Digital and Computational Cytology: What Is in the Horizon - Guest Editor: Jianyu Rao, Los Angeles, CA - Karger Publishers
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65 | 4 | 21 ISBN 978–3–318–06673–6 Digital and Computational Cytology: What Is in the Horizon Guest Editor: Jianyu Rao, Los Angeles, CA
The International L AC A D E M NA Y I N T E R N AT I O OF C Y TO LO G Academy of Cytology HE T Y ... ... 19 5 7 Tentative IAC The role of cytology in complex Examination sites CSF diagnostics 14. October 2021 Cartagena, Colombia Dr. Ondrej Sobek, Laboratory for CSF, Saturday, 25. September 2021 Neuroimmunology, Pathology and XXX Congreso De La Sociedad Latinoameri- Special Diagnostics, Topelex sro. Prague, cana De Citopatologia Czech Republic IV Congreso Del Capitulo De Citopatologia De La Asociacion Colombiana De Patologia Further IAC Events Wrocław, Poland Tuesday, 05. October 2021 IAC Annual General Meeting 2021 43rd European Cytology Congress 2021 Friday, 17. September 2021 Virtual Meeting on-line Paris, France Tuesday, 16. November 2021 IAC International Congress & Annual General Meeting 2022 21st International Congress of Cytology & IAC webinars the 70th Annual Scientific Meeting of the American Society of Cytopathology Lung Cytology 14.–19. November 2022 08. July 2021 Baltimore, USA Dr. Maria D. Lozano Escario, Navarra Cancer Center, Universidad de Navarra, Pamplona, Spain For more information visit www.cytology-iac.org EA21091 Associate Prof. Andrew S. Field Prof. Fernando Schmitt MB BS(Hons), FRCPA, FIAC, MD, PhD, FIAC Diploma of Cytopathology (RCPA) General Secretary President MI21002
Acta Cytologica L AC A D E M NA I N T E R N AT I O Y OF C Y TO LO HE The Journal of Clinical Cytology and Cytopathology G T Y ... ... 19 5 7 Founded 1957 by George L. Wied Continued 2004–2013 by Marluce Bibbo Editor-in-Chief Kari J. Syrjänen – SMW Consultants Ltd., Turku, Finland Associate Editors Massimo Bongiovanni – SYNLAB Pathology SA, Lausanne, Switzerland Lukas Bubendorf – University Hospital Basel, Basel, Switzerland Lan Chen – Department of Pathology, Beijing Hospital, Beijing, China Edmund S. Cibas – Brigham and Women’s Hospital, Boston, MA, USA Andrew S. Field – St Vincent’s Hospital, Sydney, NSW, Australia Kusum Kapila – Kuwait University Faculty of Medicine, Kuwait-City, Kuwait Ivana Kholová – Tampere University Hospital, Tampere, Finland Adhemar Longatto-Filho – University of Minho School of Health Sciences, Braga, Portugal Robert Y. Osamura – Keio University School of Medicine, Kawasaki-ku, Japan Fernando C. Schmitt, University of Porto, Porto, Portugal Pio Zeppa – Azienda Ospedaliera Universitaria, Salerno, Italy Honorary Editor Marluce Bibbo – Jefferson University Hospital, Philadelphia, PA, USA Editorial Board Mousa A. Al-Abbadi – University of Jordan School of Medicine, Amman, Jordan Syed Z. Ali – The Johns Hopkins Hospital, Baltimore, MD, USA Zubair W. Baloch – Hospital of the University of Pennsylvania, Philadelphia, PA, USA Beata Bode-Lesniewska – University Hospital Zurich, Zurich, Switzerland Sule Canberk – University of Porto, Porto, Portugal Ashish Chandra – St Thomas’ Hospital, London, UK Nikolaos Chantziantoniou – CellPathology Plus, Richmond Hill, ON, Canada Angela Chong – Singapore General Hospital, Singapore, Singapore Beatrix Cochand-Priollet – Cochin Hospital, Paris, France Immacolata Cozzolino – University of Naples, Naples, Italy Peter Dalquen – University Hospital Basel, Sissach, Switzerland Ben Davidson – Oslo University Hospital, Oslo, Norway Udupi S. Dinesh – Sri Dharmasthala College of Medical Sciences and Hospital, Dharwad, India Hormoz Ehya – Fox Chase Cancer Center, Philadelphia, PA, USA Marianne Engels – University Hospital Cologne, Cologne, Germany Guido Fadda – Foundation “Agostino Gemelli” University Hospital, Rome, Italy Annabelle Farnsworth – Douglass Hanly Moir Pathology, North Ryde, NSW, Australia Pinar Firat – Istanbul University Faculty of Medicine, Istanbul, Turkey (Continued on next page) Printed in Germany on acid-free and non-aging paper (ISO 9706) by Printec Offset, medienhaus, Kassel
(Continued) Franco Fulciniti – Istituto Cantonale di Patologia, Locarno, Switzerland Rosario Granados Carreño – Hospital Universitario de Getafe, Madrid, Spain Shirley E. Greening – International Academy of Cytology, Philadelphia, PA, USA Philip Ip – Queen Mary Hospital, Hong Kong, SAR Deepali Jain – All India Institute of Medical Sciences, New Delhi, India Walid E. Khalbuss – NGHA King Abdulaziz Medical City, Riyadh, Saudi Arabia Jerzy Klijanienko – Institut Curie, Paris, France Tadao K. Kobayashi, – Osaka University Graduate School of Medicine, Osaka, Japan Britt-Marie Ljung – University of California Comprehensive Cancer Center, San Francisco, CA, USA Zahra Maleki – The Johns Hopkins Hospital, Baltimore, USA Pamela M. Michelow – University of