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Bychkov A, Yoshikawa A, Munkhdelger J, Hori T, Fukuoka J. Integrating cytology into routine digital pathology workflow: a 5-year journey. Virchows Arch 2023; 483:555-559. [PMID: 37119336 DOI: 10.1007/s00428-023-03547-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/13/2023] [Accepted: 04/20/2023] [Indexed: 05/01/2023]
Abstract
Despite recent advances in digital imaging, the adoption of digital cytology is challenging due to technical limitations. This study describes our 5-year institutional experience with the implementation of digital cytology. The routine cytology workflow included conventional two-step screening by cytotechnologists, followed by sign out by pathologists. We introduced sign out of cytologic cases using a microscopic digital imaging platform operated by cytotechnologists, which allowed for remote review of slides by cytopathologists via video streaming. We also provided cytologic correlation to support the virtual slide-based sign out of histopathological specimens and for a weekly pathology-radiology conference. In addition, positive cytology cases were archived for integration into the laboratory information system and for prospective computational pathology studies. We also summarized lessons learned over the years and outlined our vision for future developments. This unique experience may serve as a role model for other institutions.
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Affiliation(s)
- Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, 929 Higashi-Cho, Kamogawa, Chiba, Japan.
| | - Akira Yoshikawa
- Department of Pathology, Kameda Medical Center, Kamogawa, 929 Higashi-Cho, Kamogawa, Chiba, Japan
| | - Jijgee Munkhdelger
- Department of Pathology, Kameda Medical Center, Kamogawa, 929 Higashi-Cho, Kamogawa, Chiba, Japan
| | - Takashi Hori
- Department of Pathology, Kameda Medical Center, Kamogawa, 929 Higashi-Cho, Kamogawa, Chiba, Japan
| | - Junya Fukuoka
- Department of Pathology, Kameda Medical Center, Kamogawa, 929 Higashi-Cho, Kamogawa, Chiba, Japan
- Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Antonini P, Santonicco N, Pantanowitz L, Girolami I, Rizzo PC, Brunelli M, Bellevicine C, Vigliar E, Negri G, Troncone G, Fadda G, Parwani A, Marletta S, Eccher A. Relevance of the College of American Pathologists guideline for validating whole slide imaging for diagnostic purposes to cytopathology. Cytopathology 2023; 34:5-14. [PMID: 36082410 PMCID: PMC10087327 DOI: 10.1111/cyt.13178] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/17/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022]
Abstract
Whole slide imaging (WSI) allows pathologists to view virtual versions of slides on computer monitors. With increasing adoption of digital pathology, laboratories have begun to validate their WSI systems for diagnostic purposes according to reference guidelines. Among these the College of American Pathologists (CAP) guideline includes three strong recommendations (SRs) and nine good practice statements (GPSs). To date, the application of WSI to cytopathology has been beyond the scope of the CAP guideline due to limited evidence. Herein we systematically reviewed the published literature on WSI validation studies in cytology. A systematic search was carried out in PubMed-MEDLINE and Embase databases up to November 2021 to identify all publications regarding validation of WSI in cytology. Each article was reviewed to determine if SRs and/or GPSs recommended by the CAP guideline were adequately satisfied. Of 3963 retrieved articles, 25 were included. Only 4/25 studies (16%) satisfied all three SRs, with only one publication (1/25, 4%) fulfilling all three SRs and nine GPSs. Lack of a suitable validation dataset was the main missing SR (16/25, 64%) and less than a third of the studies reported intra-observer variability data (7/25, 28%). Whilst the CAP guideline for WSI validation in clinical practice helped the widespread adoption of digital pathology, more evidence is required to routinely employ WSI for diagnostic purposes in cytopathology practice. More dedicated validation studies satisfying all SRs and/or GPSs recommended by the CAP are needed to help expedite the use of WSI for primary diagnosis in cytopathology.
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Affiliation(s)
- Pietro Antonini
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Nicola Santonicco
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ilaria Girolami
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Paola Chiara Rizzo
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Matteo Brunelli
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | | | - Elena Vigliar
- Public Health, University of Naples Federico II, Naples, Italy
| | - Giovanni Negri
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | | | - Guido Fadda
- Section of Pathological Anatomy, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Messina, Italy
| | - Anil Parwani
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Stefano Marletta
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
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