{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:51:03Z","timestamp":1791273063641,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytopathology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Pancreatic malignancies present major diagnostic challenges. The gold standard for diagnosis is endoscopic ultrasound\u2010guided fine\u2010needle aspiration (\n                      <jats:styled-content style=\"fixed-case\">FNA<\/jats:styled-content>\n                      ) with cytopathological assessment. Workforce shortages have driven interest in computer\u2010assisted diagnosis (\n                      <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n                      ) to improve efficiency. However, its overall diagnostic impact in pancreatic cytology remains unclear. We evaluated the accuracy of\n                      <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n                      in this setting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis. Five databases were searched (January 2010\u2013May 2025) for studies applying CAD to pancreatic FNA cytology. Two reviewers independently screened studies, with risk of bias assessed using QUADAS\u20102. Random\u2010effects bivariate models generated pooled sensitivity, specificity, and summary receiver\u2010operating\u2010characteristic (SROC) curves. Studies were analysed according to the unit of analysis: image\u2010level studies generated predictions from individual cytopathological images, whereas patient\/case\u2010level studies integrated multiple images per case to produce a single diagnostic output.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies met eligibility criteria and provided quantitative data. At the image\u2010level, pooled sensitivity and specificity were 91% [95% confidence interval: 86\u201394] and 92% [87\u201396], respectively, with a\n                      <jats:styled-content style=\"fixed-case\">SROC<\/jats:styled-content>\n                      area under the curve (\n                      <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>\n                      ) of 0.962. At the patient\/case\u2010level, pooled sensitivity and specificity were 85% [69\u201393] and 91% [73\u201397], respectively, with an\n                      <jats:styled-content style=\"fixed-case\">SROC AUC<\/jats:styled-content>\n                      of 0.919. Heterogeneity was high (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200965%\u201393%), driven by retrospective designs and variable reference standards.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CAD tools achieve near\u2010expert accuracy for definitive diagnoses, reducing routine screening burdens and accelerating surgical planning. However, selection bias, single\u2010centre training and inconsistent thresholds limit generalisability. Prospective multi\u2010centre validation using whole\u2010slide workflows is warranted, and telepathology integration could expand low\u2010resource access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Print Synopsis (For \u2018Inside This Month's Cytopathology\u2019)<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis shows that computer\u2010assisted diagnosis for pancreatic EUS\u2010FNA cytology achieves high accuracy in distinguishing benign from malignant lesions, with pooled sensitivity up to 91% and specificity up to 92%. Current evidence is dominated by retrospective and curated image\u2010level studies, highlighting the need for prospective multicentre validation using whole\u2010slide workflows before routine clinical adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweet\u2010Length Synopsis<\/jats:title>\n                    <jats:p>Computer\u2010assisted diagnosis for pancreatic EUS\u2010FNA cytology shows promising accuracy in this systematic review and meta\u2010analysis, but current evidence is still limited by retrospective, curated datasets. Considerable prospective multicentre validation in real\u2010world whole\u2010slide workflows is needed before clinical adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cyt.70092","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T03:59:46Z","timestamp":1779854386000},"page":"587-602","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["What Are Computer\u2010Assisted Methods Achieving in Fine\u2010Needle Aspiration Cytology of the Pancreas? A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3642-3392","authenticated-orcid":false,"given":"Al\u2010Amaan","family":"Mohamed Mirzan","sequence":"first","affiliation":[{"name":"Imperial College School of Medicine Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Dina","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4021\/wjon.v10i1.1166"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201073525\u2010y"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30974\u20100"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.25259\/ijmr_1729_23"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v7.i4.318"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u20101010273"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.71.845.9691893"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/EUS\u2010D\u201021\u201000119"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010020\u201002894\u20106"},{"key":"e_1_2_10_12_1","unstructured":"Meeting\u2010Pathology\u2010Demand\u2010Histopathology\u2010Workforce\u2010Census\u20102018.pdf accessed April 25 2025 https:\/\/www.rcpath.org\/static\/952a934d\u20102ec3\u201048c9\u2010a8e6e00fcdca700f\/Meeting\u2010Pathology\u2010Demand\u2010Histopathology\u2010Workforce\u2010Census\u20102018.pdf."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253876"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.4337"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2011\u20100188\u2010OA"},{"key":"e_1_2_10_16_1","unstructured":"Covidence Systematic Review Software accessed December 15 2025 https:\/\/www.covidence.org."},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11517\u2010024\u201003045\u20108"},{"key":"e_1_2_10_18_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2025"},{"key":"e_1_2_10_19_1","volume-title":"RStudio: Integrated Development Environment for R","author":"Posit Team","year":"2025"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","unstructured":"Sousa\u2010Pinto PD With Contributions From B. Mada: Meta\u2010Analysis of Diagnostic Accuracy(2022) https:\/\/doi.org\/10.32614\/CRAN.package.mada.","DOI":"10.32614\/CRAN.package.mada"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"e_1_2_10_23_1","volume-title":"readxl: Read Excel Files","author":"Wickham H.","year":"2025"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.01686"},{"key":"e_1_2_10_25_1","volume-title":"caTools: Tools: Moving Window Statistics, GIF, Base64, ROC AUC, etc","author":"Tuszynski J.","year":"2024"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2022.104022"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-16-2102-4_42"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201072312\u20103"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.04.1946"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105085(20)30723\u2010X"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.25259\/Cytojournal_61_2022"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/eus.eus_9_19"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16073"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21915"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6335"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201042045\u2010w"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12051149"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1109\/JBHI.2023.3234289"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2023.107969"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2019.08.153"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2024.02.001"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12020434"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010025\u201013910\u2010w"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105085(21)00792\u20107"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.04.654"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.03.436"}],"container-title":["Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70092","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cyt.70092","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cyt.70092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:57:01Z","timestamp":1791269821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cyt.70092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":45,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/cyt.70092"],"URL":"https:\/\/doi.org\/10.1111\/cyt.70092","archive":["Portico"],"relation":{},"ISSN":["0956-5507","1365-2303"],"issn-type":[{"value":"0956-5507","type":"print"},{"value":"1365-2303","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2026-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}