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House JC, Henderson-Jackson EB, Johnson JO, et al. Diagnostic digital cytopathology: Are we ready yet?. J Pathol Inform. 2013;4:28doi: 10.4103/2153-3539.120727.
House, J. C., Henderson-Jackson, E. B., Johnson, J. O., Lloyd, M. C., Dhillon, J., Ahmad, N., Hakam, A., Khalbuss, W. E., Leon, M. E., Chhieng, D., Zhang, X., Centeno, B. A., & Bui, M. M. (2013). Diagnostic digital cytopathology: Are we ready yet?. Journal of pathology informatics, 428. https://doi.org/10.4103/2153-3539.120727
House, Jarret C, et al. "Diagnostic digital cytopathology: Are we ready yet?." Journal of pathology informatics vol. 4 (2013): 28. doi: https://doi.org/10.4103/2153-3539.120727
House JC, Henderson-Jackson EB, Johnson JO, Lloyd MC, Dhillon J, Ahmad N, Hakam A, Khalbuss WE, Leon ME, Chhieng D, Zhang X, Centeno BA, Bui MM. Diagnostic digital cytopathology: Are we ready yet?. J Pathol Inform. 2013 Oct 29;4:28. doi: 10.4103/2153-3539.120727. eCollection 2013. PMID: 24392242; PMCID: PMC3869956.
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J Pathol Inform. 2013 Oct 29;4:28. doi: 10.4103/2153-3539.120727. eCollection 2013.

Diagnostic digital cytopathology: Are we ready yet?.

Journal of pathology informatics

Jarret C House, Evita B Henderson-Jackson, Joseph O Johnson, Mark C Lloyd, Jasreman Dhillon, Nazeel Ahmad, Ardeshir Hakam, Walid E Khalbuss, Marino E Leon, David Chhieng, Xiaohui Zhang, Barbara A Centeno, Marilyn M Bui

Affiliations

  1. Department of Pathology and Cell Biology, University of South Florida College of Medicine, Tampa, FL, USA.
  2. Department of Pathology and Cell Biology, University of South Florida College of Medicine, Tampa, FL, USA ; Department of Anatomic Pathology, Cytology Division, Tampa, FL, USA.
  3. Analytic Microscopy Core, Moffitt Cancer Center, Tampa, FL, USA.
  4. Cytology Division, Shadyside Hospital, University of Pittsburgh, PA, USA.
  5. Department of Pathology, Cytology Division, Yale University, New Haven, CT, USA.
  6. Department of Pathology and Cell Biology, University of South Florida College of Medicine, Tampa, FL, USA ; Analytic Microscopy Core, Moffitt Cancer Center, Tampa, FL, USA.

PMID: 24392242 PMCID: PMC3869956 DOI: 10.4103/2153-3539.120727

Abstract

BACKGROUND: The cytology literature relating to diagnostic accuracy using whole slide imaging is scarce. We studied the diagnostic concordance between glass and digital slides among diagnosticians with different profiles to assess the readiness of adopting digital cytology in routine practice.

MATERIALS AND METHODS: This cohort consisted of 22 de-identified previously screened and diagnosed cases, including non-gynecological and gynecological slides using standard preparations. Glass slides were digitalized using Aperio ScanScope XT (×20 and ×40). Cytopathologists with (3) and without (3) digital experience, cytotechnologists (4) and senior pathology residents (2) diagnosed the digital slides independently first and recorded the results. Glass slides were read and recorded separately 1-3 days later. Accuracy of diagnosis, time to diagnosis and diagnostician's profile were analyzed.

RESULTS: Among 22 case pairs and four study groups, correct diagnosis (93% vs. 86%) was established using glass versus digital slides. Both methods more (>95%) accurately diagnosed positive cases than negatives. Cytopathologists with no digital experience were the most accurate in digital diagnosis, even the senior members. Cytotechnologists had the fastest diagnosis time (3 min/digital vs. 1.7 min/glass), but not the best accuracy. Digital time was 1.5 min longer than glass-slide time/per case for cytopathologists and cytotechnologists. Senior pathology residents were slower and less accurate with both methods. Cytopathologists with digital experience ranked 2(nd) fastest in time, yet last in accuracy for digital slides.

CONCLUSIONS: There was good overall diagnostic agreement between the digital whole-slide images and glass slides. Although glass slide diagnosis was more accurate and faster, the results of technologists and pathologists with no digital cytology experience suggest that solid diagnostic ability is a strong indicator for readiness of digital adoption.

Keywords: Digital diagnostic cytopathology; virtual microscopy; whole slide imaging

References

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