Utility of 2-D and 3-D Virtual Microscopy in Cervical Cytology Education and Testing

OBJECTIVE To evaluate the effectiveness of 3-D vs. 2-D virtual microscopy as adjuncts to education and assessment in cervical cytology. STUDY DESIGN Five cervical cytology slides were acquired in 2-D; then the identical area of the slide was acquired in 3-D, resulting in 2 sets of virtual slides for comparison with the original glass slide. Seventy-nine paid volunteer cytologists and cytotechnology students participated. Approximately half were sent the 2-D set of slides via the Web, and the others a 3-D set of slides on a DVD. Evaluators examined the virtual slides and committed to an interpretation. After receipt of the original glass slides, a second interpretation was made, if different from the virtual slide interpretation. RESULTS Diagnostic accuracy using virtual cytology slides was similar to that for glass slides (94% vs. 96%). There was no difference in diagnostic accuracy between 2-D and 3-D slides (p = 0.28); however, the ability to focus 3-D slides in the z-axis was strongly endorsed by the participants because of the uncertainty and frustration of having some cells out of focus on 2-D virtual slides. CONCLUSION There was consensus that virtual cervical cytology slides would be a useful augmentation to education and testing.

[1]  A. Praestgaard,et al.  Interobserver variability in subclassification of squamous intraepithelial lesions: Results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. , 1999, Archives of pathology & laboratory medicine.

[2]  Fred R. Dee,et al.  Implementation of virtual microscope slides in the annual pathobiology of cancer workshop laboratory. , 2003, Human pathology.

[3]  D. Petitti,et al.  The clinical significance of the poor correlation of cervical dysplasia and cervical malignancy with referral cytologic results. , 1999, American journal of obstetrics and gynecology.

[4]  Mark Sherman,et al.  The 2001 Bethesda System: terminology for reporting results of cervical cytology. , 2002, JAMA.

[5]  John Lough,et al.  Complete and rapid switch from light microscopy to virtual microscopy for teaching medical histology. , 2005, Anatomical record. Part B, New anatomist.

[6]  R N Taylor,et al.  CytoView. A prototype computer image-based Papanicolaou smear proficiency test. , 1999, Acta cytologica.

[7]  Virtual Slides for Teaching Histology and Pathology , 2005 .

[8]  Syed Z. Ali,et al.  Application of virtual microscopy in clinical cytopathology , 2001, Diagnostic cytopathology.

[9]  T Harris,et al.  Comparison of a virtual microscope laboratory to a regular microscope laboratory for teaching histology , 2001, The Anatomical record.

[10]  D A Silage,et al.  Digital image tiles: a method for the processing of large sections , 1985, Journal of microscopy.

[11]  R S Weinstein,et al.  Telepathology overview: from concept to implementation. , 2001, Human pathology.

[12]  I. Ramzy,et al.  Increased Detection of Epithelial Cell Abnormalities by Liquid-Based Gynecologic Cytology Preparations , 1998, Acta Cytologica.

[13]  T Gahm,et al.  Non-distorted assemblage of the digital images of adjacent fields in histological sections. , 1993, Analytical cellular pathology : the journal of the European Society for Analytical Cellular Pathology.

[14]  Mark H Stoler,et al.  New Bethesda terminology and evidence-based management guidelines for cervical cytology findings. , 2002, JAMA.

[15]  James Duncan,et al.  Integrated approach to teaching and testing in histology with real and virtual imaging , 2002, The Anatomical record.

[16]  Fred R. Dee,et al.  Virtual microscopy for learning and assessment in pathology , 2004, The Journal of pathology.