Internet-based gynecologic telecytology with remote automated image selection: results of a first-phase developmental trial.
A retrospective set of 191 gynecologic cytology slides with reference interpretations was run on an automated screening device that selects fields of view (FOVs) based on a hierarchical probability of abnormality being present. An interface was developed between the device and a remote server using customized image review software. FOVs were reviewed by 3 cytotechnologists and 3 cytopathologists, and binary triage (unsatisfactory for evaluation/negative for intraepithelial lesion or malignancy [NILM] vs "abnormal" [neither unsatisfactory nor NILM]) and specific interpretations were done. No morphologic training before FOV review was provided. Three or more reviewers agreed on the correct categorization of NILM/unsatisfactory in 89% (85/96) and abnormal in 83% (79/95). Three or more reviewers triaged cases to abnormal as follows: atypical squamous cells of uncertain significance, 83% (5/6); atypical squamous cells, cannot exclude high-grade lesion, 100% (3/3); low-grade squamous intraepithelial lesion (SIL), 83% (52/63); high-grade SIL, 94% (17/18); and atypical glandular cells, 40% (2/5). This procedure may have comparable sensitivity and specificity and possibly could provide effective initial triage to further evaluation. A review of individual cases suggests that further accuracy can be achieved with additional training and experience.
Eichhorn
John H
JH
Cytopathology Division, Massachusetts General Hospital, Boston, MA 02114, USA.
Buckner
Leigh
L
Buckner
Sally Beth
SB
Beech
David P
DP
Harris
Kimberly A
KA
McClure
Douglas J
DJ
Crothers
Barbara A
BA
Wilbur
David C
DC
D001331:Automation; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008403:Mass Screening / Q000379:methods; D012680:Sensitivity and Specificity; D012984:Software; D019113:Telepathology / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*