Hologic Thinprep Imaging System for Routine Urine Screening: Evaluation of Screening Time and Diagnostic Comparison
Karen Ferraro, Amanda Kanaracus, Elizabeth M Kurian. Memorial Medical Center, University of Massachusetts, Worcester, MA
Background: Automated screening has become essential in decreasing screening time and calculated workload for cytotechnologists' evaluation of Pap test slides. We propose the novel use of the same Hologic Thinprep Imaging System (Imager) for evaluation of urine with assessment of screening time and diagnostic outcome in comparison to routine Thinprep full manual review (FMR).
Design: In this prospective study, urine Thinprep pap stained slides were processed for diagnostic evaluation with consecutive Thinprep slides using the Hologic Imaging system pap staining kit (n=86). Clinical records for cytotechnologists and cytopathologists' diagnoses were reviewed with comparison to timed re-review of the same Thinprep urine slide by FMR (EMK) and Thinprep Imager-stained slides (KF, EMK). Routine practice prompts a FMR when the Thinprep Imaging system rejects screening of the slide or if a diagnostic category of atypical or greater is seen in the Imager designated 22 fields of view (FOV).
Results: Results indicate concordant diagnoses in 78% (67/86) up to 91% (78/86) if Imager-rejected samples are included. Categorical diagnostic changes based on the Imager- stained slide include negative to atypical (2); atypical to negative (3); non-diagnostic to negative (2); and negative to non-diagnostic (1). Cytotechnologist timed 22 FOV of 52 Imager-stained slides averaged 48 seconds per case; versus FMR of slides rejected by the Imaging system (11 cases, 12 sec/case) and FMR of 6 cases triggered by cytologic atypia or worse (84 sec/case). Cytopathologist full slide screening (n=86) of Thinprep urine slides was 48 sec/case versus 84 sec/case in Imager-stained urine slides.
Conclusions: Our data shows the advantages of using Hologic Thinprep Imaging System to decrease cytotechnologist screening time with comparable diagnostic outcome. In a large volume setting, where the majority of urine samples are negative, further study will be necessary to determine if the added testing costs is outweighed by the benefit of automated imaging system reductions in cytotechnologist time and calculated workload.
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 74, Tuesday Morning