ArticleScientific reports2024
Concordance in the estimation of tumor percentage in non-small cell lung cancer using digital pathology.
Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The critical role of accurate neoplastic cell percentage (NCP) assessment: investigating targeted training strategies for pulmonary biopsy and cytology specimens.Virchows Archiv : an international journal of pathology · 2026Article
- Validation of QuANTUM-derived tumor cell fraction for molecular testing in high-grade serous tubo-ovarian carcinoma.NPJ precision oncology · 2026Article
- Reframing tumor bed evaluation in non-small cell lung cancer: histopathological challenges and future directions in the era of neoadjuvant immunotherapy.Frontiers in oncology · 2026Review
- Tumor Cell Proportion Assessment in Advanced Non-Squamous Non-Small Cell Lung Cancer Tissue Samples in Real-World Settings in Japan: The ASTRAL Study.Diagnostics (Basel, Switzerland) · 2025Article
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Authors and funding
18 authors.
Funding
Abstract
The incorporation of digital pathology in clinical practice will require the training of pathologists in digital skills. Our study aimed to assess the reliability among pathologists in determining tumor percentage in whole slide images (WSI) of non-small cell lung cancer (NSCLC) using digital image analysis, and study how the results correlate with the molecular findings. Pathologists from nine centers were trained to quantify epithelial tumor cells, tumor-associated stromal cells, and non-neoplastic cells from NSCLC WSI using QuPath. Then, we conducted two consecutive ring trials. In the first trial, analyzing four WSI, reliability between pathologists in the assessment of tumor cell percentage was poor (intraclass correlation coefficient (ICC) 0.09). After performing the first ring trial pathologists received feedback. The second trial, comprising 10 WSI with paired next-generation sequencing results, also showed poor reliability (ICC 0.24). Cases near the recommended 20% visual threshold for molecular techniques exhibited higher values with digital analysis. In the second ring trial reliability slightly improved and human errors were reduced from 5.6% to 1.25%. Most discrepancies arose from subjective tasks, such as the annotation process, suggesting potential improvement with future artificial intelligence solutions.
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