“FISHing” to detect urinary and other cancers

• Published in: Cancer cytopathology 2010-02, Vol.118 (1), p.56-64
• Main Authors: Smith, G. Denice, Bentz, Joel S.
• Format: Article
• Language: English
• Subjects: BioView; cytology; cytotechnologist; Duet; image analysis; image processing; molecular diagnostics; UroVysion fluorescence in situ hybridization
• ISSN: 1934-662X; 1934-6638
• DOI: 10.1002/cncy.20066

BACKGROUND: The UroVysion Bladder Cancer Kit detects amplifications of chromosomes 3, 7, and 17, and the deletion of 9p21, by fluorescence in situ hybridization (FISH). Because manual interpretation of UroVysion FISH is time consuming and can be challenged by variable probe signal strengths and background labeling, the authors investigated an automated image analysis system to improve throughput, productivity, quality control, and accuracy. METHODS: The authors evaluated the interactive BioView Duet imaging system as an aid to UroVysion FISH interpretation in a 2‐armed, blinded comparison with manual screens of the same 135 consecutive cases. Manual and Duet‐assisted interpretations were compared with respect to concordance, reproducibility, and timing. RESULTS: Eighty‐one cases were interpreted as positive or negative with 94% concordance and a kappa value of 0.84 between manual and Duet‐aided interpretations. Three cases that ultimately were judged positive were detected with the aid of Duet but were missed with a manual screen. A final interpretation could not be given for≈25% of Duet‐scanned cases. Duet‐aided interpretation was highly reproducible for patient and control slides. Pathologist evaluation time per case was 4 minutes compared with 30 minutes for manual interpretation. Cytotechnologist involvement added 18 minutes for a total of 22 minutes, a savings of 8 minutes per case. CONCLUSIONS: Duet‐aided interpretations were at least equivalent to manual interpretations. The system permitted interactive review of abnormal cells and had the ability to evaluate the same cells for brightfield cytology followed by FISH. The image processing and analysis tools of the Duet system enhanced the morphology skills of cytology professionals in providing accurate interpretations. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society. Manual interpretations and interpretations that were aided by an interactive, automated image processing and analysis system (BioView Duet) were compared in 135 cases that were processed using a proprietary bladder cancer kit for fluorescence in situ hybridization (the UroVysion Bladder Cancer Kit). The Duet imaging system‐aided screens were at least equivalent to manual screens with respect to accuracy, reproducibility, and timing.