Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, TX 77030, USA.
Arch Pathol Lab Med. 2013 May;137(5):618-24. doi: 10.5858/arpa.2012-0430-OA. Epub 2012 Sep 12.
Digital whole slide imaging is the anticipated future of anatomic pathology, where sign-out of glass slides will be replaced by scanned images. Whole slide imaging has been successfully used in surgical pathology, but its usefulness and clinical application have been limited in cytology for several reasons, including lack of availability of z-axis depth focusing and large file size. Recently, several systems have become available in the United States for whole slide imaging with z-axis technology.
To determine the accuracy and efficiency of whole slide imaging, as compared with traditional glass slides, for use in cervicovaginal diagnostic cytology.
Eleven cervicovaginal cytology cases (ThinPrep and SurePath) scanned at ×20, ×40, and ×40 z-stack magnifications using the BioImagene iScan Coreo Au 3.0 scanner were evaluated by 4 cytotechnologists and 3 pathologists in a blinded study. Different magnification scans were recorded as separate cases and presented in a randomized sequence. Corresponding glass slides were also reviewed. For each case, the diagnoses and total time to reach each diagnosis were recorded.
Diagnostic accuracy was higher and average time per case was lower with glass slides as compared with all digital images. Among the digital images, the ×40 or ×40 z-stack had the highest diagnostic accuracy and lowest interpretation time.
Whole slide imaging is a viable option for the purposes of teaching and consultations, and as a means of archiving cases. However, considering the large file size and total time to reach diagnosis on digital images, whole slide imaging is not yet ready for daily cervicovaginal diagnostic cytology screening use.
数字全玻片成像技术是病理诊断的未来趋势，届时将用扫描图像取代玻璃载玻片的阅片。全玻片成像技术已经成功应用于外科病理学，但由于缺乏轴向深度聚焦能力和文件过大等原因，其在细胞学中的应用和实用性受到了限制。最近，美国有几个系统具备了应用于全玻片成像的轴向技术。
评估全玻片成像技术在宫颈阴道细胞学诊断中的准确性和效率，与传统的玻璃载玻片相比。
11 例（ThinPrep 和 SurePath）宫颈阴道细胞学标本（×20、×40 和×40 轴位放大倍数）使用 BioImagene iScan Coreo Au 3.0 扫描仪进行扫描，由 4 名细胞技术专家和 3 名病理学家在盲法研究中进行评估。不同放大倍数的扫描被记录为单独的病例，并以随机顺序呈现。相应的玻璃载玻片也进行了评估。记录每个病例的诊断结果和达到每个诊断的总时间。
与所有数字图像相比，玻璃载玻片的诊断准确性更高，平均每个病例的用时更短。在数字图像中，×40 或×40 轴位放大倍数的诊断准确性最高，解读时间最短。
全玻片成像技术是教学和咨询以及存档病例的可行选择。然而，考虑到数字图像的大文件大小和达到诊断的总时间，全玻片成像技术尚未准备好用于日常宫颈阴道细胞学诊断筛查。
