Telecytology in the diagnosis of pleural effusion smears

ABSTRACT

Telecytologic diagnosis of pleural effusion smears is potentially useful because it could allow more efficient use of cytopathologist resources and expertise. The purpose of our investigation was to evaluate how well this type of review correlates with a review which the entire silde is available for examination by the. pathologist. 35 pleural effusion smears with different diagnosis were selected retrospectively. they includ 16 benign, 5 suspiicious for malignancy and 14 malignant which were confirmed with two expert cytopathologists. for each slide number 3 to 11 fields containing abnormal cells were digitaly imaged. Pathologists reviewed all glass slides and digitized images individually. Diagnoses based on selected digitized images were compared with those based on conventional review. The kappa static, a measure of chance-corrected agreement [reroducibility], was calculated in each setting. The interobserver kappa value for the 3 observe for the slides was 76%. The interobserver kappa value for the digital images was 67%. The disagreement between a pathologist's glass slide and digital dignose [mean intraobserver kappa value = 73%] is greate than that or different pathologists reviewing glass slides [mean slide interobserverr kappa value= 76%]. Overall, intraobserver and intreobserrver reproducibility of pleural effusion slides [consists of direct smear after centrifugation and cytospin preparation] diagnoses is good to excellent