title: Diagnostic accuracy of frozen section of central nervous system lesions: a 10-year study.
abstract: OBJECTIVE
  Definitive diagnosis of the central nervous system (CNS) lesions is unknown prior to histopathological examination. To determine the method and the endpoint for surgery, intraoperative evaluation of the lesion helps the surgeon. In this study, the diagnostic accuracy and pitfalls of using frozen section (FS) of CNS lesions is determined.
  
  
  METHODS
  In this retrospective study, we analyzed the results of FS and permanent diagnoses of all CNS lesions by reviewing reports from 3 general hospitals between March 2001 and March 2011.
  
  
  RESULTS
  273 cases were reviewed and patients with an age range from 3 to 77 years of age were considered. 166 (60.4%) had complete concordance between FS and permanent section diagnosis, 83 (30.2%) had partial concordance, and 24 cases (9.5%) were discordant. Considering the concordant and partially concordant cases, the accuracy rate was 99.5%, sensitivity was 91.4%, specificity was 99.7%, and positive and negative predictive values were 88.4% and 99.8%, respectively.
  
  
  CONCLUSIONS
  Our results show high sensitivity and specificity of FS diagnosis in the evaluation of CNS lesions. A Kappa agreement score of 0.88 shows high concordance for FS results with permanent section. Pathologist's misinterpretation, small biopsy samples (not representative of the entire tumor), suboptimal slides, and inadequate information about tumor location and radiologic findings appear to be the major causes for these discrepancies indicated from our study.
authors.affiliation: Pediatric Pathology Research Center, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran. ; Department of Pathology, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
authors.forename: Maliheh
authors.initials: M
authors.lastname: Khoddami
authors.affiliation: Department of Pathology, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Akbarzadeh
authors.affiliation: Department of Pathology, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Mordai
authors.affiliation: Department of Pathology, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
authors.forename: Farahnaz
authors.initials: F
authors.lastname: Bidari-Zerehpoush
authors.affiliation: Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Alipour
authors.affiliation: Department of Pediatrics, Imam Reza Hospital, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Samadzadeh
authors.affiliation: Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Bijan
authors.initials: B
authors.lastname: Alipour
keywords: Accuracy; CNS lesions; Frozen section; Intraoperative consultation