Assessment of reprocessed ThinPrep cytology cases after glacial acetic acid wash procedure using the Hologic Genius Digital Diagnostics System.

Abstract

Introduction: This study focuses on ThinPrep Pap tests with a low to borderline number of cells and the performance of AI-assisted digital systems in cases that have undergone the acetic acid wash procedure (AAW).

Materials and methods: Four hundred sixty-two cases initially interpreted as unsatisfactory and finally interpreted as satisfactory after AAW procedure were included in the study. These ThinPrep Pap slides were scanned using the Genius Digital Diagnostic System (GDDS).

Results: Overall agreement between GDDS and Original ThinPrep Interpretation (OTPI) was 63.2% for diagnostic match (Negative for Intraepithelial Lesion, ASCUS, Low Grade Squamous Intraepithelial Lesion, Atypical Squamous Cells, High Grade, Atypical Glandular Cells, or unsatisfactory), and 66.0% when ASCUS + diagnoses are grouped. Out of the 462 cases, 364 (78.8%) were called Negative for Intraepithelial Lesion based upon the manual OTPI, as opposed to 310 (67.1%) reviewed using the GDDS. There were 17.5%, 1.3%, 0.9% and 1.5% cases called Atypical Squamous Cells of Undetermined Significance, Low Grade Squamous Intraepithelial Lesion, Atypical Squamous Cells, High Grade Cannot be Excluded, and Atypical Glandular Cells respectively on OTPI, as opposed to 24.7%, 3.0%, 0.6% and 1.5% respectively by the GDDS. Only 3.0% of the cases were deemed unsatisfactory by GDDS. All the cases with high grade results in the subsequent cervical biopsy were diagnosed as at least Atypical Squamous Cells of Undetermined Significance and above by the GDDS. The diagnostic agreement between GDDS and biopsy was 65.2% compared to 58.7% for OTPI, although this is not statistically significantly different, (χ² (1) = 0.415, P = 0.519).

Conclusions: Our results demonstrate that the GDDS can be successfully used to screen ThinPrep Pap Tests that have undergone the AAW procedure.