Cervicovaginal cytology in patients undergoing pelvic radiotherapy using the Focalpoint system: results from the RODEO study

BackgroundEvaluate the performance of the Focalpoint system in identifying and classifying cervical cytology alterations from samples collected from patients treated with Radiotherapy (RT).MethodsThe reproducibility of manual and automated screening by cytotechnologists using the BD Focalpoint GS Imaging System was examined. Samples were collected from May 2010 to August 2011.ResultsA total of 378 treated with RT and 8,967 cytology samples from patients without previous RT, were evaluated. The kappa values for cytological diagnoses read manually and automated in cases without previous RT were as follows: < ASC-H vs. ¿ ASC-H¿=¿0.71; < LSIL vs. ¿ LSIL¿=¿0.66; and¿<¿HSIL vs. ¿ HSIL¿=¿0.67. The kappa for cytological diagnoses in post-RT women have showed: < ASC-H vs. ¿ ASC-H¿=¿0.71; < LSIL vs. ¿ LSIL¿=¿0.65; < HSIL vs. ¿ HSIL¿=¿0.57.ConclusionsThere was no significant difference among the kappa values we found. Post-RT cytology showed small diagnostic agreement between manual and automated examination.The authors are indebted to BD Brazil, which partially supported the study by providing the SurePath (TM) collection kits and equipment. The study design, screening, statistical analyses, and manuscript writing were independently performed by the Center for the Researcher Support of the Barretos Cancer Hospital

A multi-modal data resource for investigating topographic heterogeneity in patient-derived xenograft tumors.

Patient-derived xenografts (PDXs) are an essential pre-clinical resource for investigating tumor biology. However, cellular heterogeneity within and across PDX tumors can strongly impact the interpretation of PDX studies. Here, we generated a multi-modal, large-scale dataset to investigate PDX heterogeneity in metastatic colorectal cancer (CRC) across tumor models, spatial scales and genomic, transcriptomic, proteomic and imaging assay modalities. To showcase this dataset, we present analysis to assess sources of PDX variation, including anatomical orientation within the implanted tumor, mouse contribution, and differences between replicate PDX tumors. A unique aspect of our dataset is deep characterization of intra-tumor heterogeneity via immunofluorescence imaging, which enables investigation of variation across multiple spatial scales, from subcellular to whole tumor levels. Our study provides a benchmark data resource to investigate PDX models of metastatic CRC and serves as a template for future, quantitative investigations of spatial heterogeneity within and across PDX tumor models

Diagnosis of Cervical Cancer and Pre-Cancerous Lesions by Artificial Intelligence: A Systematic Review

The likelihood of timely treatment for cervical cancer increases with timely detection of abnormal cervical cells. Automated methods of detecting abnormal cervical cells were established because manual identification requires skilled pathologists and is time consuming and prone to error. The purpose of this systematic review is to evaluate the diagnostic performance of artificial intelligence (AI) technologies for the prediction, screening, and diagnosis of cervical cancer and pre-cancerous lesions

Radial Basis Function Artificial Neural Network for the Investigation of Thyroid Cytological Lesions

Objective. This study investigates the potential of an artificial intelligence (AI) methodology, the radial basis function (RBF) artificial neural network (ANN), in the evaluation of thyroid lesions. Study Design. The study was performed on 447 patients who had both cytological and histological evaluation in agreement. Cytological specimens were prepared using liquid-based cytology, and the histological result was based on subsequent surgical samples. Each specimen was digitized; on these images, nuclear morphology features were measured by the use of an image analysis system. The extracted measurements (41,324 nuclei) were separated into two sets: the training set that was used to create the RBF ANN and the test set that was used to evaluate the RBF performance. The system aimed to predict the histological status as benign or malignant. Results. The RBF ANN obtained in the training set has sensitivity 82.5%, specificity 94.6%, and overall accuracy 90.3%, while in the test set, these indices were 81.4%, 90.0%, and 86.9%, respectively. Algorithm was used to classify patients on the basis of the RBF ANN, the overall sensitivity was 95.0%, the specificity was 95.5%, and no statistically significant difference was observed. Conclusion. AI techniques and especially ANNs, only in the recent years, have been studied extensively. The proposed approach is promising to avoid misdiagnoses and assists the everyday practice of the cytopathology. The major drawback in this approach is the automation of a procedure to accurately detect and measure cell nuclei from the digitized images

