TeleCyP (Telecytopathology): Real-Time Fine-Needle Aspiration Interpretation

Abstract

Objective: To assess the application of TeleCyP for real-time fine-needle aspiration interpretation (RFI) necessary for case management and specimen triage. Study Design: Twenty-two endobronchial ultrasound (EBUS)-guided mediastinal and pulmonary cases were included in the learning phase to determine the time and efficiency of TeleCyP. Slides were scanned by a cytopathology fellow in real time, and high-speed transmitted images over a secure network were interpreted by a cytopathologist while maintaining audio communication. In the validation phase, an additional 38 pancreas cases from endoscopic ultrasound (EUS) were evaluated recapitulating the RFI scenario from the learning phase. The cytopathologist was blinded to the results of the diagnosis in both phases. Results: The time to provide assessment of specimen adequacy and a preliminary diagnosis was 53 s in the learning phase and 49 s in the validation phase. There was 100% correlation between RFI and TeleCyP assessment for specimen adequacy. TeleCyP particularly posed challenges in providing definitive interpretation on EUS-fine-needle aspiration of some of the pancreatic solid masses (11%, 4/36). Conclusion: TeleCyP can serve as a powerful alternative, time-efficient strategy to provide RFI, and for specimen triaging which is critical for personalized medicine and patient management.

Perspective on cells: Evolution of cytopathology and the University of Pennsylvania, Philadelphia PA

“…This unit also provides FNA services in areas of the thyroid, lung cancer, and the melanoma clinics. Besides being identified as an integral part of the patient care team, the cytopathology at the PeCAM offers several unique opportunities including organ focused sign out, point of care reporting, and is equipped to provide real time Telecytopathology services and training . One of us was designated (NJ) at the time to direct the functions of this unit so that the cytopathology section continues to expand its core offerings, develop services, and provide excellence in patient care services.…”

Rapid on-site evaluation with dynamic telecytopathology for ultrasound-guided fine-needle aspiration of head and neck nonthyroid lesions

“…However, most studies using dynamic telecytopathology have been retrospective. [91011] Only a few studies have focused on the application of dynamic telecytopathology for initial real-time on-site diagnosis in aspiration cytology and these have been restricted mainly to the pancreas, thyroid, lung, axillary lymph nodes, and mediastinum. [121314151617181920] There continues to be a need for other organ-based and body site-specific studies on the use of telecytology for immediate assessment of FNA to evaluate its pitfalls and limitations.…”

Telepathology in Cytopathology: Challenges and Opportunities

“…A variety of institutions and practices have described their experience with telepathology in the cytopathology laboratory [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. The aim of this article is to discuss the concepts and goals of telepathology, review the infrastructure necessary for implementation, and cover the necessary validation and regulatory requirements.…”