January 2013
Cytopathology And More

Barbara Blond, MBA, MT(ASCP)

The CAP has a new gynecologic cytopathology education program that uses the agile DigitalScope viewer to look at whole-slide image Pap tests. An all-online program, Pap Education Digital (PED) has modules consisting of SurePath (PEDK/APEDK), ThinPrep (PEDM/APEDM), or liquid-based slidesets that feature both slide technologies (PEDL/APEDL).

The PED program consists of access to two whole-slide image “slidesets” annually and one slideset of advanced education cases. Those who complete all three virtual slidesets can earn up to 13 continuing medical education/continuing education credits annually. The advanced education slidesets are the same cases as are included with the glass slidesets and can be claimed for credit only one time.

The PED dashboard features case history and tools to traverse the DigitalScope slide. The user can choose the objectives (4×/10×/20×/40×) or scroll with the mouse to magnify the slide view quickly. The cellular material in the circular area of the slide is captured in three dimensions (also known as Z focus). Each imaged area has nine planes of focus (PDF, 2.85 MB) so the screener can see the cellular details. The focus function can be controlled with a computer mouse or by moving the tool on the computer screen. Slides can be marked with a tool for areas or cells of interest.

In the laboratory, primary screeners preview slides before the secondary screener. In PED, the primary screener (usually a cytotechnologist) will read the clinical history for each case and then view the whole-slide image. The primary screener will electronically mark areas of interest, including abnormal cells, on each stained SurePath or ThinPrep Pap slide. The primary screener will provide cytopathologic interpretation for each slide and submit his or her answers. The intended response and educational information for each case will be provided after submission.

In the laboratory, slides and paperwork pass from the primary to the secondary screener. In the PED program, the secondary screener (pathologist) can view the primary screener’s marks on the whole-slide image and results. Alternatively, the secondary screener can view an unmarked whole-slide image. After review, the secondary screener will submit the cytopathologic interpretations for each case, and will receive the intended response and educational information.

The program will include a laboratory slideset for use in roundtable discussions and in reaching a consensus on interpretations. This mimics decisionmaking activities in the cytopathology laboratory where Pap interpretations may be collaborative.

Enrollment in the PED program has many advantages:

• Use of the DigitalScope viewer, which provides an easy-to-navigate whole-slide image.
• After submission, immediate feedback on the interpretation as well as educational comments.
• Pathologists see how their cytotechnologist staff choose fields of interest and gain insight into internal educational needs.
• Practice in use of whole-slide images (virtual slides).
• Access at any time of day/night from any computer at any location.
• Cases can be reviewed for a prolonged time (glass slides must be returned within three weeks).
• For international laboratories, no customs issues and no shipping fees as for glass slides, and no fax result delays.

Participation in PED requires use of Microsoft Silverlight. This enhanced viewing option requires a one-time download and installation of free software.

Participants who use SurePath slides should order PEDK, and APEDK for each additional participant. Participants who use ThinPrep slides should order PEDM, and APEDM for each additional participant. Those who are interested in viewing slides of each preparation type should order PEDL, and APEDL for each additional participant. To enroll or ask questions about the PED program, call the CAP customer contact center at 800-323-4040 option 1.