Morphologic Evaluation of Hyperchromatic Crowded Groups Present in Cervical Thin Prep Cytology Tests as Identified by the Hologic Genius Digital Diagnostics System: A Descriptive Study.

BACKGROUND

Our descriptive study focused on morphologic characteristics of hyperchromatic crowded groups (HCGs) in ThinPrep cervical cytology tests when reviewed with the artificial intelligence (AI)-assisted Hologic Genius Digital Diagnostics System (HGDDS).

METHOD: After IRB approval, our archives were searched over a 1-year period for potential HCGs. A total of 157 slides with HCGs were selected, scanned, and analyzed using the HGDDS. One cytologist and one cytopathologist interpreted these cases while enumerating the cytomorphologic characteristics as seen with the HGDDS.

RESULTS

Of the 157 cases, a total of 84.7% were called Negative for Intraepithelial Lesion or Malignancy (NILM) on original ThinPrep interpretation (OTPI) as opposed to 76.4% with HGDDS. 5.7% and 3.2% of the cases were called high-grade squamous intraepithelial lesion (HSIL) and atypical glandular cells (AGC) on OTPI, as compared to 4.5% and 8.3% on HGDDS. 6.4% of cases were interpreted as adenocarcinoma on both OTPI and HGDDS. A total of 16 cases were called NILM-Atrophy by both modalities. Concordance for pathologist diagnosis between HGDDS and OTPI for 157 cases was 0.610 (kappa value). For 25 cases, there was a follow-up biopsy diagnosis, including 10 cases of adenocarcinoma, 5 of Cervical Intraepithelial Neoplasia (CIN) 2-3, and 1 case of CIN 1. The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of CIN2+ lesions, when ASC-H/AGC and above were considered, were 100%, 50%, 75%, and 100%, respectively.

CONCLUSION

Our initial study shows encouraging results in the evaluation of HCGs presented as two-dimensional static images on a computer monitor by the HGDDS.