Reproducibility determination of WHO classification of endometrial hyperplasia/well differentiated adenocarcinoma and comparison with computerized morphometric data in curettage specimens in Iran

<p>Abstract</p> <p>Background</p> <p>Management of endometrial precancerous lesions has been of much debate due to inconsistencies in their classification, natural history and histologic diagnosis. Endometrial hyperplasia constitutes a wide range of histomorphologic features associated with high intra and interobserver diagnostic variability.</p> <p>Although traditional microscopic diagnosis is by far the most applicable method and the gold standard for histomorphologic diagnosis, digitized image analysis has been used as a powerful adjunct to maximize the histologic data retrieval and to add some detailed objective criteria for correct diagnosis in difficult cases.</p> <p>Methods</p> <p>A series of 100 endometrial curettage specimens with diagnosis of endometrial hyperplasia or well differentiated adenocarcinoma were blindly reviewed by 5 pathologists; their intra and interobserver reproducibility determined and further compared to the objective morphometric data i.e. D-score and volume percent of stroma (VPS).</p> <p>Results</p> <p>The results were assessed using the weighted kappa statistics. Mean intraobserver kappa value was 0.8690 (99.44% agreement). Mean interobserver kappa values by diagnostic category were: simple hyperplasia without atypia: 0.7441; complex hyperplasia without atypia: 0.3379; atypical hyperplasia: 0.3473, and well-differentiated endometrioid carcinoma: 0.6428; with a kappa value of 0.5372 for all cases combined.</p> <p>Interobserver agreement was in substantial rate for simple hyperplasia (SH) and well differentiated adenocarcinoma (WDA) but was in fair limit for complex hyperplasia (CH) and atypical hyperplasia (AH). Intraobserver agreement was almost perfect. The specimens were divided in two groups according to the computerized morphometric analysis: Endometrial Hyperplasia (EH) ( D Score ≥ 1 or VPS ≥ 55%) and Endometrial Intraepithelial Neoplasia (EIN) (D-Score < 1 or VPS < 55%). Morphometric findings were closely compatible with routine WHO classification made by one expert pathologist; however; diagnosis of (CH) and (AH) made by other pathologists were not concordant with morphometric data.</p> <p>Conclusion</p> <p>It may be necessary to make some revisions in WHO classification for endometrial hyperplasia and precancerous lesions.</p

Efficiency of an inexpensive liquid-based cytology performed by cytocentrifugations: a comparative study using the histology as reference standard

BACKGROUND: Although liquid-based cytology (LBC) is now recommended for cervical cancer screening, it requires expensive automated devices and materials. To evaluate the efficiency of inexpensive LBC methods relying on an inexpensive fixative liquid, Easyfix(®), we compared the results obtained by the liquid-based cytology (LBC) diagnoses performed by cytocentrifugations (Papspin(® )and Turbitec(®)) with those obtained by histology. Furthermore, we evaluated the efficiency of the fixative liquid, Easyfix(®), to preserve HPV DNA in the collected samples. METHOD: 266 LBC were compared with 174 colposcopies and 91 Loop Electrosurgical Excision Procedure (LEEP). Among the LBC, 51 were performed using the Papspin(® )system and 215 were performed using the Turbitec(® )system. To control the quality of the preservation liquid, Easyfix(®), we correlated the results of HCII assays with those of HPV PCR. RESULTS: For Papspin(® )and Turbitec(® )systems, the sensitivities were respectively 82.6% (95% CI: 61.2–95.0%, p < 0.001) and 75.0% (95% CI: 64.4–89.8%, p < 0.001) and the specificities were 92.6% (95%CI: 76.5–99.1%, p < 0.001) and 96.2% (95% CI: 91.3–98.7%, p < 0.001). We find no statistical difference between the results of the both systems (p = ns). The sensitivity of the HCII was 86.4% (95% IC: 77.4–92.8%, p < 0.001) and the specificity was 39.4% (95% CI: 31.2–48.1%, p < 0.001). The comparison between HCII and HPV-PCR shows a good correlation: the kappa was 0.89. CONCLUSION: LBC performed by cytocentrifugations are inexpensive, reduce inadequate smears, show excellent efficiency and allow HPV detection by molecular biology

