Implementation of the Thinprep imaging system in a tertiary military medical center

Duby, Jeanne M.; DiFurio, Megan J.

doi:10.1002/cncy.20033

Cited by 25 publications

(43 citation statements)

References 17 publications

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“…Previous data in nonrandomized settings have shown better performance of CAS compared with manually read LBC [16][17][18]28,29 and CC. 15,17 In a large prospective Australian 1 Conventional cytology: total n cytologically positives: 93 (60 histologically confirmed, 33 imputed).…”

Section: Discussionmentioning

confidence: 99%

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Klug

Neis

Harlfinger³

et al. 2012

Intl Journal of Cancer

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Liquid-based cytology (LBC) has replaced conventional cytology (CC) for cervical cancer screening in some countries. However, it remains unclear whether LBC is superior to CC. A randomized controlled trial was conducted between August 2007 and March 2009 in Germany to compare LBC, alone and in combination with computer-assisted imaging technology (CAS), to CC in the detection of histologically confirmed cervical intraepithelial neoplasia (CIN). The main outcome measures were detection rates, relative sensitivities, positive predictive values (PPVs) and relative PPVs comparing LBC without and with CAS to CC. Primary histological outcome was CIN2 or higher. Included were 20,627 women participating in opportunistic cervical cancer screening at 20 gynecologic practices. The practices were randomized weekly to use LBC (n 5 11,331) or CC (n 5 9,296). Patients with positive findings were invited to expert colposcopy. The relative sensitivity of LBC versus CC using the CIN21 cut-off was 2.74 (95% confidence interval [CI] 1.66-4.53). The relative sensitivity of LBC/CAS versus CC for CIN21 was 3.17 (95% CI 1. 94-5.19). The PPV of LBC and CC for CIN21 was 48% and 38%, respectively. The PPV ratio did not differ significantly from unity. Differences between LBC and CC were smaller in some sensitivity and subgroup analyses; however, relative sensitivity of LBC remained increased. LBC without and with CAS compared with CC under the field conditions of an opportunistic screening system had a significantly higher sensitivity for the detection of CIN without deterioration of PPVs. Additional use of CAS did not further improve sensitivity of LBC. V C 2012 Wiley Periodicals, Inc.Key words: randomized controlled trial, early detection of cancer, uterine cervical neoplasm, Papanicolaou smear, liquid-based cytology, computer-assisted imaging technology Additional Supporting Information may be found in the online version of this article. Stefanie J. Klug, Jochem K€ onig and Hans Ikenberg had full access to all the data of the study. They take responsibility for the integrity of the data and the accuracy of the data analysis. Hans Ikenberg, Stefanie J. Klug, Klaus J. Neis and Werner Harlfinger take responsibility for the study concept and design. Werner Harlfinger and Klaus J. Neis take responsibility for the acquisition of data. Stefanie J. Klug, Jochem K€ onig, Veronika Weyer and Hans Ikenberg take responsibility for the analysis and interpretation of data. Stefanie J. Klug and Hans Ikenberg take responsibility for the drafting of the manuscript. All are responsible for the critical revision of the manuscript for important intellectual content. Jochem K€ onig, Veronika Weyer and Stefanie J. Klug did the statistical analysis. Werner Harlfinger, Klaus J. Neis, Armin Malter and Hans Ikenberg obtained funding. Sibylle Spieth, Friederike Brinkmann-Smetanay and Friedrich Kommoss had the administrative, technical or material support. Study supervision is by Hans Ikenberg, Werner Harlfinger, Klaus J. Neis and Stefanie J. Klug. Stefanie J. Klu...

