title: Radiology contributes to better cytological diagnosis of lung tumors.
abstract: OBJECTIVE
  Cytology is well established and widely accepted method to diagnose lung tumors. However, cytological changes of malignant cells can be so subtle that cytopathologists cannot always diagnose with certainty. In such cases, some cytopathologists believe that radiological assessment is important for correct cytological diagnosis. However others deny the importance of radiological information, because they believe it could not change the cytological assessment. This study mainly aimed to clarify how radiologist's comments affect cytological diagnosis of lung tumors.
  
  
  METHODS
  Of 201 patients who underwent cytological examinations, 131 and 57 patients were diagnosed with malignant and benign lung lesions, respectively. Study coordinators randomly selected 60 cytological slides each of the benign and malignant lesions. A radiologist graded their CT images by using a 5-point confidence scale. Three cytotechnologists assessed the 120 cytological slides twice on the basis of a 5-grade classification: first before and then after obtaining radiologist's grading. Receiver operating characteristic analysis was performed. The Az values, sensitivities, and specificities of the cytological diagnoses were calculated for comparing the results before and after obtaining radiologist's grading.
  
  
  RESULTS
  The mean Az value for cytological assessment after obtaining radiologist's grading (0.88) was significantly higher than that before obtaining radiologist's grading (0.78). The mean sensitivity of cytological assessment after obtaining radiologist's grading (77%) was significantly higher than that before obtaining radiologist's grading (67%).
  
  
  CONCLUSIONS
  Radiological assessment, together with a radiologist's confidence, improves cytological diagnoses of lung diseases. Thus, the importance to positively provide radiological assessment to cytopathologists should be considered by all clinicians.
authors.affiliation: Department of Pathology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298, Japan. utaroh-motosugi@nifty.com
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kato
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kamakura
authors.forename: Tomoko
authors.initials: T
authors.lastname: Saze
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Saki
authors.initials: S
authors.lastname: Yajima
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Murata
authors.forename: Michio
authors.initials: M
authors.lastname: Shimizu
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D003581:Cytodiagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed