Feasibility and accuracy of touch imprint cytology for rapid cancer diagnosis in resource-constrained environments

Touch Imprint Cytology for intraoperative diagnosis in developing countries

  • Ernest Adankwah Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • Ishmael Kyei Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • Babatunde Duduyemi Department of Pathology, University of Sierra Leone Teaching Hospitals Complex / College of Medicine & Allied Health Sciences. Freetown, Sierra Leone
  • Bernard Elikplim Petershie Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • Alexander Kwarteng Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • Nicholas Akinwale Titiloye Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • Michael Nyantakyi Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • Richard Swatson Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • Anna Kwayie Boadi Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • Valentine Christian Kodzo Tsatsu Tamakloe
  • Paul Poku Sampene Ossei Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • William Gilbert Ayibor Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • Naa-Anyima Boateng Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
  • Kwabena Owusu Danquah Noguchi Memorial Institute for Medical Research
DOI: https://doi.org/10.46829/hsijournal.2026.4.8.2.1498-1507
Keywords: Touch Imprint Cytology, Intraoperative diagnosis, Histopathology, Frozen section

Abstract

Background: Conventional cancer diagnosis is largely dependent on histology and frozen sections (FS)
and thus, presents challenges in resource-limited settings due to cost and technical demands. Conversely, Touch Imprint Cytology (TIC) is rapid, easy to perform, and requires less expertise and facilities. This study investigated TIC’s diagnostic performance in Ghana.
Objective: This study investigated TIC’s diagnostic performance in Ghana.
Methods: A descriptive cross-sectional study of 28 participants with suspected tumour lesions was conducted. Four tumour imprints were prepared for each sample: two smears were immediately fixed with 95% ethanol and stained with Papanicolaou stain, and the remaining two smears were air-dried and Giemsa-stained. The tissues from surgery were fixed in 10% neutral buffered formalin, processed into paraffin wax blocks, sectioned and stained with Haematoxylin and Eosin for histopathological analysis.
Results: TIC diagnosed 32.1% (n = 9), 60.7% (n = 17) and 7.1% (n = 2) cases as malignant, benign and atypical, respectively. Histopathology diagnosed 35.7% (n = 10) cases as malignant and 18 (64.3%) as benign. There was an almost perfect agreement between TIC and histopathology (Cohen’s Kappa: 0.856). TIC showed high diagnostic performance, with a sensitivity of 90% (95% CI: 59.6% - 98.2%) and specificity of 100% (95% CI: 82.5% - 100.0%). The overall accuracy was 96.4% with 95%CI (82.3% - 99.4%)
Conclusion: TIC demonstrates high diagnostic accuracy for malignancies. Its ease of use and affordability support its potential as a viable substitute for FS and a valuable adjunct to histopathology in resource-limited countries.

Author Biography

Valentine Christian Kodzo Tsatsu Tamakloe

1Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 

Published
2026-04-01
Issue
Vol 8 No 2 (2026): Health Sciences Investigations (HSI)  Journal
Section
Original Research Article