{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T23:01:22Z","timestamp":1794351682014,"version":"4.9.0"},"reference-count":32,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:p>\n                    <jats:italic>Context<\/jats:italic>\n                    .\u2014Digital whole slide imaging is the anticipated future of anatomic pathology, where sign-out of glass slides will be replaced by scanned images. Whole slide imaging has been successfully used in surgical pathology, but its usefulness and clinical application have been limited in cytology for several reasons, including lack of availability of z-axis depth focusing and large file size. Recently, several systems have become available in the United States for whole slide imaging with z-axis technology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    .\u2014To determine the accuracy and efficiency of whole slide imaging, as compared with traditional glass slides, for use in cervicovaginal diagnostic cytology.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design<\/jats:italic>\n                    .\u2014Eleven cervicovaginal cytology cases (ThinPrep and SurePath) scanned at \u00d720, \u00d740, and \u00d740 z-stack magnifications using the BioImagene iScan Coreo Au 3.0 scanner were evaluated by 4 cytotechnologists and 3 pathologists in a blinded study. Different magnification scans were recorded as separate cases and presented in a randomized sequence. Corresponding glass slides were also reviewed. For each case, the diagnoses and total time to reach each diagnosis were recorded.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    .\u2014Diagnostic accuracy was higher and average time per case was lower with glass slides as compared with all digital images. Among the digital images, the \u00d740 or \u00d740 z-stack had the highest diagnostic accuracy and lowest interpretation time.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    .\u2014Whole slide imaging is a viable option for the purposes of teaching and consultations, and as a means of archiving cases. However, considering the large file size and total time to reach diagnosis on digital images, whole slide imaging is not yet ready for daily cervicovaginal diagnostic cytology screening use.\n                  <\/jats:p>","DOI":"10.5858\/arpa.2012-0430-oa","type":"journal-article","created":{"date-parts":[[2012,9,12]],"date-time":"2012-09-12T12:21:36Z","timestamp":1347452496000},"page":"618-624","source":"Crossref","is-referenced-by-count":83,"title":["Digital Slide Imaging in Cervicovaginal Cytology: A Pilot Study"],"prefix":"10.5858","volume":"137","author":[{"given":"Angela M.","family":"Wright","sequence":"first","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakula","family":"Dhurandhar","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Fairley","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Scheiber-Pacht","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhendu","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blythe K.","family":"Gorman","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Mody","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Coffey","sequence":"additional","affiliation":[{"name":"From the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"12","key":"i1543-2165-137-5-618-b01","series-title":"Hum Pathol","first-page":"1318","article-title":"Telecytology: intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears","volume":"32","author":"Alli\n              PM,","year":"2001","unstructured":"Alli\n              PM, \n            \n              Ollayos\n              CW, \n            \n              Thompson\n              LD, \n            et al\n          . Telecytology: intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears. Hum Pathol. 2001;32(12):1318\u20131322."},{"issue":"4","key":"i1543-2165-137-5-618-b02","series-title":"Cancer","first-page":"199","article-title":"A novel automated screening and interpretation process for cervical cytology using the internet transmission of low-resolution images: a feasibility study","volume":"105","author":"Eichhorn\n              JH,","year":"2005","unstructured":"Eichhorn\n              JH, \n            \n              Brauns\n              TA, \n            \n              Gelfand\n              JA, \n            \n              Crothers\n              BA, \n            \n              Wilbur\n              DC. \n          \n          A novel automated screening and interpretation process for cervical cytology using the internet transmission of low-resolution images: a feasibility study. Cancer. 