Integration of Digital Cytology in Quality Assurance Programs for Cytopathology

Background: Quality assurance (QA) and quality control (QC) are fundamental to maintaining high standards in cytopathologic diagnostics. The recent adoption of digital cytology (DC) has led to transformative changes in cytopathology workflows, including primary diagnosis, telecytopathology-based consultations, and rapid on-site evaluations (ROSEs). These technological developments call for a conceptual shift and redefinition of QA and QC frameworks in the DC era. Summary: This review explores the evolving landscape of QA and QC in cytopathology, with a focus on the integration of DC into existing quality systems. We examine the role of DC as both a QC tool and a platform for implementing DC-specific QA/QC protocols. Practical applications discussed include leveraging DC for conventional QA/QC tasks, such as education and training of laboratory staff and cytopathologists, and facilitating digital proficiency testing through cloud-based platforms. Additionally, we review current international recommendations for the adoption of DC in cytopathology and propose strategies for the safe and efficient management of digital environments. Key Messages: (i) DC is reshaping the practice of cytopathology and requires updated QA/QC strategies. (ii) DC can enhance QA/QC activities through improved training, proficiency testing, and collaborative diagnostics. (iii) The development and implementation of DC-specific protocols are essential for ensuring accuracy and reliability in digital cytopathologic practice.