Witwatersrand, Johannesburg, South Africa Maria Nasioutziki – University of Thessaloniki, Medical School Aristotle, Thessaloniki, Greece Ritu Nayar – Northwestern Memorial Hospital, Chicaco, IL, USA Binnur Önal – Cinnah Cadessi, Ankara, Turkey Bo Ping – Fudan University Shanghai Cancer Center, Shanghai, China Álvaro P. Pinto – Boston Medical Center, Boston, MA, USA Aruna Prayaga – Nizam’s Institute of Medical Sciences, Hyderabad, India Marc Pusztaszeri – Hôpitaux Universitaires de Genève, Geneva, Switzerland Samreung Rangdeang – Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand Olaf Reich – Medizinische Universität Graz, Graz, Austria Alenka Repše-Fokter, Celje General Hospital, Celje, Slovenia Esther D. Rossi – Catholic University of Sacred Heart, Rome, Italy Mauro A. Saieg – Santa Casa Medical School, Sao Paolo, Brazil Torill Sauer – UiO Institute of Clinical Medicine, Nordbyhagen, Norway Spasenija Savic – University Hospital Basel, Basel, Switzerland Pawel T. Schubert – Stellenbosch University & NHLS, Tygerberg, South Africa Irena Shabalova – Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation Momin T. Siddiqui – New York Presbyterian Hospital, New York, NY, USA Lambert Şkoog – Karolinska Hospital, Stockholm, Sweden John H.F. Smith – Lodge Moor, Sheffield, UK Yuko Sugiyama – Cancer Institute Hospital, Tokyo, Japan Eszter Szekely – Semmelweis University, Budapest, Hungary Nobuhiro Takeshima – Cancer Institute Hospital, Tokyo, Japan Edneia M. Tani – Karolinska Institute and Hospital, Stockholm, Sweden Esperanza Teuzaba – Institution Patolab Rx Ltda, Bogota, Colombia Helen J. Trihia – Metaxas Cancer Hospital, Piraeus, Greece Gary Tse – Prince of Wales Hospital, Hong Kong, Hong Kong, SAR Laszlo Vass – Flor Ferenc Hospital of Pest County, Kistarcsa, Hungary Guang-Ping Wu – China Medical University, Shenyang, China Junior Editorial Board Ricardo R. Lastra – University of Chicago Medical Center, Chicago, IL, USA Yurina Miki – Guy’s and St Thomas’ NHS Foundation Trust, London UK Joerg Schwock – University Health Network, Toronto, CA José Cândido Xavier Jr – Unisalesiano Araçatuba, Brazil © 2021 S. Karger AG, Basel www.karger.com karger@karger.com
National and Regional Societies and Editors A L AC A D E M ON YO I N T E R N AT I International Editor F C Y TO LO G Kari J. Syrjänen HE T Y ... ... 19 5 7 The journal is also the official periodical of the following National and Regional Societies National and Regional Editors Albanian Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Majlinda Buba Ikonomi Sociedad Argentina de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mercedes Gamboni Australian Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Andrew S. Field Société Belge de Cytologie Clinique/Belgische Vereniging voor Klinische Cytologie . . . . . . . . . . . . Claire Bourgain Sociedade Brasileira de Citopatologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Álvaro Piazzeta Pinto British Society for Cytopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Karin Denton The Canadian Society of Cytology/Société Canadienne de Cytologie . . . . . . . . . . . . . . . . . . . . . Harmanjatinder S. Sekhon Ceská spolecnost pro klinickou cytologii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jaroslava Dušková Sociedad Chilena de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Miguel Socias Chinese Society of Cytopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dongge Liu Colombian Association of Pathology, Section of Cytopathology, ASOCOLPAT . . . . . . . . . . . . . . . Esperanza Teuzaba Torres Croatian Society for Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Vesna Mahovlić Danish Society of Pathologic Anatomy and Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . Doris Schledermann Deutsche Gesellschaft für Zytologie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dietmar Schmidt Dutch Society of Pathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Elle K.J. Risse European Federation of Cytological Societies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Martin Tötsch Sociedad Española de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mercedes Santamaría Martínez Finnish Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Leena Krogerus La Société Française de Cytologie Clinique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marie-Cécile Vacher Lavenu Hellenic Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ekatreini Politi Hong Kong Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nancy Yuen Magyar Pathologusok Tarsasaga-Cytodiagnosztikai Sectio . . . . . . . . . . . . . . . . . . . . . . . . . . . . László Vass Indian Academy of Cytologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Meherbano M. Kamal Iranian Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mansour Mehzad Società Italiana di Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Patricia Maioli Società Italiana di Anatomia Patologica Citodiagnostica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sonia Prandi Japanese Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kenji Yanou Kazakhstan Association of Clinical Cytologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Leyla B. Djansugurova Korean Society for Cytopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Soon Won Hong Sociedad Latino-Americana de Citología . