Adaptation of CytoProcessor for cervical cancer screening of challenging slides

Abstract

Background Current automated cervical cytology screening systems require purchase of a dedicated preparation machine and use of a specific staining protocol. CytoProcessor (DATEXIM, Caen, France) is a new automated system, designed to integrate seamlessly into the laboratory's existing workflow. We previously demonstrated the superior performance of CytoProcessor for diagnosis of ThinPrep slides compared to the ThinPrep Imaging System (HOLOGIC, Marlborough, MA). Next, we analyzed whether CytoProcessor technology can be adapted for use on Novaprep slides. Methods Using artificial intelligence, we developed a new algorithm in CytoProcessor for the analysis of slides prepared using the NOVAPREP Processor System NPS50 (Novacyt, Vélizy‐Villacoublay, France). A representative population of 309 cases was selected from the routine workflow in a public hospital. We compared the diagnoses made using CytoProcessor or conventional screening with a microscope. All discordances were resolved by a consensus committee. Results The performance of CytoProcessor in terms of diagnostic accuracy on Novaprep slides was very similar to that observed previously on ThinPrep slides. Compared to conventional screening, CytoProcessor slightly improves diagnostic sensitivity while maintaining a statistically equivalent specificity. Diagnosis was reached 1.6 times faster with CytoProcessor compared to using a microscope. Conclusion CytoProcessor is a robust automated cervical cytology screening system that can be used successfully with samples having very different characteristics. As previously shown, CytoProcessor confers significant gains in processing time and diagnostic precision. CytoProcessor is accessible through a secured internet connection, making remote diagnosis of Papanicolaou tests possible.

Cervical cancer: Automation of Pap test screening

“…The ThinPrep System 48,60,64,71 showed an ~75% productivity improvement. In comparison, the CytoProcessor System 49 generated a 60% increase in productivity.…”

“…Studies that evaluated segmentation and/or classification algorithms rather than the automated system available for implementation were excluded. Table 1 presents the relevant information from the reviewed articles 48‐81 …”

“…Three studies 60,73,74 reported the number of slides/day, and the ThinPrep System evaluated an average of 190 slides/day. Four studies 49,64,66,71 analyzed hourly counts and showed an average of 16 slides/hour. Considering 8 hours as a working day, this equals 128 slides/day.…”

“…Considering 8 hours as a working day, this equals 128 slides/day. Only one study 49 evaluated the CytoProcessor System and reported an average of 36 slides/hour.…”

Сontroversial issues in cytological screening for cervical cancer (literature review)

“…Недавно появилось сообщение о разработке новой автоматизированной системы для цервикального цитологического скрининга CytoProcessor ™ (Datexim, Франция), первой из новой генерации автоматических скрининговых систем, которая увеличивает чувствительность и имеет преимущество использования технологии виртуального слайда для упрощения рабочих процессов и сокращения времени обработки препарата [52,53]. Для идентификации атипических клеток среди десятков тысяч клеток в цитологическом препарате применяют технологию искусственного интеллекта.…”