Lopamudra Das et al JMSCR Volume 2 Issue 6 June 2014 Page 1510 JMSCR Volume||2||Issue||6||Page 1510-1514||June 2014 2014 Impact Factor 1.1147 www.jmscr.igmpublication.org ISSN (e)-2347-176x Cervical Smear Screening Using Cost-effective Liquid Based Cytology Authors Lopamudra Das* 1 , Phani Krishna Karri 1 , Ashok K. Maiti 2 , Tandra Sarkar 3 , Keya Basu 4 , Sukla Naskar 4 , Soumen Das 1 , Jyotirmoy Chatterjee 1 1 School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, India 2 Department of Pathology, Midnapore Medical College and Hospital, Midnapore, India 3 Department of Radiology, Apollo Gleanengles Hospital, Kolkata, India 4 Department of Pathology, Calcutta National Medical College, Kolkata, India Email ID: lopamudra.das.iitkgp@gmail.com, phani.moresmiles@gmail.com, asokkumarmaiti@gmail.com, tandra.dr@gmail.com, keyapatho@gmail.com, sukla.naskar@gmail.com, sou@smst.iitkgp.ernet.in, jchatterjee@gmail.com Abstract Objective: To minimise false negativity in cervical cancer screening with Papanicolaou (Pap) test, there is a need to explore novel cytological technique and identification of unique and important cellular features. Method: The present study explores the feasibility of low cost cervical monolayer in comparison to conventional Pap smear and available liquid based cytology techniques in extracting cytopathological features to classify normal and abnormal conditions. Comparative efficacy of newly developed technique to that of commercially prepared one was validated by automated cellular image analysis. Result: The results show that newly developed monolayer technique for cervical smears was cost effective, capable of better cyto-pathological evaluation and also compatible for automation. The precision and sensitivity were remarkably improved for nucleus and cytoplasm using cost effective monolayer in comparison to other available techniques. Conclusion: The proposed cost-effective monolayer technology could increase the efficiency of the cervical screening to a greater extent thereby reducing the rates of faulty diagnosis. Keywords: Cervical cytology screening, Liquid based technology, Automated image analysis, Sensitivity, Accuracy, Precision 1. INTRODUCTION Cervical cancer is the second most common cancer among women worldwide 1 . During the last 35 years, the Conventional Pap Smear (CPS) has been recognised globally as the primary technique for screening of cervical cancer 2 as it is safe, efficient, well established and non-invasive. Many advanced technologies have been developed to reduce the false negative cases 3 . Liquid Based Cytology (LBC) is a technique employed to improve the smear preparation forming monolayer slides devoid of the blood, mucus and other debris thereby increasing the sensitivity by reducing the rate of false negative compared to CPS 4 . LBC technique successfully reduces the number of inadequate smears and provides scope to detect infectious agents 5 . However, the commercial kit based LBC is costly and inaccessible to the common people in India for cervical cancer screening 6 . In order to make the LBC technique more informative and easily accessible to the common people, an effort has been made to bring down the cost of cervical monolayer by developing an easy and low cost technique which eliminates the mucus, RBC and reduces the load of inflammatory cells and bacterial flora rather than completely eliminating them. The LBC though efficient compared to CPS, still suffers greatly from inter-observer variability especially in addressing the problem of false negativity. To reduce this shortcoming, computer assisted diagnosis supported by the image processing technique is gaining importance 5 . In this regard the proposed low cost LBC may be useful for image processing and analysis towards developing automated screening. Partial automation of screening has been achieved using image processing techniques 6 . For nucleus identification, morphological reconstruction based methods has been adopted and extended to levelsets for accurate segmentation 7 . Hence, the present study aims at characterization of cervical exfoliative cytology through development of cost-effective LBC for cervical smear and assessing its compatibility in computer assisted analysis of features. 2. MATERIALS AND METHODS 2.1 Study Sample A total of 120 samples were collected for the study between the periods of April 2012 to January 2013 from Midnapore Medical College and Hospital, WB and National Medical College and Hospital, Kolkata. The patients were of age group 18 to 70 years. Out of 120, number of abnormal cases was 40