Digital Examination of LYmph node CYtopathology Using the Sydney system (DELYCYUS): An international, multi-institutional study.
digital cytopathology
lymph node
reproducibility
virtual microscopy
whole-slide imaging
Journal
Cancer cytopathology
ISSN: 1934-6638
Titre abrégé: Cancer Cytopathol
Pays: United States
ID NLM: 101499453
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
20
03
2023
received:
05
02
2023
accepted:
10
04
2023
medline:
3
11
2023
pubmed:
7
7
2023
entrez:
7
7
2023
Statut:
ppublish
Résumé
After a series of standardized reporting systems in cytopathology, the Sydney system was recently introduced to address the need for reproducibility and standardization in lymph node cytopathology. Since then, the risk of malignancy for the categories of the Sydney system has been explored by several studies, but no studies have yet examined the interobserver reproducibility of the Sydney system. The authors assessed interobserver reproducibility of the Sydney system on 85 lymph node fine-needle aspiration cytology cases reviewed by 15 cytopathologists from 12 institutions in eight different countries, resulting in 1275 diagnoses. In total, 186 slides stained with Diff-Quik, Papanicolaou, and immunocytochemistry were scanned. A subset of the cases included clinical data and results from ultrasound examinations, flow cytometry immunophenotyping, and fluorescence in situ hybridization analysis. The study participants assessed the cases digitally using whole-slide images. Overall, the authors observed an almost perfect agreement of cytopathologists with the ground truth (median weighted Cohen κ = 0.887; interquartile range, κ = 0.210) and moderate overall interobserver concordance (Fleiss κ = 0.476). There was substantial agreement for the inadequate and malignant categories (κ = 0.794 and κ = 0.729, respectively), moderate agreement for the benign category (κ = 0.490), and very slight agreement for the suspicious (κ = 0.104) and atypical (κ = 0.075) categories. The Sydney system for reporting lymph node cytopathology shows adequate interobserver concordance. Digital microscopy is an adequate means to assess lymph node cytopathology specimens.
Sections du résumé
BACKGROUND
After a series of standardized reporting systems in cytopathology, the Sydney system was recently introduced to address the need for reproducibility and standardization in lymph node cytopathology. Since then, the risk of malignancy for the categories of the Sydney system has been explored by several studies, but no studies have yet examined the interobserver reproducibility of the Sydney system.
METHODS
The authors assessed interobserver reproducibility of the Sydney system on 85 lymph node fine-needle aspiration cytology cases reviewed by 15 cytopathologists from 12 institutions in eight different countries, resulting in 1275 diagnoses. In total, 186 slides stained with Diff-Quik, Papanicolaou, and immunocytochemistry were scanned. A subset of the cases included clinical data and results from ultrasound examinations, flow cytometry immunophenotyping, and fluorescence in situ hybridization analysis. The study participants assessed the cases digitally using whole-slide images.
RESULTS
Overall, the authors observed an almost perfect agreement of cytopathologists with the ground truth (median weighted Cohen κ = 0.887; interquartile range, κ = 0.210) and moderate overall interobserver concordance (Fleiss κ = 0.476). There was substantial agreement for the inadequate and malignant categories (κ = 0.794 and κ = 0.729, respectively), moderate agreement for the benign category (κ = 0.490), and very slight agreement for the suspicious (κ = 0.104) and atypical (κ = 0.075) categories.
CONCLUSIONS
The Sydney system for reporting lymph node cytopathology shows adequate interobserver concordance. Digital microscopy is an adequate means to assess lymph node cytopathology specimens.
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
679-692Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 The Authors. Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.
