Telecytology in East Africa: a feasibility study of forty cases using a static imaging system
Telecytology in East Africa: a feasibility study of forty cases using a static imaging system
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DOI：
10.1258/jtt.2011.110308
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发表时间：
2012-01-01
影响因子：
4.7
通讯作者：
Sohani, Aliyah R.
中科院分区：
文献类型：
--
作者：
Kumar, Neeta;Busarla, Satya Vara Prasad;Sohani, Aliyah R.
我们进行了一项试点研究，以评估远程细胞学作为东非一家医院疑难病例诊断工具的可行性。转诊病理学家认为困难的四十个细胞学病例被发布在远程病理学网站上。六名病理学家独立评估静态图像。将远程细胞学诊断与载玻片上做出的共识诊断以及可用的组织学诊断进行比较。六位病理学家的诊断一致性为 71-93%，经验越丰富的病理学家诊断一致性越高。不一致的原因包括图像质量差、涂片较厚区域存在诊断细胞、采样偏差和筛查错误。在所有 17 例进行活检的病例中，一致诊断与组织学诊断一致。个别病理学家的诊断准确率（即远程细胞学诊断与组织学诊断）为 65-88%。为了确保诊断准确性，转诊和咨询病理学家必须接受足够的细胞学、图像采集和基于图像诊断的培训，并且转诊病理学家在发布病例时必须清楚地传达重要的诊断问题。
We conducted a pilot study to assess the feasibility of telecytology as a diagnostic tool in difficult cases originating from a hospital in East Africa. Forty cytology cases considered difficult by a referring pathologist were posted on a telepathology website. Six pathologists independently assessed the static images. Telecytology diagnoses were compared with the consensus diagnoses made on glass slides and also with the histogical diagnoses when available. The diagnostic agreement of the six pathologists was 71-93% and tended to be higher for pathologists with more experience. Reasons for discordance included poor image quality, presence of diagnostic cells in thick areas of smears, sampling bias and screening errors. The consensus diagnoses agreed with histological diagnoses in all 17 cases in which a biopsy was performed. Diagnostic accuracy rates (i.e. telecytology diagnosis vs. histological diagnosis) for individual pathologists were 65-88%. To ensure diagnostic accuracy both referring and consulting pathologists must have adequate training in cytology, image acquisition and image-based diagnosis and the diagnostic questions of importance must be clearly communicated by the referring pathologist when posting a case.