Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Telepathology”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Development and evaluation of the virtual pathology slide: a new tool in telepathology.

BACKGROUND: The Virtual Pathology Slide is an interactive microscope emulator that presents, via the Internet or CD-ROM, a complete 15.53 mm x 11.61 mm digitalized tissue section. The Virtual Pathology Slide mimics the use of a microscope in both the stepwise increase in magnification (from 16x up to 2000x) and in lateral motion in the X and Y Cartesian directions. This permits a pathologist to navigate to any area on a slide, at any magnification, similar to a conventional microscope. OBJECTIVE: The aim of this study was to assess the diagnostic accuracy and acceptability of the Virtual Pathology Slide. METHODS: Ten breast needle core biopsies were randomly selected and presented to 17 pathologists or trainee pathologists with at least 2 years experience in pathology practice. Participants were required to examine each case online and provide a diagnostic classification using online feedback forms. The recorded data permitted examination of interobserver variability and user satisfaction. RESULTS: Agreement between original glass-slide diagnosis and consensus diagnosis using the Virtual Pathology Slide was reached in 9 out of 10 slides. Percentage concordance for slides lay in the range of 35.3% to 100% with an average percentage concordance between slides of 66.5%. The average Kappa statistics for interobserver agreement was 0.75 while average percentage concordance amongst participants was 66.5%. Participants looked at an average of 22 fields of view while examining each slide. Confidence: 81.25% of the participants indicated confidence using the Virtual Pathology Slide to make a diagnostic decision, with 56.25% describing themselves as "reasonably confident," 18.75% as "confident," and 6.25% as "very confident." Ease of use: 68.75% reported the system as "easy" or "very easy" to use. Satisfaction: 87.5% of participants expressed satisfaction with image quality, with 43.75% describing the image quality as "adequate," 25% describing it as "good," and 18.75% describing the image quality as "excellent." Pathologists with a working bandwidth greater than 20 kilobits per second found the download speed of the Virtual Pathology Slide "adequate" or better. CONCLUSIONS: Results from this study show that the Virtual Pathology Slide can be used to make a correct diagnostic decision, and that the system is a realistic alternative to dynamic telepathology.

Biopsy, Needle↗
PubMed1999

[Present and prospects of telepathology].

Nearly ten years have passed since telepathology was introduced and real-time pathology consultations were conducted. Long distance consultations in pathology, cytology, computed tomography and magnetic resonance imaging, which are referred to as telemedicine, clearly enhance the level of medical care in remote hospitals where no full-time specialists are employed. To transmit intraoperative frozen section images, we developed a unique hybrid system "Hi-SPEED". The imaging view through the CCD camera is controlled by a camera controller that provides NTSC composite video output for low resolution motion pictures and high resolution digital output for final interpretation on computer display. The results of intraoperative frozen section diagnosis between the Gihoku General Hospital 410 km from SRL showed a sensitivity of 97.6% for 82 cases of breast carcinoma and a false positive rate of 1.2%. This system can be used for second opinions as well as for consultations between cytologists and cytotechnologists.

Forecasting↗
PubMedDate not supplied

Telepathology support for the Mediterranean Institute for Transplantation and Advanced Specialized Therapies.

The telepathology project is UPMC's first 24-hour, 7-day international telemedicine application. It is an important milestone in UPMC Health System's plan to develop a worldwide network of transplant hospitals largely supported by telemedicine. The project's success is the result of a team effort between UPMC's Division of Pathology Informatics, Division of Transplant Pathology, Diversified Services, European Medical Division and ISMETT.

Humans↗
PubMed2006

Variability in the diagnosis of dysplasia in ulcerative colitis by dynamic telepathology.

