Diagnostic Agreement in Whole Slide Digital Images of Cervical Cytology and Cell Blocks

Background: Cell blocks (CB) are an established technique in non-gynecological cytology, but experience in gynecological cytology is still relatively limited. In this study, we compared the diagnostic agreement between liquid-based cytology (LBC) and CB using whole slide digital imaging (WSI).

Methods: WSI of 82 specimens (41 LBC and 41 CB) were evaluated independently by three observers.

Results: The overall agreement was 0.463 for all 82 cases including both LBC and CB, 0.439 for LBC alone, and 0.484 for CB alone. Agreement was highest for HSIL, NILM, cancers and lower for borderline (ASC-US, ASC-H). There was no significant difference in agreement between LBC and CB.

Conclusions: WSI of CB can be used for the diagnosis of cervical lesions and may be particularly useful in cases with high atypical cellularity or large hyperchromatic cell groups.