2005;105(4):199\u2013206."},{"issue":"3","key":"i1543-2165-137-5-618-b03","series-title":"Am J Clin Pathol","first-page":"356","article-title":"Accuracy and reproducibility of telecytology diagnosis of cervical smears: a tool for quality assurance programs","volume":"119","author":"Lee\n              ES,","year":"2003","unstructured":"Lee\n              ES, \n            \n              Kim\n              IS, \n            \n              Choi\n              JS, \n            et al\n          . Accuracy and reproducibility of telecytology diagnosis of cervical smears: a tool for quality assurance programs. Am J Clin Pathol. 2003;119(3):356\u2013360."},{"issue":"1","key":"i1543-2165-137-5-618-b04","series-title":"Acta Cytol","first-page":"148","article-title":"Digital imagery\/telecytology: International Academy of Cytology Task Force summary: Diagnostic Cytology Towards the 21st Century: an international expert conference and tutorial","volume":"42","author":"O'Brien\n              MJ,","year":"1998","unstructured":"O'Brien\n              MJ, \n            \n              Takahashi\n              M, \n            \n              Brugal\n              G, \n            et al\n          . Digital imagery\/telecytology: International Academy of Cytology Task Force summary: Diagnostic Cytology Towards the 21st Century: an international expert conference and tutorial. Acta Cytol. 1998;42(1):148\u2013164."},{"key":"i1543-2165-137-5-618-b05","series-title":"Pathol Res Int","first-page":"264683","article-title":"Digital imaging in cytopathology","volume":"2011","author":"Khalbuss\n              WE,","year":"2011","unstructured":"Khalbuss\n              WE, \n            \n              Pantanowitz\n              L, \n            \n              Parwani\n              AV. \n          \n          Digital imaging in cytopathology. Pathol Res Int. 2011;2011:264683."},{"issue":"8","key":"i1543-2165-137-5-618-b06","series-title":"Hum Pathol","first-page":"1070","article-title":"Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology: the University Health Network experience","volume":"40","author":"Evans\n              AJ,","year":"2009","unstructured":"Evans\n              AJ, \n            \n              Chetty\n              R, \n            \n              Clarke\n              BA, \n            et al\n          . Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology: the University Health Network experience. Hum Pathol. 2009;40(8):1070\u20131081."},{"issue":"3","key":"i1543-2165-137-5-618-b07","series-title":"Semin Diagn Pathol","first-page":"160","article-title":"Frequently asked questions concerning the use of whole-slide imaging telepathology for neuropathology frozen sections","volume":"27","author":"Evans\n              AJ,","year":"2010","unstructured":"Evans\n              AJ, \n            \n              Kiehl\n              TR, \n            \n              Croul\n              S. \n          \n          Frequently asked questions concerning the use of whole-slide imaging telepathology for neuropathology frozen sections. Semin Diagn Pathol. 2010;27(3):160\u2013166."},{"issue":"5","key":"i1543-2165-137-5-618-b08","series-title":"Hum Pathol","first-page":"702","article-title":"Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study","volume":"43","author":"Al-Janabi\n              S,","year":"2012","unstructured":"Al-Janabi\n              S, \n            \n              Huisman\n              A, \n            \n              Vink\n              A, \n            et al\n          . Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study. Hum Pathol. 2012;43(5):702\u2013707."},{"issue":"12","key":"i1543-2165-137-5-618-b09","series-title":"Arch Pathol Lab Med","first-page":"1949","article-title":"Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations","volume":"133","author":"Wilbur\n              DC,","year":"2009","unstructured":"Wilbur\n              DC, \n            \n              Madi\n              K, \n            \n              Colvin\n              RB, \n            et al\n          . Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations. Arch Pathol Lab Med. 2009;133(12):1949\u20131953."