Telepathology (TP) is the practice of evaluating pathology cases by the digital transmission of diagnostic slides as either static pictures (static TP) or by a continuous flow of pictures from a robotic microscopy (dynamic TP). The diagnostic efficacy of dynamic TP-based consultation services has not been widely tested. Dysplasia arising in association with chronic ulcerative colitis (CUC) is, at present, the most important marker for an increased risk of malignancy in patients with this disease. However, the diagnosis of dysplasia suffers from a significant degree of intra- and interobserver variability which usually necessitates a second opinion prior to definitive treatment. Thus, it is often necessary to obtain expert consultation of potential dysplasia cases by dedicated gastrointestinal pathologists. The aim of this study was to evaluate the utility and interobserver variability of diagnosing dysplasia in CUC with the use of dynamic TP. Dynamic TP was used to evaluate digitalized images of 38 CUC cases with areas considered negative, indefinite, or positive for dysplasia (low or high grade) independently by seven pathologists. Subsequently, all cases were graded by each of the pathologists by light microscopic examination of the H&E-stained glass slides. The degree of intra- and interobserver variability was determined by Kappa statistics. Overall, there was a poor degree of interobserver agreement (K=0.32) among the seven pathologists after analysis of the cases by dynamic TP. The poorest level of agreement was in the indefinite and low-grade dysplasia categories, whereas the highest level was in the negative and high-grade dysplasia categories. Grouping together several diagnostic categories (for instance: Indefinite and low, or low- and high-grade dysplasia) had no significant effect on the level of agreement. The degree of variability in interpretation of cases by microscopic slide analysis was similar (K=0.35). After reviewing all the cases by microscopic analysis of the glass slides, the diagnosis was changed in 51% of the observations; in the majority of these (61%), the grade of dysplasia was decreased. In summary, the use of dynamic TP for consultation in CUC-associated dysplasia has a poor level of interobserver agreement, but does not differ significantly from that obtained by the evaluation of the cases by microscopic slide analysis. Diagnoses rendered by dynamic TP tend to be of a higher grade compared to that obtained by microscopic slide analysis. Thus, although dynamic TP may be used for the consultation of CUC dysplasia cases, more specific criteria are needed in the general categorization of dysplasia in CUC.

Colitis, Ulcerative↗
PubMed1995

Telepathology in France. Justifications and developments.

Since 1985, the French National Association ADICAP (Association for the promotion of computer use in Cytology and Anatomic Pathology) has been active in the creation a microscope workstation for developing a bank of digitized images to be used for diagnostic and educational purposes. In 1989 one of the authors (P. Dusserre) has created a first telepathology network using this workstation. Since then, 32 workstations have been set up in private and public Departments of Pathology. Two of them are located overseas, in the Martinique and Guadeloupe islands. In this paper, the authors describe this system, called Transpath, which is a multi-purpose and modulable workstation. 3-years experience and several accuracy tests have shown that the quality of transmitted images ensure a reliable diagnosis in more than 95% of cases. It has been decided to extend this service to other French overseas territories and to develop a group of experts. The images bank will also be developed and recorded on CD-ROM. The authors intend to participate in a future European project (PILOT project, i.e. Pathology International and Local Operational Telematics), with the purpose of establishing real intercommunication between European and other networks on a worldwide basis.

Computer Communication Networks↗
PubMed1995

Telemicroscopy stations for telepathology based on broadband and ISDN connections.

Telemicroscopy equipment is a key tool to perform Telepathology successfully. It allows the local separation of the microscope with the tissue samples from the investigating pathologist. The Telemicroscopy stations presented provide the user with a full access to the functions such as scanning stage, focus, illumination and magnification selection of a remote microscope. One system applies as communication link a broadband video conference net of the German Telekom with full realtime capabilities and color TV-image quality. As this network provides adequate interfaces for video and computer net signals, it is well suited to establish within a short time interval a very comfortable Telemicroscopy connection without the development of additional equipment. As the broadband network is expensive the application is economically restricted to special applications. The other system relies on the narrow band connections of the ISDN telephone network. This design is inexpensive with respect to data transmission and is available nearly worldwide everywhere. But on the other hand this strategy is limited concerning realtime capabilities. To reduce these limitations to an acceptable level intelligent coding and operation concepts of the stations have to be developed.

Computer Communication Networks↗
PubMed1995

Future strategy for telepathology in Sweden: higher resolution, real time transmission in a multipurpose work station for diagnostic pathology.