Références
Wakely PE. The diagnosis of non-Hodgkin lymphoma using fine-needle aspiration cytopathology. Cancer Cytopathol. 2010;118(5):238-243. doi:10.1002/cncy.20106
Wang H, Hariharan VS, Sarma S. Diagnostic accuracy of fine-needle aspiration cytology for lymphoma: a systematic review and meta-analysis. Diagn Cytopathol. 2021;49(9):975-986. doi:10.1002/dc.24800
Cozzolino I, Giudice V, Mignogna C, Selleri C, Caputo A, Zeppa P. Lymph node fine-needle cytology in the era of personalised medicine. Is there a role? Cytopathology. 2019;30(4):348-362. doi:10.1111/cyt.12708
Shyu S, Rajgariah A, Saoud C, Rogers N, Ali SZ. Image-guided lymph node fine needle aspiration: the Johns Hopkins Hospital experience. J Am Soc Cytopathol. 2021;10(6):543-557. doi:10.1016/j.jasc.2021.04.004
Pizzi M, Agostinelli C, Santoro L, et al. Lymph node core needle biopsy for the diagnosis of lymphoproliferative disorders: a word of caution. Eur J Haematol. 2021;106(5):737-739. doi:10.1111/ejh.13578
Al-Abbadi M, Barroca H, Bode-Lesniewska B, et al. Letter to the Editor: Fine-needle aspiration cytology and core-needle biopsy in the diagnosis of lymphadenopathies: words of endorsement. Eur J Haematol. 2021;107(2):295-296. doi:10.1111/ejh.13646
Al-Abbadi MA, Barroca H, Bode-Lesniewska B, et al. A proposal for the performance, classification, and reporting of lymph node fine-needle aspiration cytopathology: the Sydney system. Acta Cytol. 2020;64(4):306-322. doi:10.1159/000506497
Torres Rivas HE, Villar Zarra KV, Pérez Pabón LA, et al. Ultrasound-guided fine-needle aspiration of superficial lymphadenopathy performed by interventional pathologists: the applicability of the Sydney system from 2 years of experience and 363 cases. Acta Cytol. 2021;65(6):453-462. doi:10.1159/000517314
Vigliar E, Acanfora G, Iaccarino A, et al. A novel approach to classification and reporting of lymph node fine-needle cytology: application of the proposed Sydney system. Diagnostics (Basel). 2021;11(8):1314. doi:10.3390/diagnostics11081314
Caputo A, Ciliberti V, D’Antonio A, et al. Real-world experience with the Sydney system on 1458 cases of lymph node fine needle aspiration cytology. Cytopathology. 2021;33(2):166-175. doi:10.1111/cyt.13079
Gupta P, Gupta N, Kumar P, et al. Assessment of risk of malignancy by application of the proposed Sydney system for classification and reporting lymph node cytopathology. Cancer Cytopathol. 2021;129(9):701-718. doi:10.1002/cncy.22432
Makarenko VV, DeLelys ME, Hasserjian RP, Ly A. Lymph node FNA cytology: diagnostic performance and clinical implications of proposed diagnostic categories. Cancer Cytopathol. 2022;130(2):144-153. doi:10.1002/cncy.22523
Bueno AP, Palu RF, Dalcin JF, et al. Accuracy of fine-needle aspiration of lymph nodes: a cancer center’s experience. Cytopathology. 2021;33(1):114-118. doi:10.1111/cyt.13057
Fraggetta F, Pantanowitz L. Going fully digital: utopia or reality? Pathologica. 2018;110(1):1-2.
