Inter‐ and intraobserver agreement in whole‐slide digital ThinPrep samples of low‐grade squamous lesions of the cervix uteri with known high‐risk HPV status: A multicentric international study

Kholová, Ivana; Negri, Giovanni; Nasioutziki, Maria; Ventura, Laura; Capitanio, Arrigo; Bongiovanni, Massimo; Cross, Paul; Bourgain, Claire; Edvardsson, Henrik; Granados, Rosario; Lipiński, Artur; Obermann, Ellen C.; Pinamonti, Maurizio; Šidlová, Henrieta; Fležar, Margareta Strojan; Kemenade, Folkert J. van; Vrdoljak-Mozetič, Danijela; Fassina, Ambrogio; Cochand‐Priollet, Béatrix

doi:10.1002/cncy.22624

Cited by 7 publications

(3 citation statements)

References 56 publications

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“…In cervical cytology, it has been demonstrated that knowledge of the high-risk HPV status may increase interobserver agreement for the ASC-US category. 19 In the case of high-risk HPV positivity, for instance, minor cellular changes can be upgraded to abnormal findings. The immunocytochemistry for p16/ ki67 might also help increase the reproducibility of interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, the cytopathologists interpreted anal cytology blinded to the HPV test results. In cervical cytology, it has been demonstrated that knowledge of the high‐risk HPV status may increase interobserver agreement for the ASC‐US category 19 . In the case of high‐risk HPV positivity, for instance, minor cellular changes can be upgraded to abnormal findings.…”

Section: Discussionmentioning

confidence: 99%

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Interobserver agreement in the interpretation of anal cytology

Benevolo,

Rollo,

Latini

et al. 2024

Cancer Cytopathology

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BackgroundAnal cytology represents a tool for anal cancer screening in high‐risk populations. In addition to accuracy, the reproducibility of the interpretation is of key importance. The authors evaluated the agreement of anal cytologic interpretation between two cytopathologists.MethodsLiquid‐based cytologic slides from human immunodeficiency virus (HIV)‐negative men who have sex with men (MSM) were evaluated by two readers with at least 10 years of expertise in cervical cytology. Cases with a discordant interpretation were reviewed, and a consensus was reached. Human papillomavirus (HPV) genotyping was performed using a proprietary HPV genotyping test. Unweighted and weighted Cohen kappa and 95% confidence interval (CI) values were calculated.ResultsOverall, 713 slides that were adequate for interpretation were evaluated (MSM: median age, 33 years). An HPV test was performed on 620 samples (87.0%). Considering a dichotomous interpretation (negative for intraepithelial lesion or malignancy vs. atypical squamous cells of undetermined significance or worse), the crude agreement between the two readers was 93.3% (kappa = 0.82; 95% CI, 0.77–0.87). Once a consensus for discordant cases was reached, the best agreement was found for the negative for intraepithelial lesion or malignancy category (511 of 528 samples; 96.8%), whereas the atypical squamous cells of undetermined significance category showed the lowest agreement (90 of 117 samples, 76.9%). Considering the individual cytologic categories, overall agreement was 92.1% (kappa = 0.85; 95% CI, 0.81–0.89). The discordant interpretations were not associated with high‐risk HPV infection, HPV16 infection, or MSM age.ConclusionsThe results indicating excellent interobserver agreement in this study substantiate the use of anal cytology in the setting of human immunodeficiency virus‐negative MSM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interobserver agreement in the interpretation of anal cytology

Benevolo,

Rollo,

Latini

et al. 2024

Cancer Cytopathology

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“…The quality of scanned cytology slides is inferior to the microscopic picture, and the use of scanning is still mainly in teaching, quality assurance programmes, and research [4,[14][15][16][17]. Due to the characteristics of the cytopathological specimens, which contain three-dimensional groups of cells, the use of whole-slide imaging (WSI) in cytology has lagged behind that of histopathology.…”

