Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                

Telepathology: 8 June 2013

Download as pdf or txt
Download as pdf or txt
You are on page 1of 21

TELEPATHOLOGY

8 June 2013
• Definitions and terms
• Brief History
• Approaches in telepathology
• Applications
• Adavantages
• Limitations
The basic requirements for telepathology
1. Microscope
2. High-resolution camera
3. Internet access
4. Telepathology workstation
• Telepathology
• Pathology at a distance
• Telepathology is the practice of pathology at a distance by
visualizing an indirect image on a video monitor screen
rather than viewing a specimen directly through a
microscope.
• Digital pathology
• Virtual Microscopy

Weinstein, R.S., “Prospects for Telepathology” (editorial) Human Pathology 17: 433-
434, 1986.
• Ronald S. Weinstein – father of Telepathology
• Coined the term

History
• 1990- 2000 – Internet era – static image sharing
• Current trend – whole slide imaging (WSI), Virtual
microscopy – high-speed computer networks
DMetrix Digital Eyepiece virtual slide viewer
• Telepathology systems
• Dynamic
• Dynamic robotic telepathology
• Static
• Virtual microscopy/whole slide imaging

Approaches
Sample preparation and staining

Optical image formation by slide scanner

Digital image sampling by sensors- camera

Post-processing , compression

Transmission of digital image across telepathology network

Display on a monitor infront of pathologist

Process in digital imaging


• Analog to digital
• Terminologies
• Image resolution = Width x height
• Pixel = Picture element
• Each pixel can contain only one colour
• Pixel can be 8 bit, 16 bit, 32 bit etc  colour depth
• Its number determines the size of the image not resolution
• DPI or Dots per inch/ pixel per inch = physical printed size
• CCD= Charged couple device = retina of digital camera : An array of
photosensitive elements that produce voltage when exposed to light
• Digital camera resolution = total number of elements in the array

How a digital image is created?


• Resolution is usually the size of CCD equivalent to
number of pixels on the chip.
• Size of pixel varies among different types of CCD.
• Pixel size of 6.7 micrometers is thought to be ideal for
microscopy
1. Primary consultation for cytology or histopathology
2. Second opinion in difficult cases
3. Intraoperative consultations e.g. frozen sections.
Dynamic telepathology required. High cost.
4. Retro-consultation
5. Worldwide knowledge database/ Digital archieves

Applications
6. Digital slide conferencing
7. Education
• Virtual slide box at www.uscap.org
• Virtual Pathology at the University of Leeds
http://www.virtualpathology.leeds.ac.uk/index.php
• University of Iowa : Virtual slidebox
http://www.path.uiowa.edu/virtualslidebox
8. http://www.slideconsult.com WSI using mScope
software
• Static image telepathology
• Low cost and shorter learning curve
• Less investment in technology
• Limited view of field
• Non-representative images

Advantages and Limitations


• Dynamic telepathology
• Better field of view
• Real time consultation
• Planes of focus can be addressed
• Dependence on assistant in case of non-robotic microscope
• Absence of on-site pathologist
• Requires investment in technology- high-speed network
and better imaging equipment

Advantages and Limitations


• Whole slide imaging/ Virtual microscopy
• Fidelity of diagnostic material
• Portability
• Ease of sharing
• Archival
• Ability to make use of computer aided diagnostic tools –
image algorithm.

Advantages and Limitations


• Simultaneous viewing/teleconferencing
• High resolution images and rapid interpretation
• Automated scanning
• Storage of digital images
• High speed networks
• Radiology and pathology
• Static telepathology link between Tata Meomorial
Hospital and Nurgis-Dutt rural cancer hospital in 2000.
• Upto 2004, 299 telepathology consultations
• 98% concordance rate
• 48% cases reported within 8 hrs and 91% in 3 days

Telepathology in India
• High-speed scanning : 15x15 mm tissue area at 40x in
<1 min
• Z-scanning
• Scanning fluorescent slides
• Storage costs remain a limiting factor for digital archiving

Future perpspectives
1. Weinstein RS. Prospect for telepathology. Hum Pathol 1986;17:443--‐434.

2. Sankaye SB,Kachewar SG. Telepathology for effective healthcare in developing nations. AMJ
2011, 4, 11, 592– 595

3. www.Imagescope.org. Also available from http://aperio.com/pathology--


‐services/imagescope--‐slide--‐ viewing-- software.asp© Copyright 2001 --‐ 2011 Aperio
Technologies, Inc. [Accessed on November 26,2011]

4. Human Pathology (2009) 40, 1057–1069 , Overview of telepathology, virtual microscopy,


and whole slide imaging: prospects for the future

5. Telepathology. In: Handbook on quality assurance in Fine Needle Aspiration Cytology/edited


by Elizabeth K.Abraham.- Thiruvananthapuram: Regional Cancer Centre, 2003. P.62-67 /
Preethi, T.R. (2003)

References

You might also like