Frozen Section Quality Assurance

Abstract

Objectives Composite frozen section turnaround time has limited value, precluding assessment of certain processes: slide preparation (technical) and diagnosis (interpretation). We examined whether measuring these elements could identify delays, hypothesizing that longer times were related to (1) inefficient technical processes and (2) case-specific diagnostic challenges.. Methods Technical and interpretive times were determined for 1,992 specimens submitted for frozen section in 2017; the data were sorted by surgical specialty. Mean and quartile times were determined for each category with all specimens assessed equally, including those with multiple frozen section blocks. Results Technical times were significantly longer than interpretive times. Specialty grouping facilitated trend identification and enabled assessment of technical and interpretation challenges. We identified technical issues with certain gross specimens involving overdissection and interpretation delays for specific neoplasms and margins. Conclusions Measuring technical and interpretative times and subcategorizing by specialty has aided the assessment of frozen section processing in our laboratory, enabling case isolation for process improvement.

Utilizing 3D head and neck specimen scanning for intraoperative margin discussions: Proof of concept of our novel approach

“…A large single‐institution study reported that the current average turnaround time for delivering intraoperative head and neck frozen section results is 19.7 min 18 . However, a majority of the frozen section procedures used to produce these findings were conducted on small specimens that required minimal grossing.…”

Novel rapid intraoperative qualitative tumor detection by a residual convolutional neural network using label-free stimulated Raman scattering microscopy

“…Inclusion criteria comprised: (1) Suspected tumor lesions of the central nervous system, (2) aged over 18 years, and (3) the patient is willing and able to give informed consent for participation. Exclusion criteria comprised: (1) Patient does not agree to participate in the study or (2) unable to or unwilling to give informed consent. Specimen samples were excluded if the collected specimen was inadequate, e.g.…”

“…Rapid intraoperative histopathological analysis of fresh frozen tumor tissue is an essential tool for biopsy and surgical resection control [ 1 ]. This is based on a time-consuming and costly intraoperative pathology workflow for intraoperative decision-making that often leads to prolonged surgery times with the patient kept in anesthesia waiting for the pathological diagnosis [ 2 , 3 ]. In addition, not every hospital providing surgeries in patients with brain tumors holds a (neuro)pathology unit available for rapid fresh frozen diagnostics and even if, it is usually only available during normal working hours.…”

Rapid Immunohistochemistry Based on Ultrasonic Thermal Steam Heating for Improvement of Intraoperative Diagnosis

“…However, due to the combination of antibodies used in all cases, pathologists can still draw correct conclusions through a comprehensive evaluation of the positive and negative aspects of other antibodies. The FS turnaround time is considered an important indicator, 22 so RIHC turnaround time must be completed as quickly as possible. Considering that increasing the number of antibody items extends the time required for section preparation, it is recommended to use fewer than 6 antibodies in the panel.…”