Performance of the DNA-citoliq liquid-based cytology system compared with conventional smears

To evaluate the performance of a new, manual, simplified liquid-based system, DNA-Citoliq (Digene Brasil), employed under routine conditions as compared to conventional smears collected from six collaborating private laboratories. Methods: A panel of cytopathologists, who served as the gold standard diagnosis, adjudicated discordant opinions. Results: Of 3206 pairs of slides considered valid for comparison, there were 3008 in full agreement (93.8%), 112 (3.5%) with one diagnostic category discrepancies, and 86 (2.7%) discordant cases. Among the 288 borderline+ by either method, DNA-Citoliq detected abnormalities in 243 (84.4%), and conventional smears (CS) detected abnormalities in 178 (61.8%) (McNemar test, P < 0.000), a 36.5% increased detection of borderline+ cases. Conclusions: For mild dyskaryosis, DNA-Citoliq detected 176 cases and CS 125 cases (McNemar test, P < 0.000); and for moderate+severe dyskaryosis 66 versus 32 cases respectively (McNemar test, P < 0.000)

Conventional Cytological Smear Versus Liquid Based Preparation (E-PREP) in Non Gynaecological Samples

BACKGROUND AND OBJECTIVE: Fine needle cytology (FNC) has gained tremendous popularity in recent times among clinicians and pathologist. Liquid based cytology is a new technology for fine needle aspiration samples. It is used for mainly for cervical cancer screening, now also used for non gynaecolgical samples. E-PREP system is a Liquid based cytology processor with patent dual membrane filters. In this method able to collect large number of cells and make a monolayer preparation of cells with good cytological details. In LBP easier collection and transport of samples, standardized preparation, adequate cellularity, rapid fixation, even and monolayer distribution of cells, good preservation of cell morphology and increase clarity of nuclear feature, decreased obscuring background elements, decreased air drying artefacts. Disadvantages of LBP are decreased and altered background material like necrosis, blood and inflammation, decreased and altered extracellular elements like mucin, colloid and stroma, disrupted cellular architecture like fragmentation of papillae, size of the cell smaller than conventional preparation. In this study thyroid, breast and lymphnode lesions (each 30 cases) are compared with both techniques of FNAC and Liquid based preparation (E-PREP) in non gynaecological samples. MATERIALS AND METHODS: This study is a prospective study conducted at Goschen Institute of Pathology, Madras Medical College and Rajiv Gandhi Government General Hospital Chennai, during the year 2014 (February 2014 to July 2014). This study included samples obtained from 90 patients who attended for cytology department for FNAC of thyroid, breast and lymphnode lesions. Collection of clinical data of patients attending the cytology department for FNAC for thyroid, breast and lymphnode lesions and preparing CSs & LBP. RESULTS: Smears were prepared by both methods. On analysing smears in thyroid lesion adequate smears more in CS method, superior quality smears more from LBP method and equal number diagnostically unsuitable smears from each methods of smear preparation, in breast lesions adequate smears more in LBP method, superior quality smears more from CS method and diagnostically unsuitable smears more from LBP method of smear preparation and in lymphnode lesion adequate smears more in LBP method, superior quality smears more from CS method and diagnostically unsuitable smears more from LBP method of smear preparation. On analysing and comparing average score obtained by both methods (CS & LBP) in thyroid, breast and lymphnode lesions and the P value calculated by Pearson Chi-Square test, the difference was found to be statistically insignificant P> 0.05. CONCLUSION: The decision to make, use either Conventional method or LBP may be depends on basis of nature of the lesion ( solid or cystic) and other ancillary tests to perform in the sample &each method has its own advantages and disadvantages and both methods can be combined to obtain a superior quality smears and lower the failure rates