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Luiz Martins Collaco Mexican Academy of Cytopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Oralia Barboza Quintana New Zealand Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Peter N.G. Fitzgerald Norsk Forening for Klinisk Cytologi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ben Davidson Österreichische Gesellschaft für Zytologie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Peter Regitnig Sociedad Peruana de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Delia M. Jara Facundo Sociedade Portuguesa de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fernando C. Schmitt Romanian Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Irina Ecaterina Julea Russian Association of Clinical Cytologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Naum A. Shapiro Schweizerische Gesellschaft für Klinische Cytologie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lukas Bubendorf Slovenian Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Alenka Repse Fokter Suid-Afrikaanse Vereniging vir Kliniese Sitologie/South African Society of Clinical Cytology . . . . . . . Pamela M. Michelow Svensk Förening för Klinisk Cytologi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Edneia M. Tani Taiwan Society of Clinical Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Chiung-Ru Lai Turkish Society of Cytopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Özlem Aydin Sociedad Uruguaya de Citologia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Carmen Alvarez-Santín West African Society of Cytology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jaiyeola Thomas © 2021 S. Karger AG, Basel www.karger.com karger@karger.com
Journal Information Aims and Scope With articles offering an excellent balance between clinical cytology and cytopathology, Acta Cytologica fosters the understanding of the pathogenetic mechanisms behind cyto- morphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 na- tional cytology societies around the world, Acta Cytologica evaluates new and existing diag- Guidelines for Authors nostic applications of scientific advances as well as their clinical correlations. Original papers, We strongly encourage authors to read the Guidelines for Authors at review articles, meta-analyses, novel insights from clinical practice, and letters to the editor www.karger.com/acy_guidelines prior to cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathol- submitting an article ogy to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, Acta Cytologica addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhino- laryngology, gastroenterology, urology, pulmonology and preventive medicine. Journal Contact For questions or comments, please contact the persons responsible who can be found at http://www.karger.com/Journal/Contact/254338 ISSN Print Edition: 0001–5547 Subscription Orders: Subscription Rates: Subscriptions run for a full ISSN Online Edition: 1938–2650 Orders can be placed at agencies, bookstores, calendar year. Prices are given per year. or directly with the Publisher. Journal Homepage: www.karger.com/acy Personal subscription: Bibliographic Indices: This journal is regularly listed S. Karger AG Print or Online Print+Online combined in bibliographic services, including Current Con- Medical and Scientific Publishers CHF 493.00 CHF 567.00 tents® and PubMed/MEDLINE. Allschwilerstrasse 10 EUR 452.00 EUR 520.00 CH–4009 Basel USD 524.00 USD 603.00 Publication Data: Acta Cytologica is published 6 Switzerland times a year. Volume 65 with 6 issues appears in postage and handling t: +41 61 306 11 11 2021. (added to print and print+online) f: +41 61 306 12 34 CHF 52.80 Europe, CHF 74.40 Overseas e: karger@karger.com Copyright: © 2021 S. Karger AG, Basel (Switzerland). EUR 48.00 w: www.karger.com All rights reserved. No part of this publication may be USD 72.00 translated into other languages, reproduced or uti- (for courier services only: lized in any form or by any means, electronic or me- Allschwilerstrasse 10 Institutional subscription: chanical, including photocopying, recording, micro- CH–4055 Basel) Print or Online Print+Online combined copying, or by any information storage and retrieval CHF 985.00 CHF 1133.00 system, without permission in writing from the pub- Change of Address: EUR 904.00 EUR 1040.00 lisher. Both old and