Reproducibility of Telecytology Diagnosis of Cervical Smears in a Quality Assurance Program: The Georgian Experience

Kldiashvili, Ekaterina; Schräder, Thomas

doi:10.1089/tmj.2011.0016

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Similar ranges of agreement (К = 0.47 to 0.77) have been reported in tele-cytology-based diagnosis of cervical cancer [30, 38]. While the previous tele-cytology studies, necessitated a specialist intervention at the PoC [30, 38, 39], the tele-cytology pipeline detailed in this study enabled remote diagnosis facilitating risk stratification and appropriate triaging of patients by a FHW. The images could be transferred using the mobile cellular network with an adequate resolution of the cellular morphology for accurate interpretation, making it a potential tool in a low-resource setting.…”

Section: Discussionsupporting

confidence: 77%

A smart tele-cytology point-of-care platform for oral cancer screening

et al. 2019

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Early detection of oral cancer necessitates a minimally invasive, tissue-specific diagnostic tool that facilitates screening/surveillance. Brush biopsy, though minimally invasive, demands skilled cyto-pathologist expertise. In this study, we explored the clinical utility/efficacy of a tele-cytology system in combination with Artificial Neural Network (ANN) based risk-stratification model for early detection of oral potentially malignant (OPML)/malignant lesion. A portable, automated tablet-based tele-cytology platform capable of digitization of cytology slides was evaluated for its efficacy in the detection of OPML/malignant lesions (n = 82) in comparison with conventional cytology and histology. Then, an image pre-processing algorithm was established to segregate cells, ANN was trained with images (n = 11,981) and a risk-stratification model developed. The specificity, sensitivity and accuracy of platform/ stratification model were computed, and agreement was examined using Kappa statistics. The tele-cytology platform, Cellscope, showed an overall accuracy of 84–86% with no difference between tele-cytology and conventional cytology in detection of oral lesions (kappa, 0.67–0.72). However, OPML could be detected with low sensitivity (18%) in accordance with the limitations of conventional cytology. The integration of image processing and development of an ANN-based risk stratification model improved the detection sensitivity of malignant lesions (93%) and high grade OPML (73%), thereby increasing the overall accuracy by 30%. Tele-cytology integrated with the risk stratification model, a novel strategy established in this study, can be an invaluable Point-of-Care (PoC) tool for early detection/screening in oral cancer. This study hence establishes the applicability of tele-cytology for accurate, remote diagnosis and use of automated ANN-based analysis in improving its efficacy.

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Section: Discussionsupporting

confidence: 77%

A smart tele-cytology point-of-care platform for oral cancer screening

et al. 2019

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“…Despite all these different restraints it must be stressed that in general the accuracy of the diagnoses made by telecytology is not essentially different from the accuracy of diagnoses made on the glass slides [8,9,12,13,16,40]. It has been shown with specimens of pleural effusions [27], FNAs of the breast [41] and gynecological smears [9] that interobserver variability was not significantly lower whether the participant pathologists made their diagnoses on digital images or the original glass slides of the same cases.…”

Section: Discussionmentioning

confidence: 99%

“…The latter studies have focused on cervical smears [7,8,9,10,11] or on both gynecological and nongynecological [2] as well as mixed nongynecological cytology [12,13], whereas few have focused on fine-needle aspirations (FNAs) from a single organ like the pancreas [14], thyroid gland [15,16], liver [17] or urinary tract [18]. Most of these studies on telehistology as well as on telecytology report a concordance rate of 80-90% between the diagnoses made on digital images and the reference diagnoses made on the regular glass slides.…”

Section: Introductionmentioning

confidence: 99%

Making Cytological Diagnoses on Digital Images Using the iPath Network

Dalquen¹,

Prince²,

Spieler

et al. 2014

Acta Cytologica

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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/.

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“…A Republic of Georgia study (randomized controlled study [RCT], n = 50) analyzed diagnostic accuracy and interobserver agreement of telecytology diagnosis of cervical smears in a QA program. 92 Digital images (2048 · 1536 pixels) of a mixed set of cervical smears were transmitted by e-mail, and the diagnosis of GSs (after 3 months) and digital images was made independently by three cytologists in a double-blind manner. The results showed ''.good inter-observer agreement for the first (correlation coefficient of 0.82) and second (0.68) GS diagnoses, and the first (0.80) and second (0.66) digital image diagnoses.''…”

Section: Telepathology Evidence: Feasibility and Acceptancementioning

confidence: 99%

The Empirical Foundations of Telepathology: Evidence of Feasibility and Intermediate Effects

Bashshur

Krupiński

Weinstein

et al. 2017

Telemedicine and e-Health

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The evidence regarding feasibility/acceptance of telepathology and related information technology applications has been well documented for several decades. The majority of evidentiary studies focused on intermediate outcomes, as indicated by comparability between telepathology and conventional light microscopy. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include use of telepathology and whole slide imaging for teaching, research, and outreach to resource-limited countries. Challenges still exist, however, in terms of use of telepathology as an effective diagnostic modality in clinical practice.

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Reproducibility of Telecytology Diagnosis of Cervical Smears in a Quality Assurance Program: The Georgian Experience

Abstract: Digital images are suitable substitutes for glass slides; telecytology can be used as an alternative method for the cytologic diagnosis of cervical smears, particularly in quality assurance programs.

Cited by 11 publications

References 18 publications

A smart tele-cytology point-of-care platform for oral cancer screening

A smart tele-cytology point-of-care platform for oral cancer screening

Making Cytological Diagnoses on Digital Images Using the iPath Network

The Empirical Foundations of Telepathology: Evidence of Feasibility and Intermediate Effects

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