AN INITIAL TRIAL OF A PROTOTYPE TELEPATHOLOGY SYSTEM FEATURING STATICIMAGING WITH DISCRETE CONTROL OF THE REMOTE MICROSCOPE

Routine diagnosis of pathology images transmitted over telecommunicati ons lines remains an elusive goal. Part of the resistance stems from t he difficulty of enabling image selection by the remote pathologist. T o address this problem, a telepathology microscope system (TelePath, T eleMedicine Solutions, Birmingham, Ala) that has features associated w ith static and dynamic imaging systems was constructed. Features of th e system include near real time image transmission, provision of a til ed overview image, free choice of any fields at any desired optical ma gnification, and automated tracking of the pathologist's image selecti on. All commands and images are discrete, avoiding many inherent probl ems of full motion video and continuous remote control. A set of 64 sl ides was reviewed by 3 pathologists in a simulated frozen section envi ronment. Each pathologist provided diagnoses for all 64 slides, as wel l as qualitative information about the system. Thirty-one of 192 diagn oses disagreed with the reference diagnosis that had been reached befo re the trial began. Of the 31, 13 were deferrals and 12 were diagnoses of cases that had a deferral as the reference diagnosis. In 6 cases, the diagnosis disagreed with the reference diagnosis yielding an overa ll accuracy of 96.9%. Confidence levels in the diagnoses were high. Th is trial suggests that this system provides high-quality anatomic path ology services, including intraoperative diagnoses, over telecommunica tions lines.