Utility of whole-slide imaging for rapid evaluation of thyroid FNA: A multireader prospective study

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2025-09-01 DOI:10.1002/cncy.70046

Mohammed S. Ahmed MD, Dianna Klippel-Almaraz MS, Sara E. Amin MD, Gloria H. Sura MD, Uma Rani Kundu MD, Wendong Yu MD, PhD, John M. Stewart MD, PhD, Qiong Gan MD, PhD, Savitri Krishnamurthy MD

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引用次数: 0

Abstract

Background

Rapid on-site evaluation (ROSE) of thyroid fine-needle aspiration biopsy (FNAB) improves diagnostic adequacy and facilitates ancillary molecular testing. In this prospective, multireader study, the authors evaluated the feasibility of using whole-slide images (WSIs) for ROSE to determine specimen adequacy and preliminary categorization (according to The Bethesda System for Reporting Thyroid Cytopathology [Bethesda]) of image-guided thyroid FNABs compared with conventional light-microscopic (LM) examination of the same specimens in a referral cancer center.

Methods

The authors evaluated 98 ultrasound-guided thyroid FNAB cases. Smears were stained with Papanicolaou and Diff-Quik and were scanned at ×20 magnification using a Leica Aperio CS2 scanner. Five cytopathologists evaluated specimen adequacy and Bethesda categorization using WSI followed by LM assessment after a 2-week washout. Intraobserver and interobserver agreements were calculated using Cohen and Fleiss kappa (κ) statistics. Scan time, interpretation time, and the need for ×40 magnification or z stacking were recorded.

Results

In total, 463 slides were scanned, with mean scan time of 5.48 minutes. WSI quality was acceptable in most cases. Z stacking and ×40 magnification were requested in 23% and 14% of reviews, respectively. Intrareader agreement between WSI and LM examination was excellent (κ = 0.86–0.95). Inter-reader agreement was moderate for both WSI (κ = 0.48) and LM examination (κ = 0.56). Concordance was highest for Bethesda categories I and VI and lowest for categories III–V. Interpretation with WSI took significantly longer than with LM examination (p < .0001).

Conclusions

WSI is a feasible alternative to LM examination for ROSE of thyroid FNABs, with high intrareader agreement and comparable inter-reader agreement. The limited need for high magnification and z stacking supports its practical utility.

Abstract Image

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全切片成像在甲状腺FNA快速评估中的应用：一项多阅读器前瞻性研究

背景甲状腺细针穿刺活检（FNAB）的快速现场评估（ROSE）提高了诊断的充分性，并促进了辅助分子检测。在这项前瞻性的多读者研究中，作者评估了使用全片图像（wsi）进行ROSE的可行性，以确定图像引导甲状腺fnab的标本充分性和初步分类（根据Bethesda甲状腺细胞病理学报告系统[Bethesda]），并将其与转诊癌症中心对相同标本进行常规光显微镜（LM）检查进行比较。方法对98例超声引导甲状腺FNAB进行临床评价。涂片用Papanicolaou和Diff-Quik染色，并使用徕卡Aperio CS2扫描仪×20放大扫描。5名细胞病理学家评估标本充分性和Bethesda分类使用WSI和LM评估后2周冲洗。使用Cohen和Fleiss kappa （κ）统计量计算观察者内部和观察者之间的一致性。记录扫描时间、解释时间和×40放大倍数或z堆叠的需要。结果共扫描463张切片，平均扫描时间5.48 min。在大多数情况下，WSI质量是可以接受的。分别有23%和14%的评论要求Z堆叠和×40放大。WSI和LM检查的读者内一致性极好（κ = 0.86-0.95）。WSI （κ = 0.48）和LM检查的读者间一致性为中等（κ = 0.56）。Bethesda I和VI类的一致性最高，III-V类的一致性最低。WSI的解释时间明显长于LM检查（p < .0001）。结论WSI可替代LM检查甲状腺fnab的ROSE，具有较高的读者内一致性和相当的读者间一致性。对高倍率和z堆叠的有限需求支持了它的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.