Abstract
Objective: The problems associated with telecytology using still images were examined to maximize the diagnostic yield.
Study Design: Photographs of 142 pulmonary cytologic specimens were taken with the optimal exposure according to auto bracketing function of a digital camera. In order to cover large field of view and the size of the cells a panoramic photograph was taken through a 20 power microscope objective lens and with a panorama assist mode of the digital camera, and a panoramic image was prepared with photo-editing software. To compare images of atypical cells side-by-side, index images were created using the photo-editing software. When the diagnosis of benign or malignant by the cytotechnologist and cytopathologist differed, they examined images prepared from additional photos of the same specimen and diagnosed it again.
Result: Over-diagnosis of atypical squamous cells because of overexposed photographs has been improved by using auto bracketing function of a digital camera. The panoramic image could cover large fields of view, and has reduced over-diagnosis of atypical squamous cells because of misunderstanding the size of the cells. The index image allowed comparism of cellular atypism and the size of atypical cells, and has increased the number of images to transmit. Repeat diagnosis by examination of images prepared from additional photos raised the concordance rate between histological diagnosis and cytodiagnosis.
Conclusion: The problems associated with telecytology using still images has been improved by using the functions of a digital camera and photo-editing software. Repeat diagnosis by examining images prepared from additional photos improved correct diagnostic rate.
