Diagnostic Accuracy of Frozen Sections in Central Nervous System Lesions

Introduction: Frozen section (FS) is a critical intraoperative diagnostic tool in the management of central nervous system (CNS) lesions, providing rapid histological assessment that guides surgical decision-making. Despite challenges in interpretation and tumor grading, FS remains indispensable for distinguishing neoplastic from non-neoplastic lesions and ensuring adequate tissue sampling. This study evaluates the accuracy and utility of FS in CNS lesion diagnosis, highlighting its role in optimizing neurosurgical outcomes. Aims: To evaluate the diagnostic accuracy of frozen section analysis by comparing intraoperative frozen section findings with final paraffin-embedded histopathology results. Material and methods: A retrospective study of 71 specimens of intra operative FS were carried out in histopathology section of B.J. Medical College, Ahmedabad. The diagnosis given on frozen section were compared with the final diagnosis given on permanent paraffin sections. The results were categorized into concordant and discordant. Results: The diagnostic accuracy of frozen section was found to be 90.14%. Discordant rate is 9.85%. Discordant rate or false negative diagnosis was because of technical, sampling and interpretative error. Conclusion: Frozen section is a rapid and reliable intraoperative diagnostic tool for CNS lesions, with accuracy rates typically between 85- 95%. Despite limitations in tumor grading and heterogeneous lesions, its strong concordance with paraffin histopathology makes it indispensable for guiding neurosurgical decision- making and improving patient outcomes.