Phd ceremony Mw. B. van Hemel:Innovative issues in clinical cytopathology. Quality matters

As in other pathology practices quality control and improvement are of utmost importance in clinical cytology. Only critical and objective evaluation of our professional performance will result in quality improvement. In clinical cytology quality control can be divided in several main categories like specimen collection, handling of the cell material, quality of diagnostic skills, and reporting. In this thesis we have focused on several aspects of quality control and improvement in all these categories. As a project in the evaluation of specimen collection, we investigated the procedures involved in endoscopic ultrasound fine needle aspiration of celiac lymph nodes which was part of the staging procedure of patients with esophageal cancer. Secondly, we assessed the accuracy of an alternative low cost liquid based cytology method for the use of cervical scrapings, followed by the exploration of the effectiveness of a new automated cell block processor, the Cellienttm as an innovative project in handling specimens. A comparative study on the accuracy of reading urine samples using computer analyzed screening with conventional cytopathology was performed as part of our efforts to improve urine cytodiagnostic skills. Finally, we addressed the diagnostic value and cost considerations of repeated FNA of solitary thyroid nodules primarily diagnosed as benign nodules.