Evaluating the role of Z-stack to improve the morphologic evaluation of urine cytology whole slide images for high-grade urothelial carcinoma: Results and review of a pilot study.

Autor: Kim D; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Burkhardt R; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Alperstein SA; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Gokozan HN; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Goyal A; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Heymann JJ; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Patel A; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA., Siddiqui MT; Division of Cytopathology, New York-Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA.
Jazyk: angličtina
Zdroj: Cancer cytopathology [Cancer Cytopathol] 2022 Aug; Vol. 130 (8), pp. 630-639. Date of Electronic Publication: 2022 May 18.
DOI: 10.1002/cncy.22595
Abstrakt: Background: Whole slide imaging (WSI) adoption has been slower in cytopathology due, in part, to challenges in multifocal plane scanning on 3-dimensional cell clusters. ThinPrep and other liquid-based preparations may alleviate the issue by reducing clusters in a concentrated area. This study investigates the use of Z-stacked images for diagnostic assessment and the experience of evaluating urine ThinPrep WSI.
Methods: Thirty ThinPrep urine cases of high-grade urothelial carcinoma (n = 22) and cases of negative for high-grade urothelial carcinoma (n = 8) were included. Slides were scanned at 40× magnification without Z-stack and with Z-stack at 3 layers, 1 μm each. Six cytopathologists and 1 cytotechnologist evaluated the cases in 2 rounds with a 2-week wash-out period in a blinded manner. A Cohen's Kappa (CK) calculated concordance rates. A survey after each round evaluated participant experience.
Results: CK with the original report ranged from 0.606 to 1.0 (P < .05) without Z-stack and 0.533 to 1.0 (P < .05) with Z-stack both indicating substantial-to-perfect concordance. For both rounds, interobserver CK was moderate-to-perfect (0.417-1.0, P < .05). Intraobserver CK was 0.697-1.0 (P < 0.05), indicating substantial to perfect concordance. The average scan time and file size for slides without Z-stack and with Z-stack are 6.27 minute/0.827 GB and 14.06 minute/2.650 GB, respectively. Surveys demonstrated a range in comfort and use with slightly more favorable opinions for Z-stacked cases.
Conclusions: Z-stack images provide minimal diagnostic benefit for urine ThinPrep WSI. In addition, Z-stacked urine WSI does not justify the prolonged scan times and larger storage needs compared to those without Z-stack.
(© 2022 American Cancer Society.)
Databáze: MEDLINE
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