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Pathologist Dr. Rick Cavett displays the new Cytyc ThinPrep Imaging System now in use at Baptist Laboratory Services.

Now in place at Baptist Laboratory Services, a new system for spotting cancer cells is letting both humans and computers do what they do best.

The laboratory division of Baptist Medical Center in Jackson has begun using the Cytyc ThinPrep® Imaging System for the detection of cervical cancer and its precursors. It incorporates computer-aided imaging in the examination of Pap test specimens in the cytology lab, which performs more than 20,000 such tests each year.
Baptist chief pathologist Dr. Rick Cavett described the recent upgrade as the “next logical step” for technology in the field.

“We see this as reducing the number of tests that are false negatives, and hopefully identifying more people with precursors to cancer,” he said.

The system represents a change in the way pap tests are processed and interpreted.

Traditionally, cells taken from a female patient’s cervix are viewed under a microscope, with a cytotechnologist first looking for any abnormal cells in the sample and then determining whether they are innocent or suspect.

“There is an opportunity for error in that a cell may not be found at all, so no assessment can be made as to what kind of cell it is,” Cavett said.

Under the new system, the computer takes care of the first step of spotting any abnormal cells. That’s when the human cytotechnologist, and sometimes additionally the pathologist, takes over to look at each abnormal cell and categorize it.

“The imager takes the first part of that step to a level where error is reduced about as far as it can go,” Cavett explained. “This is the most effective system yet devised to make a determination as to whether a cell is normal or suspect.”

The Baptist lab opted for the ThinPrep system over other similar systems that use computers to perform the complete screening and classify cells without any human intervention, Cavett said.

“It doesn’t do a bad job, but it has its limitations,” he said of the alternative.

“A computer is very good at looking at all the cells, and it never gets tired or distracted. But it isn’t as good at determining which abnormal cell is benign.”

The new system has no effect on the traditional collection procedure for pap tests, and patients will see no difference.

In the lab, the transition means a change in routine. The slides are processed as before, but instead of being handed to a cytologist for manual screening, they’re loaded into the imager for automatic screening. It records and photographs the locations on the slide where abnormal cells are found. When it’s done, the cytologist reviews each image on a high-resolution screen and makes a determination about each one.

Despite the changes in procedure, the cytotechnologists have enjoyed using the new equipment, Cavett said.

“I think we all enjoy knowing we’re dealing with a system that has the built-in capability to identify every potential cancer cell,” he said.

The lab has a rental agreement for the new equipment, the cost of which was covered by adding a few dollars to the price of the test.

The new system was put into place in November. Baptist was the first in Mississippi to go online full-time with the new system, Cavett said, but other hospitals have also purchased the equipment and should be introducing it soon.

As part of preparations, the Baptist team visited a lab in which the equipment had already been in use for a year.

“We were able to see it in action and talk to the people who had made the transition,” Cavett said. “That visit alleviated many of our questions.”

When the lab was ready to make the change, it phased in the use of the new equipment and ran tests both ways for a while to make sure the results were similar.

“This transition is not a revolutionary change,” Cavett said. “It’s just the next logical step in improving our quality of care.”



March 2008

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