title: Implementation of FocalPoint GS location-guided imaging system: experience in a clinical setting.
abstract: BACKGROUND
  Recently, the Food and Drug Administration approved the use of the location-guided imaging system FocalPoint GS (FPGS), on SurePath Papanicolaou (Pap) tests for primary screening. The objective of the current study was to evaluate the impact of FPGS on the following: distribution of diagnostic categories; rate of high-risk human papillomavirus (HR-HPV)-positive ASC-US cases; and quality control (QC) data before and after FPGS implementation.
  
  
  METHODS
  A search of the laboratory information system was performed to identify all SurePath Pap tests processed in our laboratory for the first 19 months after FPGS implementation. We also retrieved all SurePath specimens from a 16-month period prior to FPGS implementation to serve as the control. During the period from Janaury 2008 to April 2009, the FocalPoint Slide Profiler was used.
  
  
  RESULTS
  Implementation of FPGS resulted in a significantly higher percentage of LSIL and ASC-US interpretations, as well as a significant increase in the detection of candidiasis and bacterial vaginosis. The ASC-to-SIL ratio was 1.4 and 1.9 before and after FPGS implementation, respectively. There was a decrease in the HR-HPV positive rate in ASC-US cases, and a decrease in the estimated false-negative fraction after FPGS implementation.
  
  
  CONCLUSIONS
  In conclusion, our study seems to demonstrate a favorable performance of FPGS in the routine clinical setting. FPGS may have the potential to be a promising screening tool for gynecologic cytology in a low-risk patient population.
authors.affiliation: Department of Pathology, Yale University, 430 Congress Avenue, New Haven, CT 06520, USA. angelique.levi@yale.edu
authors.forename: Angelique W
authors.initials: AW
authors.lastname: Levi
authors.forename: David C
authors.initials: DC
authors.lastname: Chhieng
authors.forename: Kevin
authors.initials: K
authors.lastname: Schofield
authors.forename: Diane
authors.initials: D
authors.lastname: Kowalski
authors.forename: Malini
authors.initials: M
authors.lastname: Harigopal
mesh_terms: D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology; D011379:Prognosis; D011786:Quality Control; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology; D014626:Vaginal Smears