[Histonet] ThinPrep vs. SurePath

Feher, Stephen sfeher <@t> CMC-NH.ORG
Tue Nov 23 08:50:00 CST 2010

Hi Jennifer,

I have used both systems, as a cytotech, processing tech, and as a
supervisor.  As a cytotech, there is less area of the slide to have to
review so from that viewpoint it seems more efficient.  The drawback for
me was the size of the cells.  For Gyn specimens, very small high grade
cells can be difficult to detect without some sort of computer assisted
system. The Focal Point system was supposed to provide this assistance
but I found it somewhat unreliable.  This was further complicated by the
Focal Point being about 50% accurate in detecting endocervical cells.
Labs that allowed specimens that automatically signed out cases the
Focal Point deemed at the lowest risk for abnormal cells frequently had
clinicians repeating paps due to there being no endocervical material
detected.  I found that non-gyn specimens processed using SurePath were
very difficult for inexperienced techs and many pathologists simply did
not trust that they were getting the appropriate sampling of cells.
Very experienced cytotechs and some pathologists preferred SurePath for
non-gyns but they are in the minority and I found them difficult and
time consuming to review.  As a processing tech, SurePath was very time
consuming and if a lab has any kind of volume at all, had to have at
least 2 technicians dedicated to nothing but processing them.

ThinPrep has a larger are to look at and those techs who are used to
SurePath do not like to review them because the cells are quite a bit
larger, and if doing manual screening, takes a bit longer to review.
Use of the ThinPrep Imager has cut screening time down considerably.
Time and statistical analysis has shown that the Imager is a very
reliable instrument for indicating those areas of the slide where
abnormal cells may be found.  Criticism has been that the Imager
sometimes misses cells with HPV and viral  effect.  Even so, the primary
focus of many labs is to properly detect and report high grade lesions
and for this the Imager is reliable.  For me, non-gyn specimens were
easier to review and displayed a good distribution of cells.  A good
many pathologists agree and are confident that the cell sampling
adequate.  As a processing tech, ThinPrep processing takes less time and
less personnel than SurePath.  If the T-5000 processor is ever released
by the FDA for use in the US for gyn specimens, this time will be
further reduced.

In the end, the smaller cell distribution size offered by SurePath,
while seemingly more efficient, requires more time to review for many
techs due to the small size of the cells.  ThinPrep currently offers a
better solution to a majority of labs in terms of accuracy, time to
prepare, and Imaging.  

Hope this was helpful.


-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jennifer
Sent: Wednesday, November 10, 2010 6:20 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] ThinPrep vs. SurePath

Does anyone have an opinion as to why there seems to be many more
ThinPreps out there than Sure Path?  The SurePath seems more efficient,
but I might be missing something.
Thank you,
Jennifer MacDonald
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Histonet <@t> lists.utsouthwestern.edu

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