Browsing by Author "Kayser, K"
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- ItemBasic aspects of and recent developments in telepathology in Europe, with specific emphasis on quality assurance.(1999-11-24) Kayser, K; Kayser, GTelepathology is the diagnostic work of a pathologist from a distance and includes all specific fields of diagnostic pathology such as frozen section services expert consultation cytometric and histometric measurement and continuous education For about 15 years experience has been collected at several universities in the United States and Europe based upon analog telephone lines 9 2 kbaud digitized lines ISDN 64 kbaud broad band connections 1 5 Mbaud and the World Wide Web 28 kbaud Potential use can be expected in the application of telepresentation remote slide preparation remote central diagnostics and telediscussion The transfer of still images is well developed that of live images is used in only a few institutions for frozen section services The image quality and spatial resolution as well as the transfer speed are sufficient for expert consultations morphometric measurements quality assurance and education All applications focus on discontinuous work flow Although the European Community focuses on user needs and standardization aspects of telepathology by sponsoring a widespread telepathology project Europath implementation of telepathology into routine application in the continuous work flow has still to be developed The technical equipment has still to be adjusted to the labor flow charts in routine pathologic diagnostic procedures Telepathology seems to be the appropriate technique to offer both improvement in diagnostic quality and inclusion of the control institution into diagnostic responsibility
- ItemDiagnostic errors in interactive telepathology.(2001-05-07) Stauch, G; Schweppe, K W; Kayser, KTelepathology TP as a service in pathology at a distance is now widely used It is integrated in the daily workflow of numerous pathologists Meanwhile in Germany 15 departments of pathology are using the telepathology technique for frozen section service however a common recognised quality standard in diagnostic accuracy is still missing In a first step the working group Aurich uses a TP system for frozen section service in order to analyse the frequency and sources of errors in TP frozen section diagnoses for evaluating the quality of frozen section slides the important components of image quality and their influences an diagnostic accuracy The authors point to the necessity of an optimal training program for all participants in this service in order to reduce the risk of diagnostic errors In addition there is need for optimal cooperation of all partners involved in TP service
- ItemFrom telepathology to virtual pathology institution: the new world of digital pathology.(2005-04-25) Kayser, K; Kayser, G; Radziszowski, D; Oehmann, ATelepathology has left its childhood Its technical development is mature and its use for primary frozen section and secondary expert consultation diagnosis has been expanded to a great amount This is in contrast to a virtual pathology laboratory which is still under technical constraints Similar to telepathology which can also be used for e learning and e training in pathology as exemplarily is demonstrated on Digital Lung Pathology Klaus Kayser charite de at least two kinds of virtual pathology laboratories will be implemented in the near future a those with distributed pathologists and distributed or 1 laboratories associated to individual biopsy stations surgical theatres and b distributed pathologists usually situated in one institution and a centralized laboratory which digitizes complete histological slides Both scenarios are under intensive technical investigations The features of virtual pathology comprise a virtual pathology institution mode a that accepts a complete case with the patient s history clinical findings and pre selected images for first diagnosis The diagnostic responsibility is that of a conventional institution The Internet serves as platform for information transfer and an open server such as the iPATH http telepath patho unibas ch for coordination and performance of the diagnostic procedure The size and number of transferred images have to be limited and usual different magnifications have to be used The sender needs to possess experiences in image sampling techniques which present with the most significant information A group of pathologists is on duty or selects one member for a predefined duty period The diagnostic statement of the pathologist s on duty is retransmitted to the sender with full responsibility The first experiences of a virtual pathology institution group working with the iPATH server working with a small hospital of the Salomon islands are promising A centralized virtual pathology institution mode b depends upon the digitalization of a complete slide and the transfer of large sized images to different pathologists working in one institution The technical performance of complete slide digitalization is still under development Virtual pathology can be combined