The general reaction among Swedish pathologists to the nationwide experimentation static teletransmission of microscopic images can be briefly summarized as follows: "interesting, but technically imperfect: we need more friendly interface, faster transmission, preferably in real time, better resolution, and the possibility for slide operation by the receiver". In Sweden all Pathology laboratories are presently changing administrative routines to PC-platformed networks, which means that each pathologist has a microscope and a PC as obligatory tools to perform diagnostic work. Therefore, we plan to incorporate Telepathology, including picture archiving, along with administrative software and improved software for static DNA-measurements and morphometry. The latter is including a novel system for quantification of color images e.g. immunohistochemistry into a standard work-station for diagnostic pathology. The features of this technique are presented as well as the general outline of the work-station. Steps have been taken to build up and test such a work-station in the broad band (ATM) laboratories of the Ericsson Company and a cooperation with several Scandinavian partners in computer and teletechnology. Hopefully, similar competitive actions are taken elsewhere to help bring down the prices and facilitate adoption among diagnostic pathologists world-wide.

Computer Communication Networks↗
PubMed1995

Concept of telepathology in Croatia.

The authors proposed a hierarchically organized telepathology system in Croatia connecting smaller hospitals with a single pathologist to three regional centers and connecting these regional centers to the National center in Zagreb. The national center in Zagreb should later be connected further with all highly specialised pathological units in Zagreb and with international centers. This will offer broad possibilities of pathological consultations which is the primary aim of this system. Further, clave cooperation with other participants in telemedicine should be developed, as well as investigation on image analysing of transmitted pictures.

Croatia↗
PubMed1991

Remote frozen section service: a telepathology project in northern Norway.

We discuss the organization of a remote frozen section service in northern Norway. The service is operated by remote control of a motorized video-microscope located at Kirkenes Hospital, at a distance of more than 400 km from the workstation at the University Hospital in Tromsø. The video images of the frozen section are transmitted via a two-way telephone and video telenetwork with a 2 Mbit/s capacity. The images are displayed on monitors and diagnosed by pathologists in Tromsø. To date, 17 patients have been examined by remote frozen section. Correct benign versus malignant diagnoses have been given in all 17 cases compared with final diagnoses based on formalin-fixed and paraffin-embedded material. The average time taken for examining each frozen section was 15 minutes (range, 5 to 30 minutes). In none of the cases was the interpretation of the slides difficult due to deficient quality of the video images. For small hospitals with limited availability of local pathology services and for hospitals with a deficiency of specialists, telepathology may be a worthwhile substitute.

Equipment and Supplies, Hospital↗
PubMed1993

Use of remote video microscopy (telepathology) as an adjunct to neurosurgical frozen section consultation.

We investigated the use of remote video microscopy (telepathology) to assist in the diagnosis of 52 neurosurgical frozen section cases. The TelMed system (Discovery Medical Systems, Overland Park, KS), in which the referring pathologist selects appropriate fields for transmission to the consultant, was used for the study. There was a high degree of concordance between the diagnosis rendered on the basis of transmitted video images and that rendered on the basis of direct evaluation of frozen sections; however, in seven cases there was substantial disagreement. Remote evaluation was associated with a more rapid consultation from the standpoint of the consultant, who spent approximately 2 minutes less per case when using remote microscopy; this was achieved at the expense of considerably greater effort on the part of the referring pathologist, who spent approximately 16 minutes per case selecting an average of 4.5 images for transmission to the consultant. The use of remote video microscopy for pathology consultation is associated with a complex series of tradeoffs involving cost, information loss, and timeliness of consultation.

Frozen Sections↗
PubMed1993

Telepathology with an integrated services digital network--a new tool for image transfer in surgical pathology: a preliminary report.

We describe a low-cost telepathology system working via a commercial integrated services digital network (ISDN) and consisting of modular software and hardware elements. The main elements are Apple Macintosh workstations; a software program for the simultaneous transfer of pictures, voice, and data; and procedures for image processing and general administration of all the information generated. Additionally, the system allows remote control of any peripheral instruments by a "picture-instrument manager." The transfer rate is currently 64 kbit/s; it will be extended to 128 kbit/s (ISDN basic rate) in the near future and to 2 Mbit/s (ISDN primary rate) in the next 2 years. The system was tested by the regional hospital in Samedan, Switzerland, and the Department of Pathology, University of Basel, Basel, Switzerland, a distance of 250 km, by offering a remote frozen section service to the regional hospital in 16 cases. Fifty-four to 58 seconds were needed for the transfer of a diagnostic 8-bit grey-level image containing 341 (median value) +/- 26.1 (standard error) kbytes (n = 13) or a diagnostic 24-bit color image containing 165 (median value) +/- 16.9 (standard error) kbytes (n = 3). The time required for a diagnostic session was between 25 and 35 minutes.

