Fleury Group, São Paulo, Brazil.
Santa Casa Medical School, São Paulo, Brazil.
Cytopathology. 2023 Jul;34(4):302-307. doi: 10.1111/cyt.13234. Epub 2023 Mar 28.
Digital cytopathology is being progressively implemented in centres worldwide, but impediments such as the three-dimensionality of specimens and the size of scanned images have prevented its use from becoming widespread. This study aimed to validate the use of digital whole slide image scanning of cytopathology samples for routine sign-out.
Specimens were scanned using the Leica Aperio GT 450 System. The following sample types were used: liquid-based cytology, direct conventional smears from fine needle aspirates and cytospins. Cases were validated by the same pathologist who originally rendered the conventional diagnosis, with a washout of at least 3 months. Final digital diagnoses were compared to the original analogical diagnoses, and cases were considered concordant up to a one-degree difference between the original and digital diagnoses. Reasons for the unsuccessful scanning of slides were also noted. The technical procedures followed the College of American Pathologists' guidelines for digital pathology validation.
A total of 730 slides from 383 cases (337 female, 51 male; median age 42) were successfully scanned. These cases consisted of the following sample types: 81 (21.1%) conventional smears, 240 (62.7%) liquid-based cytology samples and 62 (16.2%) cytospins. There were only five discordant cases, with a 98.7% agreement between original and digital diagnoses using the difference rate of up to one degree. Seventy-seven slides (10.5%) had to be rescanned due to technical problems. The main reasons for unsuccessful scanning were paucicellular samples (44; 57.1%), the thickness of the smears (18; 23.4%) and issues with the coverslip (15; 19.5%).
Cytological specimens can be successfully scanned and used for digital pathology, with excellent agreement with the original diagnoses.
数字细胞病理学正在全球范围内逐步实施，但标本的三维性和扫描图像的大小等障碍阻碍了其广泛应用。本研究旨在验证数字全玻片图像扫描细胞学标本用于常规签发的可行性。
使用 Leica Aperio GT 450 系统对标本进行扫描。使用的样本类型包括：液基细胞学、细针抽吸直接常规涂片和细胞离心涂片。由最初做出常规诊断的同一位病理学家对病例进行验证，洗脱期至少为 3 个月。最终的数字诊断与原始模拟诊断进行比较，原始诊断和数字诊断相差一度以内被认为是一致的。还记录了未能成功扫描载玻片的原因。技术程序遵循美国病理学家学院数字病理学验证指南。
共成功扫描了 383 例病例中的 730 张载玻片（337 例女性，51 例男性；中位年龄 42 岁）。这些病例包括以下样本类型：81 例（21.1%）常规涂片、240 例（62.7%）液基细胞学样本和 62 例（16.2%）细胞离心涂片。仅有 5 例不一致的病例，原始诊断和数字诊断之间的一致性高达 98.7%，差异率为一度。由于技术问题，需要重新扫描 77 张载玻片（10.5%）。未能成功扫描的主要原因是细胞稀少的样本（44 例；57.1%）、涂片的厚度（18 例；23.4%）和盖玻片的问题（15 例；19.5%）。
细胞学标本可以成功扫描并用于数字病理学，与原始诊断具有极好的一致性。
