Digital Applications in Cytopathology: Problems, Rationalizations, and Alternative Approaches.

Area of Science:

• Digital pathology
• Cytopathology
• Telemedicine

Background:

• Telecytology offers remote diagnostic capabilities but faces challenges in image quality and interpretation.
• Digital applications for telecytology require optimization for accurate examination, teaching, and consultation.

Purpose of the Study:

• To identify and address problems in digital telecytology applications across three institutions: KAMC, UNMC, and UPMC.
• To propose improved digital approaches for telecytology, enhancing diagnostic accuracy and educational effectiveness.

Main Methods:

• Assessed interpretive examination scores for high-grade squamous intraepithelial lesions (HSIL) using static digital images (SDI).
• Evaluated 2D and 3D whole-slide imaging (WSI) for teaching 3D cell cluster visualization.
• Examined streaming telecytology for cell visualization at UPMC.

Main Results:

• Composite SDI (CSDI) enhanced HSIL interpretation scores by integrating diagnostic criteria from multiple regions of interest (ROI).
• Multiplane focusing via z-stacked WSI improved visualization of 3D cell clusters for teaching and consultative telecytology.
• Robotic cell analysis facilitated consultative telecytology.

Conclusions:

• Effective cytomorphology visualization and multiplane focusing are crucial for virtual cytopathology, teaching, and telecytology.
• 2D and 3D imaging are critical for visualizing diagnostic criteria in telecytology.
• Panoptiq panoramic WSI with integrated z-stacked video clips provides optimal telecytology applications.