Standardized Reporting of Core Needle Biopsy Tortuosity: BiopTort--A Computer-Aided Protocol for Categorizing Tortuosity.

Context.--Core needle biopsies (CNBs) are among the most common biopsy procedures, yielding long, thin deformation-prone cores. Core deformation results in both distorted histologic features and tortuosity (ie, deviation from the ideal straight path) along the length of the core. Tortuosity creates...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 150; no. 3; pp. 218 - 229
Autores principales: Jacobs, Jackson, Wiener, Dan, Pathak, Tilak, Farré, Xavier, Mirtti, Tuomas, Janowczyk, Andrew
Formato: pictorial research tables/charts Journal Article
Publicado: College of American Pathologists Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 150
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        atl: Standardized Reporting of Core Needle Biopsy Tortuosity: BiopTort--A Computer-Aided Protocol for Categorizing Tortuosity.
      aug:
        au:
          Jacobs, Jackson
          Wiener, Dan
          Pathak, Tilak
          Farré, Xavier
          Mirtti, Tuomas
          Janowczyk, Andrew
        affil: Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, Georgia
      sug:
        subj:
          Pathology, Clinical
          Digital Imaging
          Biopsy, Needle Classification
          Reports Standards
          Computer-Aided Design
          Protocols Methods
          Pathologists Psychosocial Factors
          Human
          Descriptive Statistics
          Interrater Reliability
          Diagnostic Imaging
          Diagnosis, Computer Assisted
          Specimen Handling
          Histocytochemistry
          Productivity
          Comparative Studies
          Confidence Intervals
      ab: Context.--Core needle biopsies (CNBs) are among the most common biopsy procedures, yielding long, thin deformation-prone cores. Core deformation results in both distorted histologic features and tortuosity (ie, deviation from the ideal straight path) along the length of the core. Tortuosity creates challenges in slide preparation and downstream pathologist assessment (eg, absent diagnostically relevant tissue after sectioning), indicating a clinical need for its minimization. Despite this need, there is no standard protocol for reporting CNB tortuosity. Objectives.--To (1) establish an actionable protocol for scoring CNB tortuosity, (2) build BiopTort, a software tool assigning CNB images interpretable, tiered scores consistent with the protocol, and (3) investigate our protocol and BiopTort's impact on interpathologist concordance and scoring time. Design.--Using a held-out CNB data set (N = 167), 3 pathologists assessed tortuosity in 3 sequential stages: (1) Baseline: a 3-tier scale based on prior experience, (2) Protocol: rescored with our 4-tier Tortuosity Scoring Protocol, (3) BiopTort-Aided: rescored with the protocol alongside BiopTort. Interrater concordance for each stage, using the Fleiss j, was recorded. Results.--Fleiss j was 0.19, 0.40, and 0.63, and average time per slide was 8.0, 24.2, and 13.3 seconds for stages 1 to 3, respectively. BiopTort was statistically noninferior to human interrater pairwise concordance. Conclusions.--These results suggest our protocol lessens interpathologist variability, with BiopTort further reducing variability and scoring protocol employment time cost. When deployed in CNB quality control workflows, our computer-aided protocol appears well situated to facilitate standardized, efficient, and actionable reporting of CNB tortuosity. BiopTort is open-source (http://bioptort.com).
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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