Implementation of Static Telecytology Applications for Remote Evaluation of Salivary Glands Fine Needle Aspiration Specimens

Introduction

Modern cytopathology laboratories have to provide results of high quality and credibility. Over the last decade, the practice of clinical cytopathology was dramatically influenced by the broad implementation of informatics and computer sciences into the laboratory workflow. Cytopathology laboratories wishing to achieve an automated and seamless workflow process, to diminish turn-around times and improve their diagnostic accuracy have successfully adopted information technologies and automation. New types of cameras and microscopes, connected to computers made possible image capture and transmission (telecytology) (Archondakis, 2020; Archondakis, 2021; Chantziantoniou et al., 2017). The comprehensive implementation became a necessity in cytopathology which is dictated by the need for real-time results.

A telemedical application is a valuable tool for cytopathologists to manage and promote interlaboratory collaboration. The result is better cytological data management and sharing (Archondakis, 2020; Archondakis, 2021; Chantziantoniou et al., 2017).

Remote cytological diagnosis can nowadays be achieved:

• 1.

  Either with the use of cytological pictures viewed in real-time from the microscope (dynamic telecytological systems); or

• 2.

  With the use of cytological images that are first captured in a digital format and then transmitted using a store-and-forward approach to distant observers (static telecytological systems) (Caron et al., 2019).

Telecytological diagnoses should be as reliable as those made using conventional microscopy. (Archondakis, 2020; Archondakis, 2021; Caron et al., 2019).

The existing studies which focused on the possible impact of static telecytology in the everyday laboratory's workflow have detected a high (around 90%) concordance between telecytological and glass slide diagnoses (Brooker et al., 2019; Chantziantoniou et al., 2017).

So far, there are very few studies that have focused on the implementation of digital images, captured by static telecytology stations. The present study evaluates the diagnostic cytology reproducibility among three cytopathologists. It uses salivary glands aspiration specimens. Representative images were captured by a static telecytology station and examine the agreement between the contributor's and the reviewer's diagnoses.

Background

The management of salivary lesions varies based on the underlying histology. Preoperative diagnosis can guide the decision for surgery and extent of resection. Surgery is often not indicated for non-neoplastic salivary gland lesions, for metastatic cancer and malignant lymphoproliferative disease (Ashraf et al., 2010; Colella et al., 2010). FNA consists of a well-recognized safe, accurate, and cost-effective method for an immediate evaluation of salivary gland lesions which can improve and facilitate patients clinical management by providing valuable information concerning the nature of the lesion examined (Ashraf et al., 2010).