Characteristics of a telecytology consultation service

The growth of digital methods in pathology is accelerating. Digital images can be used for a variety of applications in cytology, including rapid interpretations, primary diagnosis and second opinions, continuing education and proficiency testing. All of these functions can be performed using small static digital images, real-time dynamic digital microscopy, or whole-slide images. This review will discuss the general principles of digital pathology, its methods and applications to cytologic specimens. As cytologic specimens have unique features compared to histopathology specimens, the key differences will be discussed. Technical and administrative issues in digital pathology applications and the outlook for the future of the field will be presented.

Section: Telediagnosis/teleconsultationsupporting

confidence: 74%

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

Wilbur¹

2011

“…The accuracy obtained by other telemedical studies on various lesions varied between 48 and 99% [1,2,4,5,7,8,10,29]. The accuracy of cytological and histological differentiation between HCC and N-HCC achieved in our study on the original slides and on digital images by the three pathologists was similar, ranging between 78.7 and 87.7%.…”

Section: Discussionsupporting

confidence: 57%

“…Telemedical consulting offers improvement in diagnostic efficiency [1,42], but a fully accurate differential diagnosis between HCC and N-HCC is only possible by combining FNA with immunochemical tests, as suggested by others [15,16,39]. …”

Section: Resultsmentioning

confidence: 99%

“…Several papers on telecytological evaluation of fine needle aspirations (FNAs) from various body sites have been published [1,2,3,4], but only few papers are available on specimens from one topographic region like the breast [5,6,7], thyroid gland [8,9] or pancreas [10]. The results of these studies indicate that the accuracy of the telecytological diagnoses may considerably depend on the topographic origin of the specimen.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Telecytological Diagnosis of Space-Occupying Lesions of the Liver

Mostafa

Dalquen

et al. 2014

Objective: In this study, the efficiency of telemedical consulting with regard to fine needle aspirates from space-occupying lesions (SOLs) of the liver is investigated for the first time. Study Design: The study includes fine needle aspirations from 62 patients, 33 with hepatocellular carcinoma (HCC) and 29 with non-hepatic tumors. Using the Internet-based iPath system, the initial pathologist submitted 1-8 images from smears and cell block sections. One consultant assessed the cytological and another one the histological images. Both made their diagnoses independent of each other. A final diagnosis was made by immunochemistry of cell block sections. The cytological images were analyzed retrospectively for the occurrence of the most typical HCC indicators. The number of these indicators was related to the initial diagnoses of the three pathologists, and possible reasons for diagnostic errors were analyzed based on this analysis. Results: The accuracy of the preliminary telemedical diagnoses regarding HCC was 82.0% for the cytological images and 87.7% for the histological images. Most of the false diagnoses occurred in tumors with unusual cytological and histological patterns. Conclusions: Telemedical consulting is a valuable tool to obtain a second opinion. However, for improvement of the diagnosis of HCC, supplementary immunochemical tests are necessary.

“…However, they were captured by an experienced cytopathologist from optimally prepared specimens and consciously selected fields on the slides. Thus, major limitations, such as unsatisfactory fixation and deficient photographic technique [11,14,28], which frequently hamper the diagnosis on digital images sent via iPath by colleagues from countries with limited resources, were excluded. Importantly, the wet-fixed and mostly Papanicolaou-stained cells remained transparent and allowed the evaluation of the nuclear chromatin pattern as the most important cytological criterion of malignancy.…”

Section: Discussionmentioning

confidence: 99%

Making Cytological Diagnoses on Digital Images Using the iPath Network

Dalquen¹,

Prince²,

Spieler

et al. 2014

Background: The iPath telemedicine platform Basel is mainly used for histological and cytological consultations, but also serves as a valuable learning tool. Aim: To study the level of accuracy in making diagnoses based on still images achieved by experienced cytopathologists, to identify limiting factors, and to provide a cytological image series as a learning set. Method: Images from 167 consecutive cytological specimens of different origin were uploaded on the iPath platform and evaluated by four cytopathologists. Only wet-fixed and well-stained specimens were used. The consultants made specific diagnoses and categorized each as benign, suspicious or malignant. Results: For all consultants, specificity and sensitivity regarding categorized diagnoses were 83-92 and 85-93%, respectively; the overall accuracy was 88-90%. The interobserver agreement was substantial (κ = 0.791). The lowest rate of concordance was achieved in urine and bladder washings and in the identification of benignlesions. Conclusion: Using a digital image set for diagnostic purposes implies that even under optimal conditions the accuracy rate will not exceed to 80-90%, mainly because of lacking supportive immunocytochemical or molecular tests. This limitation does not disqualify digital images for teleconsulting or as a learning aid. The series of images used for the study are open to the public at http://pathorama.wordpress.com/extragenital-cytology-2013/.