Section: Discussionmentioning

confidence: 99%

Ectopic thyroid in EBUS: experience from a quality assurance programme

Vuorisalo

Tommola

Eloranta³

et al. 2023

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A diagnostic challenge is presented: Distinguishing ectopic thyroid tissue from metastatic well-differentiated follicular carcinoma in cytological material. Two cases of thyroid tissue in mediastinal lymph nodes were sampled by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Later, the cases were presented in Labquality's nongynecological external quality scheme rounds in the years 2017, 2019, and 2020. The same case was presented two times, both in the 2017 and in the 2020 rounds. The results of the three rounds and the discussion of diagnostic pitfalls of ectopic thyroid tissue are presented. A total of 112 individual laboratories worldwide participated in the external quality assurance rounds with whole-slide scanned images and digital still images of alcohol-fixed Papanicolaou-stained cytospin specimens in the years 2017, 2019, and 2020. Fifty-three laboratories participated in both the 2017 (53 of 70, 75.71%) and the 2020 (53 of 85, 62.35%) rounds. The given Pap classes between rounds were compared. Twelve (12 of 53, 22.6%) of the laboratories gave the same Pap class value, whereas 32 (32 of 53, 60.4%) were in the range of AE1 class difference (Cohen's kappa À0.035, p < 0.637). When comparing the diagnoses, 21 (21 of 53, 39.6%) laboratories gave the same diagnosis in 2017 and in 2020 (Cohen's kappa 0.039, p < 0.625). Thirty-two of the laboratories gave the same diagnosis both in 2017 and in 2020 (Cohen's kappa 0.004, p < 0.979). Ten (10 of 53, 18.9%) laboratories changed their diagnose from malignant to benign, and 11 (11 of 53, 20.8%) changed their diagnose from benign to malignant between the 2017 and the 2020 rounds. In conclusions, the expert reference diagnosis was thyroid tissue in mediastinal lymph node. Thyroid tissue in mediastinal lymph node may be either of ectopic or of neoplastic origin. The diagnostic work-up should include cytomorphological, immunohistochemical, laboratory, and imaging results. If a neoplastic change is excluded, the benign category is the most feasible one. The quality assurance rounds showed a large variability in the given Pap classes. Mirroring the problematic issue both inter-and intralaboratory of such cases both in routine diagnostics and in the classification terminologies is requiring multidisciplinary evaluation approach in the diagnostics.

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AICyte‐alone capabilities as an independent screener for triaging cervical cytology using a 50% negative cutoff value

Zeng,

Starr,

et al. 2024

Cancer Cytopathology

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BackgroundAICyte has previously demonstrated a potential role in cervical cytology screening for reducing the workload by using a 50% negative cutoff value. The aim of the current study is to evaluate this hypothesis.MethodsThe authors used the Ruiqian WSI‐2400 (with the registered trademark AICyte) to evaluate a collection of 163,848 original cervical cytology cases from 2018 to 2023 that were collected from four different hospital systems in China. A breakdown of cases included 46,060 from Shenzhen, 67,472 from Zhengzhou, 25,667 from Shijiazhuang, and 24,649 from Jinan. These collected cases were evaluated using the AICyte system, and the data collected were statistically compared with the original interpretative results.ResultsIn 98.80% of all artificial intelligence cases that were designated as not needing further review, the corresponding original diagnosis was also determined to be negative. For any cases that were designated atypical squamous cells, cannot exclude high‐grade squamous intraepithelial lesion or higher, the sensitivity and negative predictive value were 90.77% and 98.80%, respectively. The sensitivity and negative predictive value were greater in cases designated as low‐grade squamous intraepithelial lesion or higher at 98.92% and 99.94%, respectively. Of the 49 low‐grade squamous intraepithelial lesion or higher that were designed by AICyte as not needing further review, the cytohistologic correlation revealed eight cases of cervical intraepithelial neoplasia 1 and 18 negative cases; and the remaining cases were without histologic follow‐up. In practice, AICyte used at a 50% negative cutoff value could reduce the anticipated workload if a protocol were implemented to label cases that qualified within the negative cutoff value as not needing further review, thereby finalizing the case as negative for intraepithelial lesions and malignancy.ConclusionsFor pathologic practices that do not have cytotechnologists or in which the workflow is sought to be optimized, the artificial intelligence system AICyte alone to be an independent screening tool by using a 50% negative cutoff value, which is a potential assistive method for cervical cancer screening.

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Inter‐ and intraobserver agreement in whole‐slide digital ThinPrep samples of low‐grade squamous lesions of the cervix uteri with known high‐risk HPV status: A multicentric international study

Cited by 7 publications

References 56 publications

Interobserver agreement in the interpretation of anal cytology

Interobserver agreement in the interpretation of anal cytology

Ectopic thyroid in EBUS: experience from a quality assurance programme

AICyte‐alone capabilities as an independent screener for triaging cervical cytology using a 50% negative cutoff value

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