title: Is there a role for the thinprep imaging system in reporting anal cytology?
abstract: BACKGROUND
  The ThinPrep Imaging System (TIS) is an accurate time-saving method of reading cervical ThinPrep slides in screening programs. As anal and cervical cytology are morphologically similar, TIS can potentially be used for anal cytology. We assessed the performance of TIS on anal ThinPrep slides from homosexual men in a natural history study of human papillomavirus-related anal abnormalities.
  
  
  METHODS
  Four hundred nineteen anal cytology slides were processed by TIS and classified by a cytologist as either No further review (slide archived) or Manual review (slide requiring full manual screen). The results were compared with the original manual screening report for all slides and specifically for those screening episodes accompanied by a high-grade squamous intraepithelial lesion (HSIL) on concurrent biopsy.
  
  
  RESULTS
  One hundred seventy six of 419 (42.0%) slides were classified as No further review, with a trend of decreasing proportions as the degree of severity of the cytological abnormality increased. Thirteen (27.7%) slides with an original unsatisfactory report were classified as No further review. Eighty two (92.1%) of those with biopsy HSIL and cytological abnormality were classified for Manual review, including all 45 (100%) with cytological HSIL.
  
  
  CONCLUSIONS
  The cervical algorithm of TIS performed best on anal samples when HSIL was present both cytologically and histologically. The 27.7% unsatisfactory slides classified as No further review may indicate need for use of different criteria from cervical cytology. Because of the high prevalence of abnormalities, and hence the large proportion of slides needing manual review, the cytologist time-saving would compare unfavorably with use of TIS in cervical screening.
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Margaret Roberts
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Fengyi
authors.initials: F
authors.lastname: Jin
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ekman
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Kay Adams
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Ross
authors.initials: R
authors.lastname: Lindsay McDonald
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Kathleen Thurloe
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Adele
authors.initials: A
authors.lastname: Richards
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Isobel
authors.initials: I
authors.lastname: Mary Poynten
authors.affiliation: St Vincent's Hospital, Sydney, Australia.
authors.forename: Carmella
authors.initials: C
authors.lastname: Law
authors.affiliation: Melbourne Sexual Health Centre and Central Clinical School, Monash University, Victoria, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kincaid Fairley
authors.affiliation: Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.|Centre for Infectious Diseases and Microbiology, Westmead Clinical School, University of Sydney, New South Wales, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: John Hillman
authors.affiliation: Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Diseases, the Royal Women's Hospital, Victoria, Australia.|Murdoch Childrens Research Institute, Victoria, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
authors.forename: Sepehr N
authors.initials: SN
authors.lastname: Tabrizi
authors.affiliation: Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Diseases, the Royal Women's Hospital, Victoria, Australia.|Murdoch Childrens Research Institute, Victoria, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Marie Cornall
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.|RPA Sexual Health, Sydney Local Health District, Australia.
authors.forename: David
authors.initials: D
authors.lastname: James Templeton
authors.affiliation: Regional HPV Labnet Reference Laboratory, Department of Microbiology and Infectious Diseases, the Royal Women's Hospital, Victoria, Australia.|Murdoch Childrens Research Institute, Victoria, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Marie Garland
authors.affiliation: The Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Edwin Grulich
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Australia.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Farnsworth
mesh_terms: D000465:Algorithms; D001003:Anal Canal / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D008297:Male; D015588:Observer Variation; D065006:Papanicolaou Test / Q000379:methods*; D012680:Sensitivity and Specificity; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods*
keywords: ThinPrep imaging; anal cytology; high-grade squamous intraepithelial lesion