Accuracy of frozen section analysis in correlation with surgical pathology diagnosis

Parikshit Patil, Samarth Shukla, Arvind Bhake, Kishore Hiwale


Background: Intra-operative consultation by frozen section is a high risk procedure with important consequences. Therefore it is critical to determine efficiency of frozen section performance periodically. This study was performed to determine accuracy of frozen section.

Methods: In this prospective study, we compared the results of 100 consecutive cases of frozen section with their final permanent section diagnosis in a teaching hospital of Jawaharlal Nehru Medical College, Wardha, Maharashtra during July 2012 to June 2014.

Results: A total of 100 cases were studied on frozen section while one case was deferred for permanent paraffin section (deferral rate 01%). The overall accuracy of frozen section was 96.96% with false positive and false negative rates of 1.01% and 2.02% respectively. Sensitivity, specificity, positive predictive value and negative predictive value were 97.22%, 96.30%, 98.59% and 92.86% respectively. The turn-around time of 18 minutes was observed in the present study.

Conclusions: The accuracy of frozen section diagnosis at our institute can be interpreted as comparable with most international quality control statistics for frozen sections. The overall error rate and deferral rates are within the range previously published studies. The results suggest specific measures should be taken to reduce the number of discrepancies.



Intra-operative consultation, Frozen section, Accuracy, Turnaround time, Quality assurance

Full Text:



Jaafar H. Intra-operative frozen section consultation: concepts, applications and limitations. Malays J Med Sci. 2006;13(1):4-12.

Raab SS, Tworek JA, Souers R, Zarbo RJ. The value of monitoring frozen section-permanent section correlation data over time. Arch Pathol Lab Med. 2006;130(3):337-42.

Khoo JJ. An audit of intraoperative frozen section in Johor. Med J Malaysia. 2004;59(1):50-5.

Taxy JB. Frozen section and the surgical pathologist: a point of view. Arch Pathol Lab Med. 2009;133(7):1135-8.

Chang J-L, Tseng H-H, Sheu L-F, Lee W-H, Tu Y-C. Diagnostic Accuracy of Frozen Sections in Surgical Pathology-A Retrospective Analysis of 1084 Frozen Sections. Journal of Medical Sciences. 1992;13(2):133-42.

Farah-Klibi F, Neji O, Ferjaoui M, Zaouche A, Koubaa A, Sfar R, et al. Accuracy of frozen section diagnosis: an analysis of 1695 consecutive cases. Tunis Med. 2008;86(7):693-7.

Shrestha S, Lee MC, Dhakal H, Pun CB, Pradhan M, Shrestha S, et al. Comparative Study of Frozen Section Diagnoses with Histopathology. Postgraduate Medical Journal of NAMS. 2009;3(2):1-5.

Abbasi F, Yekta Z, Aryan A. Accuracy of Frozen Sections. Iranian Journal of Pathology. 2012;7(1): 3-8.

Howanitz PJ, Hoffman GG,Zarbo RJ. The accuracy of frozen-section diagnoses in 34 hospitals. Arch Pathol Lab Med. 1990;114(4):355-9.

Chandramouleeswari K, Yogambal M, Arunalatha P, Bose JC, Rajendran A. Frozen and paraffin sections- Comparative study highlighting the concordance and discordance rates in a tertiary care centre. IOSR Journal of Dental and Medical Sciences. 2013;12(5):26-30.

Ud Din N, Memon A, Idress R, Ahmad Z, Hasan S. Central nervous system lesions: correlation of intraoperative and final diagnoses, six year experience at a referral centre in a developing country, Pakistan. Asian Pac J Cancer Prev. 2011;12(6):1435-7.

Novis DA, Zarbo RJ. Interinstitutional comparison of frozen section turnaround time. A College of American Pathologists Q-Probes study of 32868 frozen sections in 700 hospitals. Arch Pathol Lab Med. 1997;121(6):559-67.