Study on the reproducibility of thyroid lesions telecytology diagnoses based upon digitized images.

The objective of this study is to evaluate the reproducibility and usefulness of telecytology diagnoses proffered on the basis of digitized images from fine-needle aspiration specimens prepared by means of liquid-based cytology. Representative digital cytological images from a total of 270 thyroid fine-needle aspiration specimens were transferred via file transfer protocol to specific password-protected accounts and were remotely reviewed by five independent board-certified cytopathologists (initial round). Their reports were recorded and classified. After 6 and 12 months, the same representative digital images were transferred in random order to the same cytopathologists and were reviewed again (first and second review rounds). The cytopathologists' first and second round diagnoses were recorded and compared with their initial ones. Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy among initial and review diagnoses. The overall interobserver agreement was almost perfect with κ values of 0.869-0.939, whereas intraobserver agreement ranged from almost perfect to perfect with κ values of 0.967-1 in all diagnostic rounds. Digitized cytological images transmission and remote evaluation allows reproducible diagnosis of thyroid gland lesions. Diagnoses made by using static telecytology systems can be equally reliable to those made by using conventional microscopy, provided that representative images are utilized and that the standard cytological diagnostic criteria are applied.