Kei Tanaka, Kris Lami, Takuma Odate, Takashi Hori, Tsubasa Sato, Ethan N. Okoshi, Junya Fukuoka
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引用次数: 0
摘要
背景:对于数字病理学在细胞学中的应用,诸如焦点精度和数据量等挑战仍然存在。本验证研究的目的是比较在宫颈细胞学(LBC)中使用z-叠扫描(z-WSI)的数字载玻片与传统玻璃载玻片之间的诊断准确性、筛查时间、注释计数以及观察者之间和观察者内部的一致性。方法:我们收集了91例LBC样本,其中NILM, LSIL, HSIL和SCC病例数量相等。四名细胞技术专家分别使用玻片和z-WSI对病例进行评估。他们根据两种不同的模式对病例进行分类:(1)“筛查-2-类别”:NILM(正常)与其他病变(ASC-US及以上);(2)“morphoo -3- category”:NILM vs. LSIL(轻度发育不良)vs. ASC-H及更高(中度发育不良至鳞状细胞癌),以反映病变严重程度和治疗意义。结果:对于筛选2类分类,玻片的观察者间一致性为0.685,z-WSI的观察者间一致性为0.637,观察者内一致性为82.4%至95.6%。对于Morpho-3-Category分类,玻片的观察者间一致性为0.700,z-WSI为0.598,表明与z-WSI的一致性降低。筛选2类准确率分别为91.2%(玻片)和87.1% (z-WSI),形态3类准确率分别为86.5%和81.0%,差异无统计学意义。在这两种模式中,细胞技术学家倾向于在真阳性病例中应用更多的注释,而在假阴性病例中应用较少。所有细胞技术人员的z-WSI筛查时间平均延长2-5分钟。结论:z-WSI并不完全等同于玻片,但它具有作为细胞学筛查工具的潜力。专门为WSI设计的培训有望提高诊断的准确性,提高工作流程的效率。
Cytology Screening Using Z-Stack Digital Slides: A Validation Study
Background
For applications of digital pathology in cytology, challenges such as focal precision and data volume remain. The goals of this validation study are to compare diagnostic accuracy, screening time, annotation counts, and inter- and intra-observer agreement between digital slides using Z-stack scanning (z-WSI) and conventional glass slides in liquid-based cervical cytology (LBC).
Methods
We collected 91 LBC samples, with an equal number of NILM, LSIL, HSIL, and SCC cases. Four cytotechnologists evaluated cases using glass slides and z-WSI separately. They classified cases under two separate schemas: (1) “Screening-2-Category”: NILM (normal) vs. other lesions (ASC-US and above); and (2) “Morpho-3-Category”: NILM vs. LSIL (mild dysplasia) vs. ASC-H and higher (moderate dysplasia to squamous cell carcinoma) to reflect lesion severity and treatment implications.
Results
For Screening-2-Category classifications, inter-observer agreement was 0.685 for glass slides and 0.637 for z-WSI, with intra-observer agreement ranging from 82.4% to 95.6%. For Morpho-3-Category classifications, inter-observer agreement was 0.700 for glass slides and 0.598 for z-WSI, indicating reduced agreement with z-WSI. Accuracy was 91.2% (glass slides) and 87.1% (z-WSI) for Screening-2-Category, and 86.5% and 81.0% for Morpho-3-Category, with no significant differences. In both modalities, cytotechnologists tended to apply more annotations in true positive cases but fewer in false negative cases. Screening time for z-WSI was 2–5 min longer on average for all cytotechnologists.
Conclusion
z-WSI is not completely equivalent to glass slides, but it has the potential to be used as a tool for cytology screening. Training specifically designed for WSI is expected to enhance diagnostic accuracy and improve workflow efficiency.
期刊介绍:
Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.