},{"key":"i1543-2165-137-5-618-b10","series-title":"Cytojournal","first-page":"6","article-title":"The impact of digital imaging in the field of cytopathology","volume":"6","author":"Pantanowitz\n              L,","year":"2009","unstructured":"Pantanowitz\n              L, \n            \n              Hornish\n              M, \n            \n              Goulart\n              RA. \n          \n          The impact of digital imaging in the field of cytopathology. Cytojournal. 2009;6:6."},{"issue":"1","key":"i1543-2165-137-5-618-b11","series-title":"Anal Cell Pathol (Amst)","first-page":"37","article-title":"Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience","volume":"35","author":"Fung\n              KM,","year":"2012","unstructured":"Fung\n              KM, \n            \n              Hassell\n              LA, \n            \n              Talbert\n              ML, \n            \n              Wiechmann\n              AF, \n            \n              Chaser\n              BE, \n            \n              Ramey\n              J. \n          \n          Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience. Anal Cell Pathol (Amst). 2012;35(1):37\u201340."},{"issue":"4","key":"i1543-2165-137-5-618-b12","series-title":"Mod Pathol. Apr","first-page":"548","article-title":"EGFR and KRAS mutation analysis in cytologic samples of lung adenocarcinoma enabled by laser capture microdissection","volume":"25","author":"Chowdhuri\n              SR,","year":"2012","unstructured":"Chowdhuri\n              SR, \n            \n              Xi\n              L, \n            \n              Pham\n              TH, \n            et al\n          . EGFR and KRAS mutation analysis in cytologic samples of lung adenocarcinoma enabled by laser capture microdissection. Mod Pathol. Apr2012;25(4):548\u2013555."},{"key":"i1543-2165-137-5-618-b13","series-title":"Daily Scan","article-title":"FDA Advisory Panel meets, debates digital pathology","author":"Eichorn\n              O.","year":"October 6, 2009","unstructured":"Eichorn\n              O. \n          \n          FDA Advisory Panel meets, debates digital pathology. Daily Scan. October 6, 2009http:\/\/blog.aperio.com\/2009\/10\/fda-advisory-panel-meets-debates-digital-pathology.html. Date accessed, February 2, 2012."},{"issue":"12","key":"i1543-2165-137-5-618-b14","series-title":"CAP Today","first-page":"1","article-title":"Where will the FDA land on whole-slide digital?","volume":"23","author":"Lusky\n              K.","year":"2009","unstructured":"Lusky\n              K. \n          \n          Where will the FDA land on whole-slide digital?\n          CAP Today. 2009;23(12):1."},{"key":"i1543-2165-137-5-618-b15","series-title":"J Pathol Inform","first-page":"36","article-title":"Review of the current state of whole slide imaging in pathology","volume":"2","author":"Pantanowitz\n              L,","year":"2011","unstructured":"Pantanowitz\n              L, \n            \n              Valenstein\n              PN, \n            \n              Evans\n              AJ, \n            et al\n          . Review of the current state of whole slide imaging in pathology. J Pathol Inform. 2011;2:36."},{"issue":"1","key":"i1543-2165-137-5-618-b16","series-title":"CAP Today","first-page":"1","article-title":"Regulators scanning the digital scanners","volume":"26","author":"Titus\n              K.","year":"2012","unstructured":"Titus\n              K. \n          \n          Regulators scanning the digital scanners. CAP Today. 2012;26(1):1."},{"issue":"12","key":"i1543-2165-137-5-618-b01","series-title":"Hum Pathol","first-page":"1318","article-title":"Telecytology: intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears","volume":"32","author":"Alli\n              PM,","year":"2001","unstructured":"Alli\n              PM, \n            \n              Ollayos\n              CW, \n            \n              Thompson\n              LD, \n            et al\n          . Telecytology: intraobserver and interobserver reproducibility in the diagnosis of cervical-vaginal smears. Hum Pathol. 2001;32(12):1318\u20131322."},{"issue":"4","key":"i1543-2165-137-5-618-b02","series-title":"Cancer","first-page":"199","article-title":"A novel automated screening and interpretation process for cervical cytology using the internet transmission of low-resolution images: a feasibility study","volume":"105","author":"Eichhorn\n              JH,","year":"2005","unstructured":"Eichhorn\n              JH, \n            \n              Brauns\n              TA, \n            \n              Gelfand\n              JA, \n            \n              Crothers\n              BA, \n            \n              Wilbur\n              DC. \n          \n          A novel automated screening and interpretation process for cervical cytology using the internet transmission of low-resolution images: a feasibility study. Cancer. 