Telecytopathology for Rapid Preliminary Diagnosis of Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodules.
Ismatun N Swati, Roberto Izquierdo, Rohini Kasturi, Kamal K Khurana. SUNY Upstate Medical University, Syracuse, NY
Background: Onsite evaluation of ultrasound-guided fine needle aspiration (USGFNA) is essential to procure adequate samples and provide initial assessment. We present our experience with onsite evaluation of USGFNA using telecytopathology.
Design: Real time images of Diff Quik stained cytology smears were obtained with an Olympus Digital camera attached to an Olympus CX41 microscope and transmitted via ethernet by cytotechnologist to a pathologist who rendered preliminary diagnosis while communicating with onsite cytotechnologist over the phone. Accuracy of preliminary diagnosis was compared with final diagnosis, retrospectively. Kappa statistic was used to compare agreements between telecytopathology preliminary diagnoses versus final diagnoses.
Results: A total of 51 patients (mean age 48.9 yr) underwent USG-FNA of 65 thyroid nodules. Preliminary diagnoses of benign, suspicious/ malignant and unsatisfactory were 77%, 5% and 18% respectively. Of the 50 cases initially reported as benign all remained benign on the final cytology. All suspicious / malignant cases on initial cytology corresponded with a malignant diagnosis on final cytology. Of the 12 cases that were initially interpreted as unsatisfactory only 2 were reclassified as benign on final diagnosis. There was excellent agreement between telecytopathology and final cytologic evaluation (Kappa value 85%). Presence of additional material on pap stained slides was the main reason for discrepancy accounting for two discrepant cases in the unsatisfactory category.
Conclusions: This retrospective study demonstrates onsite telecytopathology evaluation of thyroid USG-FNA is highly accurate compared with final cytologic evaluation. It allows pathologists to use their time more efficiently and makes onsite evaluation at a remote site possible.
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 186, Tuesday Afternoon