Inter-observer variability in the classification of ovarian cancer cell type using microscopy: A pilot study

Marios A. Gavrielides, Brigitte M. Ronnett, Russell Vang, Jeffrey D. Seidman

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


Studies have shown that different cell types of ovarian carcinoma have different molecular profiles, exhibit different behavior, and that patients could benefit from typespecific treatment. Different cell types display different histopathology features, and different criteria are used for each cell type classification. Inter-observer variability for the task of classifying ovarian cancer cell types is an under-examined area of research. This study served as a pilot study to quantify observer variability related to the classification of ovarian cancer cell types and to extract valuable data for designing a validation study of digital pathology (DP) for this task. Three observers with expertise in gynecologic pathology reviewed 114 cases of ovarian cancer with optical microscopy, with specific guidelines for classifications into distinct cell types. For 93 cases all 3 pathologists agreed on the same cell type, for 18 cases 2 out of 3 agreed, and for 3 cases there was no agreement. Across cell types with a minimum sample size of 10 cases, agreement between all three observers was {91.1%, 80.0%, 90.0%, 78.6%, 100.0%, 61.5%} for the high grade serous carcinoma, low grade serous carcinoma, endometrioid, mucinous, clear cell, and carcinosarcoma cell types respectively. These results indicate that unanimous agreement varied over a fairly wide range. However, additional research is needed to determine the importance of these differences in comparison studies. These results will be used to aid in the design and sizing of such a study comparing optical and digital pathology. In addition, the results will help in understanding the potential role computer-aided diagnosis has in helping to improve the agreement of pathologists for this task.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2015
Subtitle of host publicationDigital Pathology
EditorsMetin N. Gurcan, Anant Madabhushi
ISBN (Electronic)9781628415100
StatePublished - Jan 1 2015
EventMedical Imaging 2015: Digital Pathology - Orlando, United States
Duration: Feb 25 2015Feb 26 2015

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2015: Digital Pathology
Country/TerritoryUnited States


  • Agreement
  • Cell type
  • Diagnosis
  • Microscopy
  • Observer variability
  • Ovarian cancer
  • Pathology

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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