up to 30% of B-ALL cases were not assigned to specific entities due to the limitations of traditional diagnostic methods. The advent of comprehensive genomic analysis, especially whole-genome transcriptome sequencing, has significantly enhanced our understanding of B-ALL's molecular heterogeneity, paving the way for the exploration of novel, tailored treatment strategies. Furthermore, recent technological innovations, such as optical genome mapping, methylation profiling, and single-cell sequencing, have propelled forward the fields of cancer research and B-ALL management. These innovations introduce novel diagnostic approaches and prognostic markers, facilitating a deeper, more nuanced understanding of individual patient disease profiles. This review focuses on the latest diagnostic standards and assays for B-ALL, the importance of new technologies and biomarkers in enhancing diagnostic accuracy, and the expected role of innovative advancements in the future diagnosis and treatment of B-ALL.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 1","pages":"134-145"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infiltrative epitheliosis of the breast; a pitfall for pathologists, a case report and a review focusing on the diagnostic approach and interpretative pitfalls","authors":"Michael Minkley,&nbsp;Zuzana Kos,&nbsp;Karen Ung,&nbsp;Patrick Wong,&nbsp;Billy Teng,&nbsp;Peyman Tavassoli","doi":"10.1111/his.15347","DOIUrl":"10.1111/his.15347","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 2","pages":"311-313"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear DUX4 immunohistochemistry is a highly sensitive and specific marker for the presence of CIC::DUX4 fusion in CIC-rearranged sarcomas: a study of 48 molecularly confirmed cases","authors":"Rodrigo T Macedo,&nbsp;Vira Baranovska-Andrigo,&nbsp;Tamás Pancsa,&nbsp;Natálie Klubíčková,&nbsp;Brian P Rubin,&nbsp;Scott E Kilpatrick,&nbsp;John R Goldblum,&nbsp;Karen J Fritchie,&nbsp;Steven D Billings,&nbsp;Michal Michal,&nbsp;Marián Švajdler,&nbsp;Zdeněk Kinkor,&nbsp;Michael Michal,&nbsp;Josephine K Dermawan","doi":"10.1111/his.15341","DOIUrl":"10.1111/his.15341","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p><i>CIC</i>-rearranged sarcomas (CRS) are clinically aggressive undifferentiated round cell sarcomas (URCS), commonly driven by <i>CIC::DUX4</i>. Due to the repetitive nature of <i>DUX4</i> and the variability of the fusion breakpoints, <i>CIC::DUX4</i> fusion may be missed by molecular testing. Immunohistochemical (IHC) stains have been studied as surrogates for the <i>CIC::DUX4</i> fusion. We aim to assess the performance of DUX4 IHC in the work-up of CRS and its expression in non-CRS round cell or epithelioid neoplasms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>Cases of molecularly confirmed CRS (<i>n</i> = 48) and non-CRS (<i>n</i> = 105) were included. CRS cases consisted of 35 females and 13 males, with ages ranging from less than 1 year to 67 years (median = 41 years). Among the molecularly confirmed non-CRS cases, C-terminal DUX4 expression was investigated in Ewing sarcomas (38 cases), alveolar rhabdomyosarcomas (18 cases), desmoplastic small round cell tumours (12 cases) and synovial sarcomas (<i>n</i> = five), as well as in non-mesenchymal neoplasms such as SMARCA4/SMARCB1-deficient tumours (<i>n</i> = five), carcinomas of unknown primary (<i>n</i> = three) and haematolymphoid neoplasms (four cases). DUX4 IHC was considered positive when strong nuclear expression was detected in more than 50% of neoplastic cells. When used as a surrogate for the diagnosis of CRS, the sensitivity and specificity of DUX4 IHC was 98 and 100%, respectively. Only one CRS case was negative for DUX4 IHC and harboured a <i>CIC::FOXO4</i> fusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DUX4 IHC is a highly sensitive and specific surrogate marker for the presence of <i>CIC::DUX4</i> fusion, demonstrating its utility in establishing a diagnosis of CRS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 3","pages":"423-432"},"PeriodicalIF":3.