Journal of Pathology Informatics Journal of Pathology Informatics
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Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 29

Conventional microscopical versus digital whole-slide imaging-based diagnosis of thin-layer cervical specimens: A validation study

1 Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands
2 Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
3 Department of Pathology, Zuyderland Hospital, Heerlen, The Netherlands; Department of Oncology, Johns Hopkins Oncology Center, Baltimore, MD, USA
4 Nap Pathology Consultance bv, Numansdorp, The Netherlands

Correspondence Address:
Mrs. Odille Bongaerts
Department of Pathology, Zuyderland Hospital, PO Box 6446, 6401 CX Heerlen
The Netherlands
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpi.jpi_28_18

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Background: Whole-slide imaging (WSI) has been implemented in many areas of pathology, but primary diagnostics of cytological specimens are lagging behind. One of the objectives of viewing scanned whole-slide images from histological or cytological specimens is remote exchange of knowledge and expertise of professionals to increase diagnostic accuracy. We compared the scoring results of our team obtained in double readings of two different data sets: conventional light microscopy (CLM) versus CLM and CLM versus WSI. We hypothesized that WSI is noninferior to CLM for primary diagnostics of thin-layer cervical slides. Materials and Methods: First, we determined the concordance rate at different thresholds of the participating cytotechnicians by double reading with CLM of 500 thin-layer cervical slides (Cohort 1). Next, CLM was compared with WSI examination of another 505 thin-layer cervical slides (Cohort 2) scanned at ×20 in single focus plane. Finally, all major discordant cases of Cohort 1 were evaluated by an external expert in the field of gynecological cytology and of Cohort 2 in the weekly case meetings. Results: The overall concordance rate of Cohort 1 (CLM vs. CLM) was 97.8% (95% confidence interval [CI]: 96.0%–98.7%) and of Cohort 2 was 95.3% (95% CI: 93.0%–96.9%). Conclusion: Concordance rates of WSI versus CLM were comparable with those of CLM versus CLM. We have made a step forward paving the road to implementation of WSI also in routine diagnostic cytology.

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