Importance of intraoperative consultation for the diagnosis of central nervous system lesions and evaluation of its diagnostic accuracy.

Abstract

Intraoperative consultation frozen section (FS) provides a surgeon background and management plan for surgery. Surgeons' and pathologists' coordination between each other including their departments' cooperation for FS management is very important. The role of FS in the intraoperative consultation is important. It is always advisable to consult an experienced histopathologist specially trained for CNS lesions for intraoperative consultation. Frozen section (FS) diagnosis provides surgeons, physicians, and pathologists a provisional diagnosis to plan out their management plan. By this study, we intended to evaluate the importance of intraoperative consultation-FS diagnosis in central nervous system (CNS) lesions. In this study, the diagnostic accuracy and the various limitations of using FS of CNS tumors were determined. In this study, we analyzed retrospectively, the results of FS and final diagnoses of all CNS tumors were made at our institute for the duration of 1 year from July 2014 to June 2015. We all authors state that all human studies have been approved by the Institutional Ethics Committee. We all authors also gave our informed consent before their inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted. We studied 252 cases of age group from 1 to 76 years. Out of which, 155 (61.50%) cases had complete concordance between FS and final diagnosis, 77 (30.5%) cases had a partial concordance, and 20 cases (8.0%) were discordant. Considering the concordant and partially concordant cases, the accuracy rate was 92.0%, sensitivity was 93.42%, specificity was 91.66%, and positive and negative predictive values were 94.66% and 59.45%, respectively. A Kappa agreement score of 0.75 (substantial agreement score) showed high concordance for FS results with the permanent section. We came to the final conclusion that high sensitivity and specificity were seen with FS diagnosis in the CNS tumors.