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turmeric supplement-associated hepatitis: a clinicopathological series of 11 cases highlighting pan-lobular and zone 3 injury","authors":"David J Papke Jr,&nbsp;Kathleen Viveiros,&nbsp;Victor Zota,&nbsp;Ryan M Gill,&nbsp;Iván A González,&nbsp;Joseph Misdraji,&nbsp;Deepa T Patil","doi":"10.1111/his.15333","DOIUrl":"10.1111/his.15333","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Although turmeric is commonly ingested and well tolerated, there is increasing evidence that over-the-counter turmeric supplements can cause drug-induced liver injury. We sought to thoroughly characterise clinicopathological features of patients for whom liver injury was attributed clinically to turmeric supplements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>We identified 11 patients via retrospective pathology archive review: 10 females (91%) and one male, with a median age of 58 years (range = 37–66 years). Six patients (55%) were asymptomatic with abnormal liver function tests, while five patients (45%) presented with malaise and/or jaundice. Ten patients (91%) showed predominant transaminase abnormalities, while one exhibited predominant alkaline phosphatase elevation. Histologically, biopsies showed acute hepatitis (eight cases, 73%, including five pan-lobular and three zone 3-predominant inflammation), scattered lobular aggregates of histiocytes (two; 18%) and a chronic hepatitis pattern of injury (one; 9%). Mild bile duct injury was present in five biopsies (45%). All patients stopped ingesting turmeric supplements after presenting with liver injury, and four patients additionally received steroid therapy; liver function tests normalised in all patients. Roussel Uclaf causality assessment method (RUCAM) analysis estimated the likelihood of turmeric supplement-associated liver injury to be probable (eight cases) and possible (three).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Histological features in the ‘possible’ cases were consistent with drug-induced injury, highlighting the added benefit of histological analysis relative to RUCAM analysis isolation. This study underscores the need to obtain a full history of over-the-counter medications and supplements when investigating aetiologies for liver injury, including supplements purportedly containing innocuous compounds such as turmeric.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 3","pages":"410-422"},"PeriodicalIF":3.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-oral extralingual ectomesenchymal chondromyxoid tumour involving the hard palate with molecular confirmation","authors":"Hamza N Gokozan,&nbsp;Matthew R Avenarius,&nbsp;O Hans Iwenofu","doi":"10.1111/his.15319","DOIUrl":"10.1111/his.15319","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 2","pages":"306-308"},"PeriodicalIF":3.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How many polyps need to be histologically assessed when multiple polyps are submitted for the Bowel Cancer Screening Program?","authors":"Newton A C S Wong,&nbsp;Hannah E Jones,&nbsp;Katherine M Halloran","doi":"10.1111/his.15337","DOIUrl":"10.1111/his.15337","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Since 2020 there has been an increase in the number of polyps removed from patients scoped for the Bowel Cancer Screening Programme (BCSP) of England. General cellular pathology workload also continues to increase disproportionately ahead of consultant pathologist numbers in the United Kingdom. The Optical Diagnosis initiative for BCSP patients has not yet, and may not be, implemented at every hospital in England. The following study therefore aimed to determine whether only a certain number of removed polyps need to be histologically assessed to consistently guide a BCSP patient's post-polypectomy management, and whether all remaining smaller polyps beyond that number could then be discarded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study considered all BCSP specimens/cases submitted to the Cellular Pathology department of a large English teaching hospital from 2016 to 2024. Only cases with six or more resected polyps, for which the endoscopic report stated individual sizes, were included in the final study cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 8066 BCSP cases submitted to the aforementioned department, there were six or more polyps for 345 cases. Analysis of the final study cohort of 135 cases showed that assessment of the seven largest polyps measured endoscopically was sufficient to correctly guide follow-up management of the BCSP patient as per the 2020 British Society of Gastroenterology post-polypectomy guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When colonoscopy of a BCSP patient leads to removal of multiple polyps, only the seven largest polyps need to be assessed histologically and the remaining smaller polyps could be discarded with no impact to the patient's BCSP-related management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 2","pages":"302-305"},"PeriodicalIF":3.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new algorithm for coeliac disease based on the ‘long forgotten’ TCRγδ+ intra-epithelial lymphocytes detected with an antibody working on FFPE sections","authors":"Eda N Kozan,&nbsp;Bilge A Kırmızı,&nbsp;Ceyda T Kirsaclioglu,&nbsp;Derya Gokmen,&nbsp;Berna Savas,&nbsp;Aydan Kansu,&nbsp;Arif I Soykan,&nbsp;Arzu Ensari","doi":"10.1111/his.15330","DOIUrl":"10.1111/his.15330","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diagnosis of coeliac disease (CD) with mild mucosal changes is difficult for all parties involved. We aimed to determine the power of T cell receptor (TCR)γδ⁺ intra-epithelial lymphocytes (IELs) in discriminating CD from other causes of intra-epithelial lymphocytosis using a new monoclonal antibody.