with e learning and e training that will serve for a powerful daily work integrated pathology system At present e learning systems are stand alone solutions distributed on CD or via Internet A characteristic example is the Digital Lung Pathology CD which includes about 60 different rare and common lung diseases with some features of electronic communication These features include access to scientific library systems PubMed distant measurement servers EuroQuant automated immunohisto chemistry measurements or electronic journals Elec J Pathol Histol www pathology online org It combines e learning and e training with some acoustic support A new and complete database based upon this CD will combine e learning and e teaching with the actual workflow in a virtual pathology institution mode a The technological problems are solved and do not depend upon technical constraints such as slide scanning systems At present telepathology serves as promoter for a complete new landscape in diagnostic pathology the so called virtual pathology institution Industrial and scientific efforts will probably allow an implementation of this technique within the next two years with exciting diagnostic and scientific perspectives
- ItemRecent developments and present status of telepathology.(2001-05-07) Kayser, K; Beyer, M; Blum, S; Kayser, GTelepathology which is the diagnostic work of a pathologist at a distance has been developed to routine application within the last ten years It can be classified in relation to application technical solutions or performance conditions Diagnostic pathology performance distinguishes primary diagnosis for example frozen section statement from secondary diagnosis for example expert consultation and quality assurance diagnostic accuracy continuous education and training Applications comprise a frozen section service b expert consultations c remote control measurements and d education and training The technical solutions distinguish active remote control live imaging systems from passive conventional microscope handling static imaging and the performance systems with interactive on line live imaging use from those with passive offline static imaging practice Intra operative frozen section service is mainly performed with remote control systems whereas expert consultations and education training are commonly based upon Internet connections with static imaging in an off line mode The image quality transfer rates and screen resolution of active and passive telepathology systems are sufficient for an additional or primary judgment of histological slides and cytological smears From the technical point of view remote control telepathology requires a fast transfer and at least near on line judgement of images i e image acquisition transfer and presentation can be considered one performance function Thus image size line transfer rate and screen resolution define the practicability of the system In expert consultation the pixel resolution of images and natural color presentation are the main factors for diagnostic support whereas the line transfer rate is of minor importance These conditions define the technical compartments especially size and resolution of camera and screen The performance of commercially available systems has reached a high quality standard Pathologists can be trained in a short time and use the systems in a routine manner Several telepathology systems have been implemented in large Institutes of Pathology which serve for frozen section diagnosis in small hospitals located in the local area In contrast expert consultation is mainly performed with international connections There is a remarkable increase of expert consultations by telepathology according to the experiences of the Armed Forces Institute of Pathology or the Department of Pathology Thoraxklinik Heidelberg In expansion of these experiences a globalization of telepathology can be expected Telepathology can be used to shrink the period necessary for final diagnosis by request for diagnostic assistance to colleagues working in appropriate related time zones Telepathology is therefore not a substitute of conventional diagnostic procedures but a real improvement in the world of pathology
- ItemTelecommunication--a new tool for quality assurance and control in diagnostic pathology.(2000-11-03) Kayser, K; Beyer, M; Blum, S; Kayser, GTelepathology is the diagnostic work of a pathologist at a distance It includes specific application fields which require specific system solutions These comprise a frozen section service b expert consultations c remote control measurements and d education and training Applications but in addition all aspects of diagnosis especially those involved in the daily work flow of a pathologist The image quality transfer rates and screen resolution of telepathology systems are sufficient for an additional or primary judgment of histological slides and cytological smears It is therefore possible to include this technique into intralaboratory quality control of all steps of diagnostic procedures and to use this technique for quality assurance and control Diagnostic