Elsevier

Human Pathology

Volume 32, Issue 12, December 2001, Pages 1304-1308
Human Pathology

Telepathology Symposium
Online Internet-based robotic telepathology in the diagnosis of neuro-oncology cases: A teleneuropathology feasibility study*

https://doi.org/10.1053/hupa.2001.29647Get rights and content

Abstract

This feasibility study examined the diagnostic accuracy of Internet-based dynamic-robotic telepathology using neuropathology cases. Randomly, 83 cases were selected from the routine diagnostic workload of the Neurosurgical Pathology Laboratory in Poznan, Poland. Telepathology diagnoses were compared with conventional paraffin section diagnosis. The neuropathologists, operating a robotically controlled motorized microscope over the Internet from 3 different Polish cities, individually reviewed the cases using computer workstations. Viewing times ranged from 2 minutes 54 seconds to 32 minutes 12 seconds per case. The mean diagnostic accuracy for telepathology diagnosis was 95%, with 2 of 3 observers achieving 100% diagnostic accuracy. Image quality was judged to be sufficient for correct evaluation, and the viewing times required to establish a final diagnosis by remote video microscopy were acceptable. Generally, user acceptance of robotic telepathology was high. HUM PATHOL 32:1304-1308. Copyright © 2001 by W.B. Saunders Company

Section snippets

Materials and methods

Between December 1999 and July 2001, paraffin sections from 83 current neurosurgical tumor cases were analyzed telemicroscopically before routine light microscopic examination. The mean age of patients in this study was 48 (±16) years. The ages ranged from 6 to 76 years. Of the 83 patients, 43 were female and 40 were male. Eighty-two tumor specimens were removed surgically, and 1 specimen was obtained by stereotactic biopsy. Seventy-five patients had primary tumors, and 8 had tumor metastasis

System validation

The 3 neuropathologist participants, in 3 different Polish cities, each worked in a different telecommunications environment. Participant A, in Poznan, worked within a local area network (LAN; 100 Mb/s) with the following outside connections to the Internet: through the Metropolitan Area Network POZMAN (622 Mb/s) and to the National Academic Network POL-34/155 (155 Mb/s). Telepathologic diagnostic sessions were done with a IBM-compatible Pentium II 440 MHz PC with 128 Mb RAM. Video images were

Discussion

Despite advances in molecular diagnostics, paraffin section light microscopy remains the primary method for the diagnosis of most lesions in the central nervous system. In some cases, paraffin sections are augmented with other techniques to corroborate a primary diagnosis rendered from paraffin sections stained with hematoxylin and eosin. The time required to establish final diagnosis varies and depends in part on the complexity of viewed material. Access to expert consultation can be highly

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*

Address correspondence and reprint requests to Janusz Szymas MD, PhD, Department of Pathology, University of Medical Sciences, Przybyszewski Str 49, 60-355 Poznan, Poland.

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