Marletta Stefano, Salatiello Maria, Pantanowitz Liron, Bellevicine Claudio, Bongiovanni Massimo, Bonoldi Emanuela, De Rezende Gisele, Fadda Guido, Incardona Paolo, Munari Enrico, Pagni Fabio, Rossi Esther Diana, Tallini Giovanni, Troncone Giancarlo, Ugolini Clara, Vigliar Elena, Eccher Albino
Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy.
Department of Pathology, Pederzoli Hospital, Peschiera del Garda, Italy.
Cytopathology. 2023 Nov;34(6):581-589. doi: 10.1111/cyt.13279. Epub 2023 Aug 2.
Despite an increase in thyroid fine needle aspiration (FNA) and advances in whole slide imaging (WSI) adoption, digital pathology is still considered inadequate for primary diagnosis of these cases. Herein, we aim to validate the utility of WSI in thyroid FNAs employing the Delphi method strategy.
A panel of experts from seven reference cytology centres was recruited. The study consisted of two consecutive rounds: (1) an open-ended, free-response questionnaire generating a list of survey items; and (2) a consensus analysis of 80 selected shared WSIs from 80 cases by six investigators answering six morphological questions utilising a 1 to 5 Likert scale.
High consensus was achieved for all parameters, with an overall average score of 4.27. The broad majority of items (84%) were ranked either 4 or 5 by each physician. Two badly scanned cases were responsible for more than half of the low-ranked (≤2) values (57%). Good to excellent (≥3) diagnostic confidence was reached in more than 95.2% of cases. For most cases (78%) WSI assessment was not limited by technical issues linked to the image acquisition process.
This systematic Delphi study indicates broad consensus among participating physicians on the application of DP to thyroid cytopathology, supporting expert opinion that WSI is reliable and safe for primary diagnostic purposes.
尽管甲状腺细针穿刺活检（FNA）有所增加，全玻片成像（WSI）的应用也取得了进展，但数字病理学仍被认为不足以用于这些病例的初步诊断。在此，我们旨在采用德尔菲法策略验证WSI在甲状腺FNA中的实用性。
招募了来自七个参考细胞学中心的专家小组。该研究包括连续两轮：（1）一份开放式、自由回答的问卷，生成一份调查项目清单；（2）由六名研究人员对80例病例中选出的80张共享WSI进行共识分析，回答六个形态学问题，采用1至5的李克特量表。
所有参数均达成高度共识，总体平均得分为4.27。绝大多数项目（84%）每位医生的评分均为4或5。两个扫描不佳的病例导致了一半以上的低排名（≤2）值（57%）。超过95.2%的病例达到了良好至优秀（≥3）的诊断信心。对于大多数病例（78%），WSI评估不受与图像采集过程相关的技术问题限制。
这项系统性的德尔菲研究表明，参与研究的医生在将数字病理学应用于甲状腺细胞病理学方面达成了广泛共识，支持了专家观点，即WSI用于初步诊断目的是可靠且安全的。