new addresses should be sent USD 1048.00 USD 1205.00 to the subscription source. Disclaimer: The statements, opinions and data con- postage and handling tained in this publication are solely those of the indi- (added to print and print+online) vidual authors and contributors and not of the pub- CHF 66.00 Europe, CHF 93.00 Overseas lisher and the editor(s). The appearance of advertise- EUR 60.00 ments in the journal is not a warranty, endorsement, USD 90.00 or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher Back Volumes and Single Issues: Information on and the editor(s) disclaim responsibility for any injury availability and prices of single print issues and print to persons or property resulting from any ideas, or electronic back volumes can be obtained from methods, instructions or products referred to in the Customer Service at service@karger.com. content or advertisements. © 2021 S. Karger AG, Basel www.karger.com karger@karger.com
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Indispensable reading in cytopathology and beyond The Journal of Clinical Cytology and Cytopathology The Journal of Clinical Cytology and Cytopathology Editor-in-Chief Kari J. Syrjänen, Turku l na L AC A D E M l jour NA Y I N T E R N AT I O OF Official Periodical C YTO LO G of the International ia Academy of Cytology fic HE of T Y ... ... 19 5 7 The of IAC The official Journal of Founded in 1957, Acta Cytologica was the first and, for decades, the only Selected contributions cytopathology journal. As the official journal of the International Academy • A Review of the Use of Fine-Needle Aspiration Biopsy of Mammary of Cytology and affiliated to nearly 50 national cytology societies around Tumors for Diagnosis and Research: Tani, E.; Fuentes-Martinez, N.; Skoog, L. the world, it remains the only truly international journal in the field. This (Stockholm) makes Acta Cytologica unique in its global coverage and geographically • Two Fortuitous Papers in 1917 That Conceived Diagnostic representative submissions. With the published original studies, reviews, Cytopathology: Chantziantoniou, N. (Doha) meta-analyses, carefully selected case reports, and letters to the editor • Criticism of the Pap Smear as a Diagnostic Tool in Cervical Cancer which maintain a good balance between clinical cytology and cytopa- Screening: Schneider, V. (Freiburg) thology, Acta Cytologica fosters the understanding of the pathogenetic • George Papanicolaou’s Efforts to Develop Novel Cytologic Methods for mechanisms behind cytomorphology. The journal thus facilitating the the Early Diagnosis of Endometrial Carcinoma: Austin, R.M. (Pittsburgh, PA) translation of cutting-edge research into clinical practice. Acta Cytologica • Two Landmark Studies Published in 1976/1977 Paved the Way for the Recognition of Human Papillomavirus as the Major Cause of the Global covers topics from diagnostic cytopathology, gynecologic and nongyne- Cancer Burden: Syrjänen, K.J. (Helsinki/Barretos) cologic cytopathology to fine needle aspiration, molecular techniques • The Bethesda System for Reporting Cervical Cytology: A Historical and their diagnostic applications, thus addressing a multidisciplinary au- Perspective: Nayar, R. (Chicago, IL); Wilbur, D.C. (Boston, MA) dience, far beyond the practicing cytopathologists and cytologists. • Expectations and Projections for the Future of Nongynecolgical Cytology 10 Years Ago: Did They Materialize and How Did We Do?: Schmitt, F.C. (Porto); Vielh, P. (Dudelange) Acta Cytologica Founded: 1957 Category: Clinical Research Field of Interest: Cytology Listed in bibliographic services, including: PubMed/MEDLINE, Web of Science, Google Scholar, Scopus, Embase 2019: Volume 63 6 issues per volume Language: English KF 19001 ISSN 0001–5547 e-ISSN 1938–2650 More information at w w w. karger.com/ac y
Digital and Computational Cytology: What Is in the Horizon There is both hope and hype around the potential of artificial in- telligence (AI) and machine learning to transform the discipline of cytopathology. On one extreme, there are claims that medical pro- fessionals will no longer be required to analyze pathology slides. On the other extreme, there are claims that AI‘s role has limited or no clinical value. The truth is somewhere in the middle, and AI will likely become a valuable companion to the cytopathologist who knows how to use and interpret it correctly. This special issue is a first step to educate our readers to become just such a cytopathologist. It includes a mixture of review and original research of application of AI systems for the cytological diagnosis of various organ systems. While primarily of interest to cytopathologists and cytotechnologists, it will also be interesting reading for pathologists of all fields and to those working in AI and health care.
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