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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)