Adult↗
PubMed1992

Telemicroscopy. Design considerations for a key tool in telepathology.

The paper introduces telemicroscopy as a mean to establish online telepathology services. It is differentiated between specialized point to point connections with only a few restrictions on one side, and telecommunication links available inexpensive worldwide in the form of the public telephone net on the other side with the restriction of a limited channel capacity. The restrictions imposed by the application of the telephone net (preferentially the ISDN service) are discussed and strategies outlined to overcome these restrictions. It is concluded, that if dedicated broadband connections are available, realtime telemicroscopy links can be realized immediately with available equipment. If a switched and general available telemicroscopy service applying public telecommunication links is favoured, for effective and acceptable ("online") links, computer intelligence has to be introduced to allow effective strategies for data reduction and data transmission. In this field design and development efforts are still necessary.

Costs and Cost Analysis↗
PubMed1992

Aspects of standardization in telepathology.

Effective telepathology is only possible, if the partners are supplied by a broad variety of equipment connected by far-spread communication lines. These prerequisites can only be fulfilled if technical and medical standards are available obligate for all participants. The technical and medical aspects of those standards are described in general and include procedures and notations in pathology, standards of the image source, image sampling, clinical information, classification of diagnosis, communication channels, hard- and software equipment. New standards should only be developed for those not existing, or if the already existing ones are not appropriate. The standardization classes should allow flexible formats and be developed as "open modules" allowing "individual" peripheral work stations and progressive development in the future.

Computers↗
PubMed1992

Legal aspects of telepathology.

The legal aspects of telecommunication are discussed briefly. Telepathology induces no new legal conditions; however, due to its somewhat higher diagnostic error rate specific problems may occur. Both the pathologist and hospital should clarify the internal liability conditions. The pathologist should be aware that he is still liable for errors induced by the technician, even without having the possibility of responsibility or any supervision.

Communication↗
PubMed1992

Human performance studies of the video microscopy component of a dynamic telepathology system.

Human performance studies were performed to evaluate the video microscopy component of a proposed dynamic telepathology system. Frozen sections from breast biopsies of 115 patients were evaluated by both conventional light microscopy and video microscopy by 6 pathologists. Receiver operator characteristic (ROC) curve studies showed nearly identical levels of discrimination between benign and malignant breast lesions for both viewing modalities. Viewing times were significantly greater (p < 0.001) for video microscopy but within a time frame that rendered the technology of potential value for pathology diagnostic applications. Large degrees of interobserver viewing time variability were found for light and video microscopy.

Biopsy↗
PubMed1992

Experience and present status of telepathology in the National Cancer Center Hospital, Tokyo.

The optical fiber high definition television (HDTV) live image system with a remote control microscope is an ideal telepathology system. Diagnostic accuracy with this system is high enough for pathology consultation. However, it is very expensive to set up. The integrated services digital network (ISDN)-HDTV still image system using public telephone lines presently available in Japan INS 64 (64 kb/s), is not suitable for frozen section diagnosis and diagnosing difficult lesions. However, it functions very well for cytology consultation. When INS 1500 (1.5 Mb/s) becomes available in practice, it can substitute the optical fiber-HDTV live image system in terms of cost and efficacy. Pathologists must become accustomed to making diagnosis from images on the monitor. They must be very careful in making diagnosis, when images are transmitted from institutions without pathologists, since selection error may occur at the time of frozen section and at the time of transmission of images.

Cancer Care Facilities↗
PubMed1992

Telepathology: a new tool of pathology? Presentation of a French national network.

The field of pathology is constantly growing and the responsibility of the pathologists has progressively increased in the decision of application of some efficient but aggressive therapies. They justify the increasing necessity of discussion between pathologists about the diagnoses of difficult or rare or severe lesions. It is now possible to discuss at distance on good definition digitized images transmitted through I.S.D.N. A French experimental network between 12 workstations has been introduced since 2 years. Difficult or severe diagnoses have been immediately solved in 85% of the discussed cases. It remain legal problems and the necessity of an evaluation protocol which could be discussed at a European level. The increase of technical progress and, above all, the decrease of the costs might favour the development of telepathology. The workstation of the pathologist in the year 2000 could be the combination of a microscope, a HD-TV-camera and a personal computer with many softwares allowing treatment and transmission of numerous pictures.

Equipment Design↗