Sirintrapun Sahussapont Joseph, Rudomina Dorota, Mazzella Allix, Feratovic Rusmir, Lin Oscar
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA.
J Pathol Inform. 2017 Sep 7;8:33. doi: 10.4103/jpi.jpi_18_17. eCollection 2017.
The use of minimally invasive procedures to obtain material for diagnostic purposes has become more prevalent in recent years. As such, there is increased demand for immediate cytologic adequacy assessment of minimally invasive procedures. The array of different locations in which rapid on-site evaluation (ROSE) is expected requires an ever-increasing number of cytology personnel to provide support for adequacy assessment. In our study, we describe the implementation process of a telecytology (TC) system in a high case volume setting and evaluate the performance of this activity.
We performed retrospectively an analysis of all consecutive remote TC ROSE evaluations obtained for 15 months. The specimens were evaluated using a TC system. The ROSE adequacy assessment obtained at the time of the procedure was compared to the final cytopathologist-rendered adequacy assessment when all the material was available for review, including the alcohol-fixed preparations.
A total of 8106 distinct cases were analyzed. TC-assisted preliminary adequacy assessment was highly concordant with the final cytopathologist-rendered adequacy assessment. Perfect concordance or accuracy was at 93.1% (7547/8106). The adequacy upgrade rate (inadequate specimen became adequate) was 6.8% (551/8106), and the initial adequacy downgrade (adequate specimen became inadequate) was <0.1% (8/8106).
The TC outcome demonstrates high concordance between the initial adequacy assessment and final cytopathologist-rendered adequacy assessment. Adequacy upgrades were minor but, more importantly, our results demonstrate a minimal adequacy downgrade. The process implemented effectively eliminated the need for an attending pathologist to be physically present onsite during a biopsy procedure.
近年来，使用微创程序获取用于诊断目的的材料变得更加普遍。因此，对微创程序的即时细胞学充分性评估的需求增加。预计快速现场评估（ROSE）的不同地点范围需要越来越多的细胞学人员来为充分性评估提供支持。在我们的研究中，我们描述了在高病例量环境中远程细胞学（TC）系统的实施过程，并评估了该活动的性能。
我们对连续15个月获得的所有远程TC ROSE评估进行了回顾性分析。使用TC系统对标本进行评估。将程序时获得的ROSE充分性评估与最终细胞病理学家在所有材料可供审查（包括酒精固定制剂）时给出的充分性评估进行比较。
共分析了8106例不同病例。TC辅助的初步充分性评估与最终细胞病理学家给出的充分性评估高度一致。完全一致或准确率为93.1%（7547/8106）。充分性升级率（不充分的标本变为充分）为6.8%（551/8106），初始充分性降级（充分的标本变为不充分）<0.1%（8/8106）。
TC结果表明初始充分性评估与最终细胞病理学家给出的充分性评估之间高度一致。充分性升级较少，但更重要的是，我们的结果表明充分性降级极少。所实施的过程有效地消除了活检程序期间主治病理学家亲自在场的必要性。
