Virtual microscopy and the internet as telepathology consultation tools - A study of gastrointestinal biopsy specimens

Telepathology (TP) is the practice of pathology at a distance using videomi croscopy and telecommunication tools. We explore the use of "virtual micros copy" techniques and the Internet as tools for TP gastrointestinal biopsy c onsultations. Thirty-Jive gastrointestinal biopsy specimens were photograph ed in Los Angeles by using a high-resolution digital camera, a light micros cope, and a Pentium 166 microcomputer: Several (2-8) digital photomicrograp hs were collected at 40x or 100x optical magnification, using 2, 700 x 3,40 0 pixel resolution. The photomicrographs illustrated all the tissue fragmen ts present in I of the biopsy levels. They were saved in medium compression JPEG image format These images can be magnified digitally up to 600% witho ut visible degradation and scrolled at different magnifications on a video monitor simulating examination under a light microscope. The image files (2 81 to 3,324 KB) were attached to e-mail messages containing patient informa tion and sent through the Internet to Michigan for interpretation using a P ower Macintosh 7100 system. The e-mail process was successful in 100% of in stances; 2 files were corrupted owing to user error and had to be resent. A dditional photos were requested in I case. Iii 33 of 35 cases, there was di agnostic concordance between the original and the TP diagnoses. The 2 discr epancies were due to diagnostic disagreement. This technology offers pathol ogists relatively inexpensive and effective tools for gastrointestinal TP c onsultations.