Technical Aspects of Telepathology with Emphasis on Future Development

Analytical Cellular Pathology, Jul 2018

Pathology undergoes presently changes due to new developments in diagnostic opportunities and cost saving efforts in health care. Out of the wide field of telepathology the paper selects three prototype applications: telepathology in teleeducation, expert advice for preselected details of a slide and finally telepathology for remote diagnosis. The most challenging field for remote diagnosis is the application in the frozen section scenario. The paper starts with the mental experiment to map conventional procedures to counterparts in telepathology.

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Technical Aspects of Telepathology with Emphasis on Future Development

Analytical Cellular Pathology 0921-8912 Technical aspects of telepathology with emphasis on future development P. Schwarzmann 0 B. Binder 0 R. Klose 0 0 Institute of Physical Electronics, University of Stuttgart , Stuttgart , Germany an increased number of expert consultations to provide the patient with a the state of the art diagnosis. It requires also adequate opportunities for continuing education to provide pathologists with the results of new developments. - Due to cost saving efforts, more and more small and medium hospitals lose their own departments of pathology and have to rely on services from outside the hospital. Telepathology; telepathology networks; artificial hand; teleeducation; virtual slide; telemedicine market - Pathology undergoes presently changes due to new developments in diagnostic opportunities and cost saving efforts in health care. Out of the wide field of telepathology the paper selects three prototype applications: telepathology in teleeducation, expert advice for preselected details of a slide and finally telepathology for remote diagnosis. The most challenging field for remote diagnosis is the application in the frozen section scenario. The paper starts with the mental experiment to map conventional procedures to counterparts in telepathology. Technical opportunities and economical restrictions of telepathology equipment are discussed with respect to the components: electronic camera, display devices, haptic sensors and displays, available telecommunication channels and telepathology software. As an example and for illustration of the state of the art for an advanced telemicroscopy system able to perform remote frozen section diagnosis, the HISTKOM equipment is presented in more details. The section concerning future developments regards the aspects of the acceptance by tentative users, legal aspects, costs and affordability of equipment, the market for equipment components and the adequate telecommunication services. Further is regarded the mutual influence of properties of existing systems and application experiences gained with them on the next generation of equipment and application software. Conclusions and references close the paper. 1. Introduction The field of pathology presently undergoes worldwide changes as a result of new scientific experiences and tools [ 3,5 ], as well as from cost saving efforts: – Pathology splits more and more into special fields, which make it difficult for the pathologist to overlook still the complete field. This requires Both trends make telepathology an attractive tool for requesters and providers of services in pathology to meet the indicated challenges. Accordingly the original motivation for the introduction of telepathology procedures was just to replace the deficiencies mentioned above by the new tool. The basic attraction were two features: (i) to avoid the physical transportation of slides and tissue and (ii) to allow a local separation of the investigated sample and the investigator. The challenge for the developers of telepathology equipment was to consider the new situation and to fit their instruments into the existing workflow in pathology. Later considerations were made, not only to reestablish the traditional workflow, but to exploit additionally new opportunities offered by telepathology. The present paper will be restricted to the technical aspects of telepathology equipment. It starts in paragraph two with a presentation of different modes of telepathology and their requirements to equipment. In part three, technical solutions together with economical restrictions are discussed and part four demonstrates an example of today’s state of the art equipment. Part five finally discusses new opportunities and possible trends. A short section with conclusions and references ends the paper. To avoid misunderstanding of the term “slide”, throughout the paper “slide” will be used only for the glass slides with the prepared tissue for inspection under the microscope, “slides” of photographic films will be called “diapositives”. 2. What is telepathology? The item “telepathology” includes a variety of very different procedures and functionalities in pathology. In principle, it includes everything, provided a telecommunication step is part of a service. A collection and an overview with definitions may be found in a report [ 4,14 ] of the EUROPATH project of the EU promoting telepathology and in [8]. For simplicity reasons, we will select three representative telepathology applications and the corresponding equipment covering almost the whole field. These prototypes of telepathology services may be characterized according to their application: – Education and continuing education; – Expert advice and 2nd opinion consultation on the basis of a few preselected images of a case; – Primary telediagnosis including 2nd opinion in the sense of a complete remote diagnosis. As the item 2nd opinion is used for different proce (...truncated)


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P. Schwarzmann, B. Binder, R. Klose. Technical Aspects of Telepathology with Emphasis on Future Development, Analytical Cellular Pathology, 21, DOI: 10.1155/2000/847247