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 167 cases categorised as coeliac (117 untreated CD, classified according to Marsh, updated by Ensari, including 29 type 1, 29 type 2, 39 type 3 and 20 treated CD), and non-coeliac groups (24 controls and 26 non-coeliac IELosis) based on clinical, serological and histological data were studied for IEL counts enumerated per 100 enterocytes using haematoxylin and eosin, CD3, TCR δ-stains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TCRγδ⁺ IELs were significantly higher in CD (24.83 ± 16.13) compared to non-CD (6.72 ± 6.32) and were correlated with the degree of mucosal damage. Both γδ⁺ IEL count and ratio showed higher performance in differentiating untreated coeliacs from controls, with a sensitivity of 83.76; 85.57 and specificity of 95.83; 79.17, respectively. TCRγδ⁺ IEL counts distinguished type 1 CD (20.41 ± 13.57) from non-coeliac IELosis (9.42 ± 7.28) (<i>p</i> = 0.025). Discriminant analysis revealed that villus/crypt ratio, γδ⁺ and CD3⁺ IEL counts, γδ⁺/CD3⁺IEL ratio, IEL distribution pattern were potent discriminants and correctly classified 82.3% of cases while the algorithm accurately diagnosed 93.4% of cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The new antibody detecting γδ⁺ IELs in FFPE sections revealed thresholds of 10.5 for γδ⁺ IELs and 14% for γδ⁺/CD3⁺IEL ratio which distinguished coeliacs from non-coeliacs with high sensitivity and specificity, particularly in cases with normal villus/crypt axis including type 1 CD, non-CD IELosis and controls. A ‘coeliac algorithm’ based on γδ⁺ IELs is proposed with the hope that it will be used in the histopathological diagnostic approach by the pathology community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 3","pages":"397-409"},"PeriodicalIF":3.9,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deep learning approach to case prioritisation of colorectal biopsies","authors":"Ciara D White,&nbsp;Runjan Chetty,&nbsp;John Weldon,&nbsp;Maria E Morrissey,&nbsp;Rob Sykes,&nbsp;Corina Gîrleanu,&nbsp;Mirko Colleuori,&nbsp;Jenny Fitzgerald,&nbsp;Adam Power,&nbsp;Ajaz Ahmad,&nbsp;Seán Carmody,&nbsp;Pierre Moulin,&nbsp;Donal O'Shea,&nbsp;Muhammad Aslam,&nbsp;Mahomed A Dada,&nbsp;Maurice B Loughrey,&nbsp;Martine C McManus,&nbsp;Klaudia M Nowak,&nbsp;Kristopher McCombe,&nbsp;Sinead Hutton,&nbsp;Máirín Rafferty,&nbsp;Niall Mulligan","doi":"10.1111/his.15331","DOIUrl":"10.1111/his.15331","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To create and validate a weakly supervised artificial intelligence (AI) model for detection of abnormal colorectal histology, including dysplasia and cancer, and prioritise biopsies according to clinical significance (severity of diagnosis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p><i>Triagnexia Colorectal</i>, a weakly supervised deep learning model, was developed for the classification of colorectal samples from haematoxylin and eosin (H&amp;E)-stained whole slide images. The model was trained on 24 983 digitised images and assessed by multiple pathologists in a simulated digital pathology environment. The AI application was implemented as part of a point and click graphical user interface to streamline decision-making. Pathologists assessed the accuracy of the AI tool, its value, ease of use and integration into the digital pathology workflow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Validation of the model was conducted on two cohorts: the first, on 100 single-slide cases, achieved micro-average model specificity of 0.984, micro-average model sensitivity of 0.949 and micro-average model F1 score of 0.949 across all classes. A secondary multi-institutional validation cohort, of 101 single-slide cases, achieved micro-average model specificity of 0.978, micro-average model sensitivity of 0.931 and micro-average model F1 score of 0.931 across all classes. Pathologists reflected their positive impressions on the overall accuracy of the AI in detecting colorectal pathology abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We have developed a high-performing colorectal biopsy AI triage model that can be integrated into a routine digital pathology workflow to assist pathologists in prioritising cases and identifying cases with dysplasia/cancer versus non-neoplastic biopsies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 3","pages":"373-384"},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}