Automated Screening of Conventional Gynecological Cytology Smears: Feasible and Reliable

Abstract

Objectives: We tested the ability of automated screening in processing conventional gynecological cytology smears and its efficacy in assessing sample adequacy and stratifying cases for risk of malignancy. Study Design: Cases were retrospectively selected, including unsatisfactory samples and slides with various sorts of artifacts. Automated screening was performed using the FocalPoint GS Imaging System (Becton Dickinson, Franklin Lakes, N.J., USA), with classification into five quintiles. For agreement purposes, cases were grouped into high risk for malignancy (quintiles 1 and 2) and low risk for malignancy (quintiles 3, 4 and 5). Results: A total of 120 cases (median age 37.5 years, range 18-85) were included in the study. Eighty-three cases (69.2%) could be successfully classified into quintiles. When divided by risk, 31 cases were placed in the high-risk and 52 in the low-risk group. The overall sensitivity and specificity of the automated analysis was 100 and 70.3%, respectively. Conclusions: Automated analysis could analyze the majority of conventional smears, including one case previously screened as unsatisfactory. All malignant and high-grade lesions were correctly classified into the high-risk group. Broad use of this automation system could potentially decrease screening time and augment the efficacy in detecting precursor neoplastic changes in cervical cytology smears.

Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

“…In addition, a number of recent publications have clearly demonstrated that LBC offers increased indexes of cytology positivity, and a consistent and remarkable reduction of unsatisfactory preparations [9,10,11,12]. Moreover, the best performance can be achieved with the use of computer-assisted screening programs, which is also feasible but not frequently employed globally with conventional Pap smears [13]. The São Paulo State Secretary of Health (SES) is responsible for the collection and analysis of approximately 2.5 million Pap tests per year, and the Fundação Oncocentro de São Paulo - FOSP (with the third-largest volume) performs about 250,000 of these tests.…”

An evaluation of the construction of the device along with the software for digital archiving, sending the data, and supporting the diagnosis of cervical cancer

“…A number of methods trying to solve these problems have been developed [11–13]; however, there are only a few studies that have been conducted on conventional smears. They often point to a high percentage of cases eliminated for further automatic analysis due to the difficulties mentioned above [14, 15]. The software developed for evaluation of conventional cytological preparations are characterised by limited sensitivity [16].…”

Pilot study of an open-source image analysis software for automated screening of conventional cervical smears

“…using the proprietary FocalPoint GS Imaging System (Beckton Dickinson). [ 2 ] However, in another study, the rate of flagging in this system was found to be high: only 16–17% slides are archived without review by a pathologist. [ 12 ]…”

“…on automated image analysis of conventional smears reported a sensitivity and specificity of 100% and 70.3% respectively, concluding that automated analysis could analyze the majority of conventional smears. [ 2 ] Bacus et al . have patented an apparatus for automated image analysis of conventional cervical smears.…”