Telepathology

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Includes various terminologies, technologies used in Telepathology. Types and applications of Telepathology.

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Telepathology

  1. 1. TELEPATHOLOGY 8 June 2013
  2. 2. • Definitions and terms • Brief History • Approaches in telepathology • Applications • Adavantages • Limitations
  3. 3. The basic requirements for telepathology 1. Microscope 2. High-resolution camera 3. Internet access 4. Telepathology workstation
  4. 4. • 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.
  5. 5. History • Ronald S. Weinstein – father of Telepathology • Coined the term
  6. 6. • 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
  7. 7. Approaches • Telepathology systems • Dynamic • Dynamic robotic telepathology • Static • Virtual microscopy/whole slide imaging
  8. 8. Process in digital imaging Display on a monitor infront of pathologist Transmission of digital image across telepathology network Post-processing , compression Digital image sampling by sensors- camera Optical image formation by slide scanner Sample preparation and staining
  9. 9. How a digital image is created? • 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
  10. 10. • 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
  11. 11. Applications 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
  12. 12. 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
  13. 13. Advantages and Limitations • Static image telepathology • Low cost and shorter learning curve • Less investment in technology • Limited view of field • Non-representative images
  14. 14. 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
  15. 15. 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.
  16. 16. • Simultaneous viewing/teleconferencing • High resolution images and rapid interpretation • Automated scanning • Storage of digital images • High speed networks • Radiology and pathology
  17. 17. Telepathology in India • 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
  18. 18. Future perpspectives • 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
  19. 19. References 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)

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