title: Whole Slide Imaging of Pap Cell Block Preparations versus Liquid-Based Thin-Layer Cervical Cytology: A Comparative Study Evaluating the Detection of Organisms and Nonneoplastic Findings.
abstract: OBJECTIVE
  Cervical cancer is one of the most common malignancies worldwide, yet it is preventable by population screening. In a previous study, we confirmed the feasibility of utilizing whole slide imaging (WSI) of cell block (CB) preparations to overcome the limitations of digitizing cytologic samples. In this study, we evaluated the accuracy of WSI in identifying various organisms and nonneoplastic findings.
  
  
  METHODS
  A total of 335 WS images from Pap CB preparations were analyzed using the Aperio system. The test performance characteristics of ThinPrep (TP) and WSI samples were compared for adequacy, for the presence of bacterial vaginosis (BV), fungi, Trichomonas vaginalis (TV) and herpes simplex virus (HSV) and for nonneoplastic findings.
  
  
  RESULTS
  The WSI samples contained optimal material from all preparations. BV was diagnosed in 33 WSI versus 36 TP samples. Budding yeasts and/or pseudohyphal forms were noted in 18 WSI versus 19 TP samples. TV organisms (10 of 11 samples) and 1 HSV case were accurately identified in the WSI and TP samples. Squamous metaplasia, keratosis and reactive/reparative and inflammatory changes were easily identified by WSI.
  
  
  CONCLUSIONS
  The concept of WSI from Pap CB preparations is potentially feasible for adoption. Digital remote web-based technology eliminates the need for an individual on site, saving time and resources.
authors.affiliation: Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, Kans., USA.
authors.forename: Ossama
authors.initials: O
authors.lastname: Tawfik
authors.forename: Marilyn
authors.initials: M
authors.lastname: Davis
authors.forename: Susan
authors.initials: S
authors.lastname: Dillon
authors.forename: Laila
authors.initials: L
authors.lastname: Tawfik
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Diaz
authors.forename: Fang
authors.initials: F
authors.lastname: Fan
mesh_terms: D001284:Atrophy; D057205:Automation, Laboratory; D005240:Feasibility Studies; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007642:Keratosis / Q000175:diagnosis; D008679:Metaplasia; D065006:Papanicolaou Test; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019113:Telepathology; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology