Cytodiagnosis by static electronic images

Telecytology of cervical smears and breast aspirates

抄録

Telecytology involves the use of telecommunication to transmit cytology images for the purposes of diagnosis, consultation or education. This paper describes the first attempt in Japan to evaluate the diagnostic accuracy of this method in cervico-vaginal smears and breast aspirates.
Cases and methods: We have used a static system which allowed us to send H 1280×V 960 high resolution images between a remote hospital and the pathology laboratory. Specimens were prepared by the cytotechnologist of the hospital, while the focus of interest was selected by the cytopathologist of the laboratory using low resolution motion pictures. Diagnosis was done by high resolution digital output on computer display.
We had a total of 57 cervico-vaginal smears and 45 cases of breast fine needle aspiration.
Results: The overall concordance of telecytology compared with conventional microscopy was 84.2% for cervical cytology. Concordance above the high grade squamous intraepithelial lesion was 81.3%. For breast aspirates accuracy was 91.1% when telecytology was compared with permanent histodiagnosis.
Discussion: Static systems have the advantage of considerably lower cost but appear to have only 80-90% levels of accuracy. Individuals participating in telecommunication of digital images for diagnosis should be properly qualified, and should protect patient confidentiality. Telecytology is particularly needed in long-distance consultation in hospitals where no full-time specialists are employed.