Welcome to the Cytology Research Home page.

The Cytology Laboratory at the IMVS has a keen interest in research relating to automated techniques and quality control procedures.

Recent research initiatives:

• Evaluation of the CytoRich© technique for cervical smears
• Effectiveness of automated cervical cytology rescreening using the AutoPap® 300 QC system
• Efficacy of AutoPap Location Guided Screening in Cervical Cytology Screening

Evaluation of the CytoRich® technique for cervical smears
The aim of the study was to assess the ability of the CytoRich® System to prepare optimal gynaecological smears for diagnosis. The diagnostic results obtained from evaluating 1,325 matched slide pairs, prepared using conventional methods and thin layer technology, were compared. Despite a number of diagnostic pitfalls associated with the interpretation of thin-layer smears, these preparations were easier and faster to screen and showed well-preserved and evenly-distributed cells.

Effectiveness of automated cervical cytology rescreening using the AutoPap® 300 QC system
This study assesses the performance of the AutoPap 300 QC system in identifying false negative (FN) smears in a slide population previously screened as normal and to compare the detection rate to that achieved with a random rescreen of the same slide population. A total of 1,840 'normal' smears were rescreened both manually and by the AutoPap 300 QC system. The study demonstrated that the AutoPap 300 QC system is superior to human random rescreen for the identification of FN smears, although the sample was small. The device also has the potential to improve the accuracy of specimen adequacy determination and serve as a useful adjunct to existing quality-control measures designed to monitor individual performance and reporting accuracy.

Efficacy of AutoPap® Location Guided Screening in Cervical Cytology Screening
A two-armed retrospective study of 6,000 smears was undertaken to test the hypothesis that AutoPap® LGS Practice is at least equivalent to the Current Laboratory Practice when detecting all abnormal (low grade epithelial abnormality or worse) slides. LGS is a feature of the AutoPap screening system. Following processing a slide image or PapMap is produced. This PapMap shows 15 areas or Field of Views (FOV) most likely to contain an abnormal finding. If examination of these areas reveals no suspicious finding, then this obviates the need for a full slide review. The slides are also assigned a numerical rank depending on the probability that the slide contains an abnormal finding. For the study, 6,000 previously screened slides were retrieved from recent archives. The slides were processed on the AutoPap System and screened by cytotechnologists who were guided by the field of view (FOV) locations provided. The screening results were compared with current practice. Discrepant diagnoses between the two study arms were subject to an internal discrepancy review process to determine the final truth diagnosis. The ability of the system to accurately rank smears with abnormalities was also determined. Preliminary results suggest that LGS is equivalent to current practice for the detection of high grade and suspected high-grade smears. However, LGS practice was not equivalent to current practice for the detection of low grade abnormalities and unsatisfactory smears; the presence of an endocervical component and infectious organisms. Slide ranking were found to be of value in the triage of high grade and suspected high grade smears facilitating the prompt reporting of these abnormalities. Further studies assessing the usefulness of this software is being undertaken. An AutoPap System was lent by TriPath Imaging for the laboratory to undertake this research study.

Mark W Stevens, Amanda J Milne, Walter W Nespolon, Ian Parkinson, Nicola Fazzalari, N Arora, T Dodd