Rapid Remote Online Evaluation in Endoscopic Diagnostics: An Analysis of Biopsy-Proven Respiratory Cytopathology

Abstract

Background: This prospective study assesses the use of rapid remote online cytological evaluation for diagnosing endoscopical achieved biopsies. It focuses on its effectiveness in identifying benign and malignant conditions using digital image processing. Methods: The study was conducted between April 2021 and September 2022 and involved analyses of 314 Rapid Remote Online Cytological Evaluations in total (154 imprint cytologies, 143 fine needle aspirations and 17 brush cytologies) performed on 239 patients at the LungenClinic Grosshansdorf. During on-site evaluation via telecytology, the time requirement was recorded and the findings were compared with the cyto-/histological and final diagnoses. Results: By means of rapid remote online evaluation, findings of 86 cytological benign, 190 malignant and 38 unclear diagnoses were recorded (Ø assessment time, 100 s; range, 11–370 s). In 27 of the 37 specimens with unclear diagnoses, the final findings were malignant tumours and only 6 were benign changes. The diagnosis of another 4 of these 37 findings remained unclear. Excluding these 37 specimens, rapid remote online evaluation achieved a sensitivity of 90.5% with a specificity of 98.5% and a correct classification rate of 92.4% with regard to the final diagnosis of all cases. As expected, an increase in the sensitivity rate for the cytological detection of malignant tumours (76.1% vs. 92.5%) was found especially in fine-needle aspirations. Conclusions: Rapid remote online analysis allows the fast quantitative and qualitative evaluation of clinically obtained cytological specimens. With a correct classification rate of more than 93%, sampling deficiencies can be corrected promptly and diagnostic and therapeutic approaches can be derived.

Evaluating Diagnostic Clarity: The Comparative Efficacy of BlueStain in Serous Effusion Cytology under the International System for Reporting Serous Fluid Cytopathology Reporting Framework

“…BlueStain emerges as a promising candidate in this regard, particularly in settings where rapid turnaround and resource optimization are critical. Future research should aim to expand the application of BlueStain across various cytological contexts and explore its integration with emerging digital pathology tools to further revolutionize cytological diagnostics [24]. This study not only reinforces the potential of BlueStain as a versatile and cost-effective stain for cytopathological evaluation but also opens new avenues for its application in more complex cytological analyses.…”

“…Papanicolaou and Giemsa staining methods require significant amounts of reagents, including highly toxic substances like alcohol or xylene. While modifications to the Papanicolaou staining process have been suggested in the past to minimize environmental impact, these alternative methods have not been widely embraced by laboratories [ 21 , 22 , 23 , 24 ]. The BlueStain method significantly diminishes the environmental impact, slashing costs by up to 90% through the elimination of harmful reagents and the decreased reliance on bulky equipment and logistics.…”

“…BlueStain emerges as a promising candidate in this regard, particularly in settings where rapid turnaround and resource optimization are critical. Future research should aim to expand the application of BlueStain across various cytological contexts and explore its integration with emerging digital pathology tools to further revolutionize cytological diagnostics [ 24 ].…”