FIRST EXPERIENCES IN A TELEPATHOLOGY CONSULTATION SERVICE

Article type: Research Article

Authors: Slodkowska, Janina | Kayser, Klaus | Radomski, Piotr | Papierz, Wielislaw

Affiliations: Department of Quantitative Pathology, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland | Department of Pathology, Thoraxklinik, Heidelberg, Germany | Department of Pathology, Medical Academy of Lodz, Lodz, Poland

Note: [] Address for corresspondence: Janina Slodkowska MD PhD Department of Quantitative Pathology Institute of Tuberculosis and Lung Diseases Plocka 26, 01138 Warsaw Poland Tel (48) (22) 6912 256 Fax (48) (22) 6912 452 e-mail:[email protected]

Abstract: The authors present their first experience in an international and domestic telepathology consulting service using static image transmission. The study assessed the technical aspects of telepathology performance and examined the consultative accuracy of telepathology in difficult lung pathology and in neuropathology cases. The referring pathologist (RP) used the image analysis system "SAMBA 2005" with Telepath software (Unilog, France), prepared the files of microscopic images, and submitted the images together with scanned HRCT graphs and e-mail messages (patients information) via Internet to the expert telepathologist (TP). The 3CCD camera was operated at 768 x 576 pixels. A JPEG compression mode was implemented. The number of microscopic images varied from 14 to 21. The files ranged from 1,58 MB to 7,4 MB. The primary diagnoses were included in the transmitted static-image files. Simultaneously the glass slides were mailed to TP to be reviewed by the telepathologist for final diagnoses (RTD). The RP cases included: A/ pilocytic juvenile type astrocytoma, B/ desmoplastic medulloblastoma, C/ pilocytic astrocytoma, D/ pulmonary plasma cell granuloma with LIP (reactive interstitial lymphoid infiltrates), E/ pulmonary chondroides hamartoma with (?) parenchymal foci of smooth muscle proliferation. The e-mail process was successful in all cases. No technical errors occurred. The TP answers were faxed within 24 hrs. There was a high concordance for the important diagnosis made by RT, TP and RTD. The TP and RTD diagnoses extended RP diagnosis in case E by recognition of metastasising uterine benign leiomyoma in the lung. Additional immunostains were proposed for the therapeutic purpose. Our static-image study showed a high degree of the diagnostic accuracy in telepathology expert consultation. This diagnostic accuracy was related to the experience of the telepathologist and referring pathologist. Teleconsultations improved the quality of the diagnoses in the cases pulmonary presented.

Keywords: telepathology, static imaging, diagnostic accuracy, pulmonary pathology

Journal: Electronic Journal of Pathology and Histology, vol. 6, no. 3, pp. 07-07, 2000