AI Article Synopsis
- Cervical cancer is the fourth most common cancer among women, and its prevention relies on vaccination and screening methods that require specialized equipment and multiple professionals.
- A central laboratory processes cervical samples from over 51 clinics, performing automated HPV testing and preparing liquid-based cytology slides for digital examination using whole-slide images (WSIs).
- The study found that while subjective confidence in diagnosing with WSIs was lower and perceived difficulty was higher, the diagnostic accuracy between conventional and digital methods remained similar, indicating moderate interobserver agreement regardless of the examination method used.
Article Abstract
Introduction: Cervical cancer is the fourth most common cancer in women, and its prevention is based on vaccination and screening. Screening consists of molecular human papillomavirus (HPV) testing and cytologic analysis of cervical smears, which require expensive equipment and the interaction of numerous professionals such as biologists, cytologists, laboratory technicians, and pathologists.
Materials And Methods: We centralize the cervical samples from more than 51 clinics in 1 main laboratory, where automated HPV testing is performed. HPV-positive cases are collected and used to prepare a liquid-based cytology slide, which is stained and immediately scanned. The resulting whole-slide images (WSIs) are immediately available in a remote laboratory where they are examined by experienced cytologists using virtual microscopy. This setup was validated by making each of the 3 readers independently diagnose 506 specimens in random order, using both conventional light microscopy (CLM) and WSIs, with a minimum wash-out period of 3 weeks and with a final discussion for all cases.
Results: Intraobserver agreement among CLM and WSI ranged from 0.71 to 0.79, and interobserver agreement for the 3 readers compared with the consensus diagnosis was similar for the 2 modes of assessment. Readers subjectively felt confident in their WSI diagnosis for inadequate and negative cases, but less so in other cases. The perceived difficulty was slightly higher in WSI readings.
Conclusions: Interobserver agreement in cervicovaginal cytology is moderate and does not vary if the slides are examined conventionally or digitally. Despite higher reported subjective difficulty and lower confidence in the WSI diagnosis, we did not observe a deterioration in diagnostic performance using WSI compared with CLM.
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| http://dx.doi.org/10.1016/j.jasc.2023.06.001 | DOI Listing |
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