Original articles

Vol. 116: Issue 5 - October 2024

Not all stains are made equal: impact of stain normalization on prostate cancer diagnosis

Authors

Giorgio Cazzaniga , Alessandro Caputo , Vincenzo L'Imperio , Fabio Gibilisco , Manuela Scotto , Orazio Maria Antonino Pennis , Nicola Michielli , Alessandro Mogetta , Filippo Molinari , Filippo Fraggetta , Massimo Salvi

Key words: digital pathology, prostate cancer, stain normalization, gleason score, H&E staining
DOI: 10.32074/1591-951X-1008
Publication Date: 2024-11-29

Abstract

Objective. Stain normalization is a technique used to standardize the color appearance of digital whole slide images (WSIs). This study aimed to assess the impact of digital stain normalization on prostate cancer diagnosis by pathologists.

Methods. A multi-institutional board of four pathologists evaluated 407 hematoxylin and eosin (H&E) prostate WSIs before and after stain normalization. The presence/absence of prostate adenocarcinoma, the Grade Groups as well as color quality perception and time required for diagnosis were recorded.

Results. After normalization, color quality improved significantly for all pathologists (median scores increased from 4-6 to 7-8/10). Average diagnosis time decreased from 50s to 35s (p < 0.001). Inter-pathologist reproducibility for Gleason risk group showed a fair to good level of agreement, with an improvement after normalization.

Conclusions. Stain normalization enhanced pathologists’ diagnosis of prostate cancer by improving color standardization, reducing diagnosis time, and increasing inter-observer reproducibility. These findings highlight the potential of stain normalization to improve accuracy and efficiency in digital pathology.

Downloads

PDF
Authors

Giorgio Cazzaniga - Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Italy

Alessandro Caputo - Department of Medicine and Surgery, University Hospital of Salerno, Baronissi, Italy

Vincenzo L'Imperio - Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, Italy

Fabio Gibilisco - UOC Anatomia Patologica, ASP Catania P.O. “Gravina”, Caltagirone, Italy

Manuela Scotto - Biolab, PoliToBIOMed Lab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy

Orazio Maria Antonino Pennis - echnology Transfer and Industrial Liaison Department, Politecnico di Torino, Turin, Italy

Nicola Michielli - Biolab, PoliToBIOMed Lab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy

Alessandro Mogetta - Biolab, PoliToBIOMed Lab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy

Filippo Molinari - Biolab, PoliToBIOMed Lab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy

Filippo Fraggetta - UOC Anatomia Patologica, ASP Catania P.O. “Gravina”, Caltagirone, Italy

Massimo Salvi - Biolab, PoliToBIOMed Lab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright

Copyright (c) 2024 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Cazzaniga, G., Caputo, A., L’Imperio, V., Gibilisco, F., Scotto, M., Pennis, O. M. A., Michielli, N., Mogetta, A., Molinari, F., Fraggetta, F., & Salvi, M. (2024). Not all stains are made equal: impact of stain normalization on prostate cancer diagnosis. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 116(5). https://doi.org/10.32074/1591-951X-1008
  • Abstract viewed - 125 times
  • PDF downloaded - 39 times