Implementation of telecytology for immediate assessment of endoscopic ultrasound-guided fine-needle aspirations compared to conventional on-site evaluation: analysis of 240 consecutive cases.
OBJECTIVE
To evaluate the implementation of telecytology in an academic cytology service for immediate assessment of endoscopic ultrasound (EUS) and endobronchoscopic ultrasound (EBUS) fine-needle aspiration (FNA).


METHODS
Telecytology was evaluated over a 10-month period. Using an Olympus BX41(®) microscope and an Olympus DP72(®) camera with Olympus cellSens(®) software, real-time dynamic images of air-dried Diff-Quik(®)-stained smears were transmitted by a cytopathology fellow or cytotechnologist using a secure internet connection. The cytopathologists remotely accessed the real-time images on a computer in their office and rendered immediate assessments. Mean procedure times, and preliminary and final diagnoses were compared between telecytology and conventional on-site evaluation.


RESULTS
Two hundred and forty consecutive EUS-FNA and EBUS-FNA procedures with immediate assessments were performed during the evaluation period, of which 158 (66%) utilized telecytology and 82 (34%) did not utilize telecytology. The mean procedure time required for cytotechnologists and cytology fellows was 1.1 h for both conventional on-site and telecytology evaluations. The mean procedure time for cytopathologists was 0.74 h for conventional on-site evaluations and 0.2 h for telecytology.


CONCLUSIONS
Incorporation of telecytology for immediate assessment of EUS-FNA increased cytopathologist efficiency.
Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. Jonathan.D.Marotti@Hitchcock.org
Jonathan D
JD
Marotti
Vickie
V
Johncox
David
D
Ng
Jorge L
JL
Gonzalez
Vijayalakshmi
V
Padmanabhan
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D003581:Cytodiagnosis / Q000295:instrumentation / Q000379:methods*; D003584:Cytological Techniques / Q000379:methods*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D008099:Liver / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019113:Telepathology / Q000295:instrumentation / Q000379:methods*