quality is not a well defined term and depends in addition to external circumstances on the diagnosis itself The diagnostic quality can be maintained or even improved by use of telepathology systems They can serve for control of image quality access to various information sources simultaneous transfer of images and diagnosis and continuous education of the involved pathologists For example in continuous education and training as a first step the pathologist should have access to an image data bank storing images related to the specific case for example images taken from the same organ and from patients of similar age The final stage would be an intra diagnostic learning from the specific case i e the time difference between questionnaires for a difficult diagnosis and the final diagnosis will become a minimum Automated storing of the specific and diagnosis associated images of the case will permit an open diagnostic system which will itself adjust to the micro environment of the department of pathology Although this future scenario has not been implemented to our knowledge there is little doubt the development in telepathology will promote the technical procedures in the environment of a diagnostic pathologist Telepathology is therefore not a substitute of conventional diagnostic procedures but a real improvement in the world of pathology
- ItemTelediagnosis of transbronchial fine needle aspirations--a feasibility study.(2001-05-07) Kayser, K; Kayser, G; Becker, H D; Herth, FTo analyze the diagnostic accuracy of telediagnostic procedures for transbronchial fine needle aspirations
- Item[Telepathology in diagnostic consultations for controversial neoplastic growths in the lung--personal experience].(2001-12-04) Słodkowska, J; Wiatr, E; Kayser, K; Bestry, IThe authors assessed the diagnostic accuracy of the static telepathology sTP for practical consultations in the controversial pulmonary oncology cases The short characteristics of the diagnostic cases is included We reported the results of 6 difficult clinico pathological cases submitted to Dept Quantitative Pathology DQP for consultations 5F and 1M age 26 68 yrs Digital images of histological or cytological samples were captured at DQP and transmitted to telepathologist TPat in Thoraxklinik Heidelberg or AFIP Washington DC Simultaneously the same slides or with a paraffin block were mailed to TPats for re evaluation with the conventional microscope dgn zwPat The controversial cases presented 2 types of diagnostic problems 1 rare entities 2 common difficulties in the routine work of pathologist but with indefinitely proved diagnosis The first group encounters TPat diagnoses as follows case A pulmonary plasma cell granuloma with lymphoidal interstitial infiltrates LIP preleukemia case B microfoci of early metastases of benign uterine leiomyoma case D small cell carcinoma spreading along pleura The second group included case C invasive epidermoidal carcinoma in bronchus case E probably metastatic adenocarcinoma of colon case F synchronous or metastasising 2 lung tumours sharing NE morphology or NE immunohistochemical features There was very high concordance between referring pathologist ref Pat diagnoses and TPat diagnoses as well as a consensus in zw TPat diagnoses In 2 cases the conceptual problem was solved by TPat Telepathology offered a support or improved the quality of the final diagnosis The implementation of sTP remarkably reduced the time of consultations and allowed to present the diagnostic problems to the international group of experts
- ItemTelepathology in Europe.(2001-05-07) Kayser, K
- ItemTelepathology overview: from concept to implementation.(2002-01-04) Weinstein, R S; Descour, M R; Liang, C; Bhattacharyya, A K; Graham, A R; Davis, J R; Scott, K M; Richter, L; Krupinski, E A; Szymus, J; Kayser, K; Dunn, B ETelepathology is the practice of pathology at a distance by using video imaging and telecommunications Significant progress has been made in telepathology To date 12 classes of telepathology systems have been engineered Rapid and ultrarapid virtual slide processors may further expand the range of telepathology applications Next generation digital imaging light microscopes such as miniaturized microscope arrays MMA may make virtual slide processing a routine laboratory tool Diagnostic accuracy of telepathology is comparable with that of conventional light microscopy for most diagnoses Current telepathology applications include intraoperative frozen sections services routine surgical pathology services second opinions and subspecialty consultations Three telepathology practice models are discussed the subspecialty practice SSP model the case triage practice CTP model and the virtual group practice VGP model Human factors influence performance with telepathology Experience with 500 telepathology cases from multiple organs significantly reduces the video viewing time per case P Under 01 Many technology innovations can be represented as S curves After long incubation periods technology use and or efficiency may accelerate Telepathology appears to be following an S curve for a technical innovation