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Papanicolaou Staining and Processing Troubleshooting Exercise Using Digital Pathology: Peer Comparison in an External Quality Assurance Setting.
Acta Cytologica ( IF 1.6 ) Pub Date : 2020-08-21 , DOI: 10.1159/000509604
Julia Pagliuso , Janelle Greaves , Adeline Lau , Tony Badrick

Background: The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) offers a comprehensive range of External Quality Assurance programs for all disciplines of pathology and is committed to delivering programs to advance outcomes in patient care and promote excellence in laboratory diagnostic and technical proficiency. Proficiency testing in cytopreparatory techniques became available for formal enrolment in 2018. The 2019 technical program focused on the demonstration of a laboratory to troubleshoot problems encountered during staining and processing. The exercise provided a peer comparison of a laboratory’s ability to (1) identify the problem viewed from a digital image and (2) describe the troubleshooting steps to rectify the problem using assessment guidelines. Methods: Ten troubleshooting exercises including whole-slide z-stacked virtual images, a reference slide, and an online Result Entry questionnaire were provided. Common staining and processing problems were demonstrated in these exercises. Multiple-choice responses were made available to participants for each case with 1 response requiring submission. Participants were then allowed free text to describe how they would rectify the problem. Results: Of the 72 participants who participated, 62 participants (86%) achieved a satisfactory assessment, 6 participants (8%) received a borderline assessment, and 4 participants (6%) received an unsatisfactory assessment. The average mark obtained was 32.7 out of a total of 45 marks, which equates to a satisfactory assessment. The highest mark obtained for this survey was 42.5. Conclusions: Quality cytopathology preparatory techniques are integral to mitigating the risk of diagnostic error. The digital pathology platform allowed homogeneity of samples for all participants and appeared to be a satisfactory mode for demonstrating the technical problems to participants. Laboratories participating in this survey showed good performance in identifying processing and staining problems on virtual images and working through the troubleshooting steps. The exercise also identified a method for troubleshooting formalin vapour-affected slides using citrate buffer which may be useful for laboratories following in-house validation.
Acta Cytologica


中文翻译:

使用数字病理学进行的Papanicolaou染色和处理故障排除练习:外部质量保证设置中的同级比较。

背景:皇家澳大利亚病理学家学会质量保证计划(RCPAQAP)为所有病理学学科提供全面的外部质量保证计划,并致力于提供计划以提高患者护理的结果并促进实验室诊断和技术水平的提高。细胞制备技术的能力测试已于2018年正式注册。2019年的技术计划着重于演示实验室以解决染色和加工过程中遇到的问题。该练习提供了实验室能力的同级比较,实验室具有以下能力:(1)从数字图像中识别出问题所在;(2)使用评估指南描述解决问题的步骤以纠正问题。方法:提供了十个故障排除练习,包括全幻灯片Z堆叠虚拟图像,参考幻灯片和在线结果录入问卷。这些练习证明了常见的染色和加工问题。每种情况下,参与者都可以选择答案,其中有1项要求提交。然后,允许参与者使用自由文本来描述他们如何解决该问题。结果:在参与的72名参与者中,有62名参与者(86%)获得了满意的评估,有6名参与者(8%)得到了边界评估,有4名参与者(6%)得到了不满意评估。满分为45分,平均得分为32.7分,令人满意。这次调查获得的最高分是42.5。结论:高质量的细胞病理学准备技术对于降低诊断错误的风险必不可少。数字病理学平台允许所有参与者均质化样品,并且似乎是向参与者展示技术问题的令人满意的模式。参与该调查的实验室在识别虚拟图像上的处理和染色问题以及完成故障排除步骤方面表现出良好的性能。演习还确定了一种使用柠檬酸盐缓冲液对福尔马林蒸气受影响的载玻片进行故障排除的方法,该方法可能对实验室进行内部验证后有用。
细胞学学报
更新日期:2020-08-21
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