Bonsembiante F, Martini V, Bonfanti U, Casarin G, Trez D, Gelain ME. Cytomorphological description and intra-observer agreement in whole slide imaging for canine lymphoma. Vet J. 2018;236:96-101. doi:10.1016/j.tvjl.2018.04.020
Martini V, Marano G, Aresu L, et al. Performance of lymph node cytopathology in diagnosis and characterization of lymphoma in dogs. J Vet Intern Med. 2022;36(1):204-214. doi:10.1111/jvim.16326
da Cunha Santos G, Saieg MA, Troncone G, Zeppa P. Cytological preparations for molecular analysis: a review of technical procedures, advantages and limitations for referring samples for testing. Cytopathology. 2018;29(2):125-132. doi:10.1111/cyt.12534
Lee RE, McClintock DS, Laver NM, Yagi Y. Evaluation and optimization for liquid-based preparation cytology in whole slide imaging. J Pathol Inform. 2011;2(1):46. doi:10.4103/2153-3539.86285
Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull. 1971;76(5):378-382. doi:10.1037/h0031619
Zarbo RJ, Varney RC, Copeland JR, D’Angelo R, Sharma G. Daily management system of the Henry Ford Production System: QTIPS to focus continuous improvements at the level of the work. Am J Clin Pathol. 2015;144(1):122-136. doi:10.1309/AJCPLQYMOFWU31CK
Layfield LJ, Wang G, Yang ZJ, Gomez-Fernandez C, Esebua M, Schmidt RL. Interobserver agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology. Acta Cytol. 2020;64(5):413-419. doi:10.1159/000506757
Lueck N, Jensen C, Cohen MB, Weydert JA. Mandatory second opinion in cytopathology. Cancer Cytopathol. 2009;117(2):82-91. doi:10.1002/cncy.20019
Bomeisl PE Jr, Alam S, Wakely PE Jr. Interinstitutional consultation in fine-needle aspiration cytopathology. Cancer Cytopathol. 2009;117(4):237-246. doi:10.1002/cncy.20037
Bailey GE, Graham A, Kahler J, et al. The value of second-opinion consultation in nongynecologic cytopathology. Am J Clin Pathol. 2022;157(5):724-730. doi:10.1093/ajcp/aqab182
Layfield LJ, Yang Z, Vazmitsel M, Zhang T, Esebua M, Schmidt R. The international system for serous fluid cytopathology: interobserver agreement. Diagn Cytopathol. 2022;50(1):3-7. doi:10.1002/dc.24900
Layfield LJ, Esebua M, Yang Z, Vatzmitsel M, Giorgadze T, Schmidt R. The Milan System for Reporting Salivary Gland Cytopathology: a study of inter-observer reproducibility. Diagn Cytopathol. 2019;47(8):765-768. doi:10.1002/dc.24187
Jin M, Wakely PE Jr. Lymph node cytopathology: essential ancillary studies as applied to lymphoproliferative neoplasms. Cancer Cytopathol. 2018;126(suppl 8):615-626. doi:10.1002/cncy.22013
Astvatsaturyan K, Ramazyan A, Bose S. Is ultrasound-guided fine needle aspiration biopsy of axillary lymph nodes a viable alternative to sentinel lymph node biopsy? Diagn Cytopathol. 2021;49(10):1099-1109. doi:10.1002/dc.24824
Kahramangil B, Kose E, Donmez M, et al. Efficacy of surgeon-performed, ultrasound-guided lymph node fine needle aspiration in patients with thyroid pathologic conditions. Surgery. 2018;164(4):657-664. doi:10.1016/j.surg.2018.05.036
Acanfora G, Iaccarino A, Dello Iacovo F, et al. A roadmap for a comprehensive diagnostic approach to fine needle cytology of lymph node metastases. Cytopathology. 2022;33(6):668-677. doi:10.1111/cyt.13172
Arcila ME, Yang SR, Momeni A, et al. Ultrarapid EGFR mutation screening followed by comprehensive next-generation sequencing: a feasible, informative approach for lung carcinoma cytology specimens with a high success rate. JTO Clin Res Rep. 2020;1(3):100077. doi:10.1016/j.jtocrr.2020.100077
