EXPERT CONSULTATION BY USE OF TELEPATHOLOGY - THE HEIDELBERG EXPERIENCES

The benefits and constraint using visual telecommunication in patholog y (telepathology) are described based upon the experiences of the auth ors for more than 4 years. The experiences include first trials in vis ual telecommunication to analyze image quality, transfer rates, handli ng of commercially available equipment, and need for routinely diagnos tic work followed by routinely expert consultations in frozen sections . A quality control study on diagnostic reliability of bronchial carci nomas was performed later, and the diagnosticly different cases were r eclassified by a panel of pathologists using visual telecommunication. The latest experiences are based upon routinely expert consultations in morphologically difficult cases by ISDN-based telecommunication. As a result, image quality and transfer rates are sufficient to permit e fficient expert contribution to diagnostically difficult cases in 30-5 0% of transmitted cases in both common telephone lines and ISDN connec tions, No influence of various staining procedures, immunohistology, o r in situ hybridization on image quality or transfer rates were observ ed. The area of transmitted images is still too small, and the reliabi lity of ISDN lines is still not sufficient for remote control service in Germany. The handling of commercially available equipment needs to be improved; however, as a general result, telepathology will probably improve the diagnostic quality and access in histopathology within th e coming years.