2005;105(4):199\u2013206."},{"issue":"3","key":"i1543-2165-137-5-618-b03","series-title":"Am J Clin Pathol","first-page":"356","article-title":"Accuracy and reproducibility of telecytology diagnosis of cervical smears: a tool for quality assurance programs","volume":"119","author":"Lee\n              ES,","year":"2003","unstructured":"Lee\n              ES, \n            \n              Kim\n              IS, \n            \n              Choi\n              JS, \n            et al\n          . Accuracy and reproducibility of telecytology diagnosis of cervical smears: a tool for quality assurance programs. Am J Clin Pathol. 2003;119(3):356\u2013360."},{"issue":"1","key":"i1543-2165-137-5-618-b04","series-title":"Acta Cytol","first-page":"148","article-title":"Digital imagery\/telecytology: International Academy of Cytology Task Force summary: Diagnostic Cytology Towards the 21st Century: an international expert conference and tutorial","volume":"42","author":"O'Brien\n              MJ,","year":"1998","unstructured":"O'Brien\n              MJ, \n            \n              Takahashi\n              M, \n            \n              Brugal\n              G, \n            et al\n          . Digital imagery\/telecytology: International Academy of Cytology Task Force summary: Diagnostic Cytology Towards the 21st Century: an international expert conference and tutorial. Acta Cytol. 1998;42(1):148\u2013164."},{"key":"i1543-2165-137-5-618-b05","series-title":"Pathol Res Int","first-page":"264683","article-title":"Digital imaging in cytopathology","volume":"2011","author":"Khalbuss\n              WE,","year":"2011","unstructured":"Khalbuss\n              WE, \n            \n              Pantanowitz\n              L, \n            \n              Parwani\n              AV. \n          \n          Digital imaging in cytopathology. Pathol Res Int. 2011;2011:264683."},{"issue":"8","key":"i1543-2165-137-5-618-b06","series-title":"Hum Pathol","first-page":"1070","article-title":"Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology: the University Health Network experience","volume":"40","author":"Evans\n              AJ,","year":"2009","unstructured":"Evans\n              AJ, \n            \n              Chetty\n              R, \n            \n              Clarke\n              BA, \n            et al\n          . Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology: the University Health Network experience. Hum Pathol. 2009;40(8):1070\u20131081."},{"issue":"3","key":"i1543-2165-137-5-618-b07","series-title":"Semin Diagn Pathol","first-page":"160","article-title":"Frequently asked questions concerning the use of whole-slide imaging telepathology for neuropathology frozen sections","volume":"27","author":"Evans\n              AJ,","year":"2010","unstructured":"Evans\n              AJ, \n            \n              Kiehl\n              TR, \n            \n              Croul\n              S. \n          \n          Frequently asked questions concerning the use of whole-slide imaging telepathology for neuropathology frozen sections. Semin Diagn Pathol. 2010;27(3):160\u2013166."},{"issue":"5","key":"i1543-2165-137-5-618-b08","series-title":"Hum Pathol","first-page":"702","article-title":"Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study","volume":"43","author":"Al-Janabi\n              S,","year":"2012","unstructured":"Al-Janabi\n              S, \n            \n              Huisman\n              A, \n            \n              Vink\n              A, \n            et al\n          . Whole slide images for primary diagnostics of gastrointestinal tract pathology: a feasibility study. Hum Pathol. 2012;43(5):702\u2013707."},{"issue":"12","key":"i1543-2165-137-5-618-b09","series-title":"Arch Pathol Lab Med","first-page":"1949","article-title":"Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations","volume":"133","author":"Wilbur\n              DC,","year":"2009","unstructured":"Wilbur\n              DC, \n            \n              Madi\n              K, \n            \n              Colvin\n              RB, \n            et al\n          . Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations. Arch Pathol Lab Med. 2009;133(12):1949\u20131953."