Preprint

DKFZ-2025-02580

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Closing the Automation Gap: Robust AI for Dual-Stain Cervical Cancer Screening Triage.

Lahrmann, B. (Corresponding author) ; Keil, A. ; Ruiz, F. M. ; Clarke, M. A. ; Egemen, D. ; Grewal, K. K. ; Grabe, F. P. ; Bartels, L.DKFZ* ; Krauthoff, A.DKFZ* ; Ströbel, P. ; Risley, C. ; Reaves, S. ; Fuller, L. A. ; Kinney, W. ; Poitras, N. ; Goldhoff, P. E. ; Suh-Burgmann, B. ; Lorey, T. S. ; Wentzensen, N. ; Grabe, N. (Last author)

2025
Research Square Durham, NC

Abstract: Dual-stain cytology, using p16 and Ki67, is superior to conventional PAP cytology for triage of HPV-positive test results in cervical cancer screening. Its AI-based evaluation can remove subjectivity, improve performance and facilitate implementation. Using 5,722 dual-stain slides from population-based screening cohorts, we developed and validated Cytoreader-V2. In the SurePath Kaiser Implementation Study, Cytoreader-V2 achieved 87.2%/57.8% (sensitivity/specificity) compared to 89.9/52.6 (manual DS) and 85.8/41.9 (Pap cytology). In the Thin-Prep Biopsy Study, it reached 95.7/44.4 versus 89.4/35.0 (manual DS), and in anal DS cytology slides, 87.0/41.3 compared to 87.0/27.7 (manual). Robustness testing demonstrated significant stability across image transformations. Cytoreader-V2 improves specificity and reproducibility compared to manual dual-stain reading while maintaining high sensitivity. Its adaptability across populations with consistent performance makes it scalable for diverse clinical settings. Cytoreader-V2 can be a transformative tool in global cervical cancer screening as a critical AI applications in digital pathology.

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Contributing Institute(s):

1. Angewandte Tumor-Immunität (D120)

Research Program(s):

1. 314 - Immunologie und Krebs (POF4-314) (POF4-314)

Appears in the scientific report 2025

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