An analysis of 46 static telecytology cases over a period of two years

Abstract

We analysed 46 telecytology cases sent from two rural hospitals about 500 km from a tertiary cancer centre. The cases were submitted for second opinion over a period of two years and evaluated using a static store and forward telecytology approach. A total of 715 digital images were studied (average 15 per case). Forty-one of the 46 cases (89%) were reported within 3 days and 54% of cases were reported within one working day. The aspiration smears and images were found to be of diagnosable quality in 89 and 93% of the cases, respectively. The diagnostic concordance was assessed by comparing the telecytology diagnosis, glass slide diagnosis and final histopathology diagnosis (when available). A clinically useful diagnosis was rendered in 91% cases with 74% complete concordance. Five out of 46 cases (11%) were deferred for glass slide review. Store and forward telecytology using the Internet is a rapid and effective method of providing expert diagnosis in cytology.

Comparison between a traditional single still image and a multiframe video image along the z‐axis of the same microscopic field of interest in cytology: Which does contribute to telecytology?

“…[2][3][4][5][6] We sometimes faced the criticism that cytotechnologist might not always pick (sample) the cells showing the most important abnormal feature in telecytology diagnosis. In addition, we have also heard people say that it was impossible to adequately express three-dimensional structure of cell cluster as a single still image.…”

“…[2][3][4][5] In each country or community, there might be various factors influencing the penetration of telecytology. However, we have often heard that one of the reasons is that a static image system only provides limited information to the consulting cytopathologist.…”

Digital Applications in Cytopathology: Problems, Rationalizations, and Alternative Approaches

“…SDI platforms capture, store, and forward galleries of digital images for remote assessment. SDI-based telecytology proved to be popular [22,23,24], with advantages including relatively low equipment start-up costs, minimal equipment maintenance, and smaller image files that are easier to manage and store. However, telecytology using SDI suffers from an inability to focus, lack of resolution, and dependency on the referring host to preselect clinically relevant ROI to be photographed [25,26].…”

Digital Cytology: Current State of the Art and Prospects for the Future

“…This hypothesis speaks to the fact that image selection quality and bias may play an important role in the variable quality of static-image telecytology. For a variety of aspiration specimens, Jialdasani et al [32] reported a ‘clinically useful’ diagnosis in 91% of cases using static-image telecytology. Yamashiro et al [33] report on their introduction of a static image-based telecytology system for primary diagnosis in Japan.…”