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Updated: Dec 3, 2025
Determining Bile Duct Density in the Mouse Liver
Published on: April 30, 2019
Interobserver agreement in pathologic evaluation of bile duct biopsies
Yong-Jun Liu1, Jessica Rogers2, Yao-Zhong Liu3
1Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, 98195, USA; Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, WI, 53705, USA.
Interobserver agreement in biliary stricture biopsies improved after consensus training, particularly for carcinoma. However, agreement remains fair to moderate for other diagnostic categories, highlighting areas for further standardization in intraductal biopsy interpretation.
Area of Science:
- Gastroenterology and Pathology
- Diagnostic accuracy in hepatobiliary diseases
Background:
- Intraductal biopsy is crucial for evaluating biliary strictures.
- Interpretation of these biopsies presents diagnostic challenges.
- Significant interobserver disagreement exists but lacks prior study.
Purpose of the Study:
- To assess interobserver concordance in intraductal biopsy interpretation.
- To evaluate the impact of consensus and training on diagnostic agreement.
Main Methods:
- Eighty-five intraductal biopsies were classified into five categories: NED, IND, LGD, HGD, and CA.
- Eight gastrointestinal pathologists performed two blind reviews.
- Agreement was measured using Fleiss κ and concordance coefficient S∗.
- A consensus/training session preceded the second review.
Main Results:
- Overall interobserver agreement improved from fair (κ=0.39) to moderate (κ=0.48) after consensus.
- Agreement was substantial to nearly perfect for carcinoma (CA) in both reviews.
- Agreement for other categories (NED, IND, LGD, HGD) was fair to moderate and improved post-consensus.
- Formalin-fixed biopsies showed higher agreement than Hollande's fixed specimens.
Conclusions:
- Consensus and training significantly improve interobserver agreement in intraductal biopsy interpretation.
- High reproducibility is achieved for carcinoma diagnosis.
- Fair to moderate agreement for other categories indicates a need for refined diagnostic criteria and standardization.