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Section: Discussionmentioning

confidence: 99%

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Klug

Neis

Harlfinger³

et al. 2012

Intl Journal of Cancer

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“…Although there have been a few reports about the effectiveness of the TIS [2,3,4,5,6,7,8,9,10,11,12,13,14,15], their study designs have differed and their findings have been inconsistent in different populations. Most of the previous studies were performed in the USA [2,3,4,5,6,7,8,10,11,12], Europe [14,15], and Australia [9,13], not in Asian countries such as Korea.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the ThinPrep Imaging System in the Detection of Abnormal Cervicovaginal Cytology: A Practical Experience in Korea

Lee

2013

Acta Cytologica

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Objective: The purpose of this study is to report our experience with the implementation of the ThinPrep Imaging System (TIS) in a tertiary hospital in Korea and to evaluate the effectiveness of the TIS compared to manual methods in the screening of cervical cytology. Study Design: Detection rates of cervical abnormalities in the pre- and post-TIS periods (January 2009 to February 2010 and March 2010 to December 2010, respectively) were compared. Follow-up cytological and histological results with concurrent or subsequent human papillomavirus (HPV) tests were retrieved. Results: ASC-US, ASC-H, LSIL, and HSIL were more frequently detected in the post-TIS period than in the pre-TIS period (p < 0.005). The proportions of correlated cases of ASC-US were 42.2 and 40.4% in the pre- and post-TIS periods, respectively. The detection rates of high-risk types of HPV in ASC-US were not significantly different between the two groups. The proportion of correlated biopsy for ASC-H, LSIL, and HSIL was similar in both periods. HPV positivity for ASC-H, LSIL, and HSIL showed no significant change between the two periods. Conclusion: The TIS is potentially useful for the detection of abnormal cervical cytology on the basis of the increased detection rate of squamous cell abnormalities, with a relatively similar proportion of correlated cases compared to the manual screening method.

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“…Many laboratories have made the switch from manual screening of ThinPrep slides to using the Imager for CAS [7,8,9,10,11]. A Danish laboratory in Odense (also having used PAPNET in the past century) remarked that in all 10 false-negative cases, the abnormal cells had been identified by the scanner, but misinterpreted by the CT [12].…”

Section: Discussionmentioning

confidence: 99%

Switching from Neural Networks (PAPNET) to the Imager (Hologic) for Computer-Assisted Screening

et al. 2011

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Objective: The large set of ThinPrep slides prepared in the Leiden Cytology and Pathology Laboratory is exploited for calculating the impact of the transition from PAPNET neural network scanning to the Imager technology. Study Design: All cervical samples were suspended and fixed in the coagulant fixative BoonFix. We compared 57,541 ThinPrep slides which were scanned by PAPNET and 64,273 ThinPrep slides processed with the Imager: 99,157 cases originated from the Dutch population screening program of asymptomatic women (screenees) and the remaining 22,657 samples were of symptomatic women. In the PAPNET series, 23% were diagnosed by additional light microscopy; in the Imager method, all slides were studied light microscopically. The cytoscores (positive cytology per 1,000 samples) were calculated for normal, atypical squamous cells of undetermined significance (ASC-US), cervical intraepithelial neoplasia (CIN) grades I–II, and for CIN III+. The odds ratios (ORs) for the positive cytoscores were assessed for both the screenees and the symptomatic women. Results: The cytoscores, per 1,000 cases, for ASC-US varied from 17.77 to 40.59, for CIN I–II from 7.17 to 33.35, and for CIN III+ from 2.81 to 8.8. These 6 cytoscores were higher for symptomatic women than for screenees. We observe significantly elevated ORs for the Imager for ASC-US (1.26 and 1.23), CIN I–II (1.45) and for CIN III+ (1.58 and 1.45). These 3 ORs are higher for screenees than for symptomatic women. Conclusion: The Imager technology is more efficacious, particularly for handling screenee slides.

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Implementation of the Thinprep imaging system in a tertiary military medical center

Cited by 25 publications

References 17 publications

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

A randomized trial comparing conventional cytology to liquid‐based cytology and computer assistance

Effectiveness of the ThinPrep Imaging System in the Detection of Abnormal Cervicovaginal Cytology: A Practical Experience in Korea

Switching from Neural Networks (PAPNET) to the Imager (Hologic) for Computer-Assisted Screening

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