From telepathology to virtual pathology institution: the new world of digital pathology.
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Date
2005-04-25
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Abstract
Telepathology 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