},{"key":"i1543-2165-137-5-618-b10","series-title":"Cytojournal","first-page":"6","article-title":"The impact of digital imaging in the field of cytopathology","volume":"6","author":"Pantanowitz\n              L,","year":"2009","unstructured":"Pantanowitz\n              L, \n            \n              Hornish\n              M, \n            \n              Goulart\n              RA. \n          \n          The impact of digital imaging in the field of cytopathology. Cytojournal. 2009;6:6."},{"issue":"1","key":"i1543-2165-137-5-618-b11","series-title":"Anal Cell Pathol (Amst)","first-page":"37","article-title":"Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience","volume":"35","author":"Fung\n              KM,","year":"2012","unstructured":"Fung\n              KM, \n            \n              Hassell\n              LA, \n            \n              Talbert\n              ML, \n            \n              Wiechmann\n              AF, \n            \n              Chaser\n              BE, \n            \n              Ramey\n              J. \n          \n          Whole slide images and digital media in pathology education, testing, and practice: the Oklahoma experience. Anal Cell Pathol (Amst). 2012;35(1):37\u201340."},{"issue":"4","key":"i1543-2165-137-5-618-b12","series-title":"Mod Pathol. Apr","first-page":"548","article-title":"EGFR and KRAS mutation analysis in cytologic samples of lung adenocarcinoma enabled by laser capture microdissection","volume":"25","author":"Chowdhuri\n              SR,","year":"2012","unstructured":"Chowdhuri\n              SR, \n            \n              Xi\n              L, \n            \n              Pham\n              TH, \n            et al\n          . EGFR and KRAS mutation analysis in cytologic samples of lung adenocarcinoma enabled by laser capture microdissection. Mod Pathol. Apr2012;25(4):548\u2013555."},{"key":"i1543-2165-137-5-618-b13","series-title":"Daily Scan","article-title":"FDA Advisory Panel meets, debates digital pathology","author":"Eichorn\n              O.","year":"October 6, 2009","unstructured":"Eichorn\n              O. \n          \n          FDA Advisory Panel meets, debates digital pathology. Daily Scan. October 6, 2009http:\/\/blog.aperio.com\/2009\/10\/fda-advisory-panel-meets-debates-digital-pathology.html. Date accessed, February 2, 2012."},{"issue":"12","key":"i1543-2165-137-5-618-b14","series-title":"CAP Today","first-page":"1","article-title":"Where will the FDA land on whole-slide digital?","volume":"23","author":"Lusky\n              K.","year":"2009","unstructured":"Lusky\n              K. \n          \n          Where will the FDA land on whole-slide digital?\n          CAP Today. 2009;23(12):1."},{"key":"i1543-2165-137-5-618-b15","series-title":"J Pathol Inform","first-page":"36","article-title":"Review of the current state of whole slide imaging in pathology","volume":"2","author":"Pantanowitz\n              L,","year":"2011","unstructured":"Pantanowitz\n              L, \n            \n              Valenstein\n              PN, \n            \n              Evans\n              AJ, \n            et al\n          . Review of the current state of whole slide imaging in pathology. J Pathol Inform. 2011;2:36."},{"issue":"1","key":"i1543-2165-137-5-618-b16","series-title":"CAP Today","first-page":"1","article-title":"Regulators scanning the digital scanners","volume":"26","author":"Titus\n              K.","year":"2012","unstructured":"Titus\n              K. \n          \n          Regulators scanning the digital scanners. CAP Today. 2012;26(1):1."}],"container-title":["Archives of Pathology and Laboratory Medicine"],"original-title":[],"link":[{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/137\/5\/article-p618.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/137\/5\/618\/1612546\/arpa_2012-0430-oa.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/137\/5\/article-p618.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/137\/5\/article-p618.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:59:15Z","timestamp":1770771555000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/137\/5\/article-p618.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5]]},"references-count":32,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.5858\/arpa.2012-0430-oa","relation":{},"ISSN":["1543-2165","0003-9985"],"issn-type":[{"value":"1543-2165","type":"electronic"},{"value":"0003-9985","type":"print"}],"subject":[],"published":{"date-parts":[[2013,5]]}}}