Experiences with Digital Cytology

Digital cytology has recently been launched by multiple commercial laboratories for use in practices, with marketing emphasizing speed of analysis and results compared to the traditional practice of submitting glass slides. This presentation will review the basic principles of slide scanning in practice and commercial laboratories, training required for personnel doing digital slide scanning, time required and maintenance and cleaning of scanners. Factors that influence the quality of the results obtained include the type of collection, type of cytologic preparation, quality of the cytologic preparation, staining, choice of slides for submission (for whole slide scanning) or selection or regions of interest (for regional scanning of slides), the number of slides or scans submitted, the quality of the scan itself, and the training and experience of the viewing clinical pathologist. Positive feedback from practices using digital scanning systems has included high satisfaction with the speed and quality of reports, ability to communicate by chat messaging regarding satisfactory or unsatisfactory scans or other information, help with improving cytologic preparations and staining, and ability to obtain second opinions rapidly. Some practices did not feel that scanning systems were an asset for their practice due to the time commitment for technicians/nurses, and the fact that the speed of results often was not of optimal value due to delays in other types of testing needed to make a complete assessment.  Examples of scanned slides, artifacts, problems and solutions will be provided.