%0 Journal Article %J Acta Cytol %D 2014 %T Making cytological diagnoses on digital images using the iPath network. %A Dalquen, Peter %A Savic Prince, Spasenija %A Spieler, Peter %A Kunze, Dietmar %A Neumann, Heinrich %A Eppenberger-Castori, Serenella %A Adams, Heiner %A Glatz, Katharina %A Bubendorf, Lukas %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Child %K Child, Preschool %K Computers, Handheld %K Cytodiagnosis %K Diagnosis, Differential %K Female %K Humans %K Hyperplasia %K Infant %K Male %K Metaplasia %K Middle Aged %K Neoplasms %K Observer Variation %K Reproducibility of Results %K Sensitivity and Specificity %K Telemedicine %X

BACKGROUND: The iPath telemedicine platform Basel is mainly used for histological and cytological consultations, but also serves as a valuable learning tool.

AIM: To study the level of accuracy in making diagnoses based on still images achieved by experienced cytopathologists, to identify limiting factors, and to provide a cytological image series as a learning set.

METHOD: Images from 167 consecutive cytological specimens of different origin were uploaded on the iPath platform and evaluated by four cytopathologists. Only wet-fixed and well-stained specimens were used. The consultants made specific diagnoses and categorized each as benign, suspicious or malignant.

RESULTS: For all consultants, specificity and sensitivity regarding categorized diagnoses were 83-92 and 85-93%, respectively; the overall accuracy was 88-90%. The interobserver agreement was substantial (κ = 0.791). The lowest rate of concordance was achieved in urine and bladder washings and in the identification of benign lesions.

CONCLUSION: Using a digital image set for diagnostic purposes implies that even under optimal conditions the accuracy rate will not exceed to 80-90%, mainly because of lacking supportive immunocytochemical or molecular tests. This limitation does not disqualify digital images for teleconsulting or as a learning aid. The series of images used for the study are open to the public at http://pathorama.wordpress.com/extragenital-cytology-2013/.

%B Acta Cytol %V 58 %P 453-60 %8 2014 %G eng %N 5 %R 10.1159/000369241