Detection of high grade squamous intraepithelial lesions and tumors using the AutoPap system

Wilbur, David C.; Prey, Marianne U.; Miller, William Marion; Pawlick, Gene F.; Colgan, Terence J.; Taylor, D. Dax

doi:10.1002/(sici)1097-0142(19991225)87:6<354::aid-cncr6>3.3.co;2-6

Cited by 7 publications

(1 citation statement)

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“…A statistically insignificant increase was also found for specimens positive for high-grade squamous intraepithelial lesions (HSIL; 97% vs. 93%). 4 For review smears, AutoPap also provides PapMaps. These are paper prints the size of a slide coverslip that show 15 circled areas that indicate the slide areas where cellular material has been classified by the system as being most abnormal.…”

Section: Methodsmentioning

confidence: 99%

Impact of the AutoPap (currently focalpoint) primary screening system location guide use on interpretation time and diagnosis

Ronco

Vineis

Montanari³

et al. 2002

Cancer

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BACKGROUND AutoPap (currently Focalpoint) is a computerized scanning system for the primary screening of cervicovaginal smears. For smears indicated to require further review, the system provides maps (PapMaps) to identify the most abnormal areas of the smear. METHODS To study the effect of PapMaps on diagnosis, 481 smears (from 4656 successfully processed smears using AutoPap) were first classified by conventional manual interpretation and then reinterpreted blind by the same cytologist who limited his examination to only the fields of view marked by the PapMaps. The interpretation time with and without PapMaps was measured on another simple random sample of 188 smears. RESULTS The interpretation time was reduced significantly, by approximately 40% using PapMaps (average reduction, 136 seconds per smear, 95% confidence interval [CI], 123–150). No cases manually classified as low‐grade squamous intraepithelial lesions (LSIL) or worse and 20% of those manually classified as atypical squamous cells of undertermined significance (ASCUS) were judged as completely normal on the basis of fields of visions marked by PapMaps. In none of the latter was a histologically confirmed intraepithelial lesion identified. In relation to detailed diagnosis, the weighted kappa between manual and PapMap‐aided interpretation was 0.745 (95% CI 0.687–0.804). Systematic differences were found (symmetry chi‐square10d.f =19.11, P = 0.039): 48% of smears classified as ASCUS and 23% classified as LSIL by conventional diagnosis were classified as less severe (including normal) on the basis of PapMaps. CONCLUSIONS Use of PapMaps resulted in a substantial reduction in interpretation time. PapMaps showed good sensitivity (100% for squamous intraepithelial lesions and 80% for ACSUC) for selecting abnormal slides. The latter require full examination: detailed diagnosis based only on areas marked by PapMaps could lead to under‐grading. Cancer (Cancer Cytopathol) 2003;99:83–8. © 2003 American Cancer Society.

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Section: Methodsmentioning

confidence: 99%

Impact of the AutoPap (currently focalpoint) primary screening system location guide use on interpretation time and diagnosis

Ronco

Vineis

Montanari³

et al. 2002

Cancer

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Effectiveness of the SurePath liquid‐based Pap test in automated screening and in detection of HSIL

Cengel

Day

Davis-Devine

et al. 2003

Diagnostic Cytopathology

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We have shown that SurePath when compared to conventional Paps fails to increase HSIL detection. In this study, assessment of test performance characteristics for the FocalPoint showed that sensitivity was 96% when manual screening was used as the "gold standard." When cervical biopsy, however, was used as the "gold standard" FocalPoint sensitivity decreased to 93%, which was the same as manual screening. Examination of the FocalPoint "no further review" cases showed that 4/296 were SIL. To understand better the implication of an SIL diagnosis, cervical biopsies generated from SurePath and conventional Paps were compared. Conventional Paps diagnosed as LSIL had a biopsy LSIL:HSIL ratio of 3.1/1, while SurePath Paps had a biopsy LSIL:HSIL ratio of 1.5/1. These results indicate that when cervical biopsy is used as the "gold standard," FocalPoint and manual screening of SurePath Paps have similar test performance but that the FocalPoint can fail to detect LSIL. Importantly, LSIL in a SurePath Pap is 1.6 times more likely to be HSIL on biopsy than LSIL in a conventional Pap.

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Cervical cytology automation: an update for 2003

Wilbur

2003

Clinics in Laboratory Medicine

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Detection of high grade squamous intraepithelial lesions and tumors using the AutoPap system

Cited by 7 publications

References 0 publications

Impact of the AutoPap (currently focalpoint) primary screening system location guide use on interpretation time and diagnosis

Impact of the AutoPap (currently focalpoint) primary screening system location guide use on interpretation time and diagnosis

Effectiveness of the SurePath liquid‐based Pap test in automated screening and in detection of HSIL

Cervical cytology automation: an update for 2003

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