Caputo A, D’Ardia A, Sabbatino F, et al. Testing EGFR with Idylla on cytological specimens of lung cancer: a review. Int J Mol Sci. 2021;22(9):4852. doi:10.3390/ijms22094852
Eccher A, Girolami I. Current state of whole slide imaging use in cytopathology: pros and pitfalls. Cytopathology. 2020;31(5):372-378. doi:10.1111/cyt.12806
Girolami I, Pantanowitz L, Marletta S, et al. Diagnostic concordance between whole slide imaging and conventional light microscopy in cytopathology: a systematic review. Cancer Cytopathol. 2019;128(1):17-28. doi:10.1002/cncy.22195
Gerhard R, Teixeira S, Gaspar da Rocha A, Schmitt F. Thyroid fine-needle aspiration cytology: is there a place to virtual cytology? Diagn Cytopathol. 2013;41(9):793-798. doi:10.1002/dc.22958
Fraggetta F, L'Imperio V, Ameisen D, et al. Best practice recommendations for the implementation of a digital pathology workflow in the anatomic pathology laboratory by the European Society of Digital and Integrative Pathology (ESDIP). Diagnostics. 2021;11(11):2167. doi:10.3390/diagnostics11112167
Stathonikos N, Nguyen TQ, Spoto CP, Verdaasdonk MAM, Diest PJ. Being fully digital: perspective of a Dutch academic pathology laboratory. Histopathology. 2019;75(5):621-635. doi:10.1111/his.13953
Fraggetta F, Caputo A, Guglielmino R, Pellegrino MG, Runza G, L'Imperio V. A survival guide for the rapid transition to a fully digital workflow: the “Caltagirone example.” Diagnostics (Basel). 2021;11(10):1916. doi:10.3390/diagnostics11101916
Baidoshvili A, Stathonikos N, Freling G, et al. Validation of a whole-slide image-based teleconsultation network. Histopathology. 2018;73(5):777-783. doi:10.1111/his.13673
Caputo A, Gibilisco F, Belmonte B, Mondello A, L’Imperio V, Fraggetta F. Real-world digital pathology: considerations and ruminations of four young pathologists. J Clin Pathol, 2022;76(1):68-70. doi:10.1136/jclinpath-2022-208218
Caron JE, Ying Y, Ye Q, Cheng L, Rao JY. International telecytology: current applications and future potential. Diagn Cytopathol. 2018;47(1):28-34. doi:10.1002/dc.23960
Marini N, Marchesin S, Otálora S, et al. Unleashing the potential of digital pathology data by training computer-aided diagnosis models without human annotations. NPJ Digital Med. 2022;5(1):102. doi:10.1038/s41746-022-00635-4
Antonini P, Santonicco N, Pantanowitz L, et al. Relevance of the College of American Pathologists guideline for validating whole slide imaging for diagnostic purposes to cytopathology. Cytopathology. 2023;34(1):5-14. doi:10.1111/cyt.13178
Sanghvi AB, Allen EZ, Callenberg KM, Pantanowitz L. Performance of an artificial intelligence algorithm for reporting urine cytopathology. Cancer Cytopathol. 2019;127(10):658-666. doi:10.1002/cncy.22176
Flach RN, Fransen NL, Sonnen AFP, et al. Implementation of artificial intelligence in diagnostic practice as a next step after going digital: the UMC Utrecht perspective. Diagnostics (Basel). 2022;12(5):1042. doi:10.3390/diagnostics12051042
da Cunha Santos G, Ko HM, Saieg MA, Geddie WR. “The petals and thorns” of ROSE (rapid on-site evaluation). Cancer Cytopathol. 2013;121(1):4-8. doi:10.1002/cncy.21215
Lin O, Rudomina D, Feratovic R, Sirintrapun SJ. Rapid on-site evaluation using telecytology: a major cancer center experience. Diagn Cytopathol. 2019;47(1):15-19. doi:10.1002/dc.23925
Faquin WC, Rossi ED, Baloch Z, et al., eds. The Milan System for Reporting Salivary Gland Cytopathology. Springer Cham; 2018.
Rosenthal DL, Wojcik EM, Kurtycz DF, eds. The Paris System for Reporting Urinary Cytology. Springer International Publishing AG; 2016.