Telepathology involves the practice of pathology at a distance using digital imaging technology. There are three main types: static telepathology which uses stored images, robotic interactive pathology which allows remote control of a microscope in real-time, and virtual slide telepathology which uses high resolution whole slide imaging. The future of telepathology depends on continued improvements in digital imaging quality and pathologist skills in virtual microscopy to match conventional diagnosis under a microscope.

1. TELE PATHOLOGY
DR.ABHINAV GOLLA
MEDICURE DIAGNOSRICS AND RESEARCH
CENTER
Vijayanagar colony, Hyderabad,
TELANGANA.

2. TELEPATHOLOGY
• Definition
• Parts
• Types
• Significant areas of development
• Applications
• Technical aspects of telepathology
• Future of telepathology

3. INTRODUCTION
• Tele is a Greek word meaning - distance .
• Pathos is a Greek word meaning - suffering
• Logia - study
• Telepathology - practice of pathology at a distance .

4. DEFINITION
• It is acquisition of histological & macroscopic images for
transmission along telecommunication pathways for
Diagnosis
Consultation
Continuing medical education

7. PARTS
• Telepathology system comprises a
1. Conventional microscope
2. Camera mounted on a light microscope
3. Telecommunications - link between sending & receiving
sites
4. Workstation at the receiving site with a high quality
monitor to view the images.

8. TYPES
Telepathology
Static telepathology
Robotic Interactive Pathology
Virtual Slide Telepathology

9. 1 .STATIC
TELEPATHOLOGY• Synonyms-Store & forward or passive telepathology .
• Advantages –
 It is cheap , simple , need a standard telephone line / internet
connection .
Images are static .
• There is no facility for recipient control .

11. STATIC TELEPATHOLOGY
• Number of images captured is limited for each case .(1-
40)
• Disadvantages -
Sampling errors
Interpretation & Video imaging quality has problems .

12. • Sampling errors/ Bias – can be prevented by using a trained
pathologist to select the images .
• There is some discordance between telepathology & glass
slide diagnosis .
• This discordance is due to
Field selection
Diagnostic interpretation
Video image quality

13. 2 .ROBOTIC
INTERACTIVE
PATHOLOGY
( RIT PATH)
• Synonyms – Dynamic telepathology /
Active telepathology /
Real time telepathology
• Advantage –
receiving pathologist can control the movement of the
slide on the stage .
To see the image in real time on a high resolution
monitor .

14. RIT PATH
• Limitation -
 Transmission time
• Examples -
1. HISTKOM RIT Path system
2. The Apollo image management system (IMS)/Corabi
dynamic module (CDT)

17. •Histkom rit path system :
• It consists of a
robotic zeiss microscope with triple charge coupled
device(CCD),
Sony video camera transmitting images to a remote station.

18. HISTKOM RIT PATH
SYSTEM :
• User is able to control all the functions of the
microscope , including the scanning stage , magnification
& light intensity.
• Soft ware at the receiving station stitches the images
together thus stimulating a moving image

19. • The apollo image management system / Corabi Dynamic
Module (IMS / CDT)
• This system provides remote stage management , focus , light
intensity & magnification .
• It has the capability of functioning as a bidirectional
telepathology system.
• Disadvantage of video conference technology in - its
susceptibility to blurring
- interruptions in image displays

20. • HYBRID system - capable of both the static telepathology
& dynamic telepathology.

21. 3 . VIRTUAL SLIDE
TELEPATHOLOGY
• It requires fast slide scanner.
• Highest image quality & speed .
• Offers better user experience & diagnostic accuracy than
robotic microscopy.
• Examination & storage in one step.

23. ADVANTAGES DISADVANTAGES
• Virtual Slide doesn't discolor • Not possible to focus the areas
that were not correctly acquired
during scanning due to irregular
surface of the sample.
• Multiple viewers can
observe Virtual Slide at the
same time
• Less space consuming
• Allows exploration of the
whole slide surface with
different magnification

24. SIGNIFICANT AREAS OF
DEVELOPMENT
• INTERNET : helps in video conferencing & presentation
of graphical images
• Adv: cost & availability
static images are sent as email attachments
• Disadvatages- slow
issue of security

25. • SLIDE DIGITISATION : It is the conversion of an
analogue source in to a digital format, so that can be
stored by a computer & recreated at a later date .
• Stained sections will fade with time , image stored in
digital form offers a longer lifespan ,

26. APPLICATIONS
• In places where full time pathologist is not available
telepathology helps in gaining a pathologist
consultation.
• Telepathology helps in taking an expert pathologist
opinion.
• Telepathology can overcome the delays associated with
the postal service .

27. • External Quality Assessment & Teaching :
 EQA programs has advantage in mass delivery .
Rather than cut multiple sections , selective images for
each case can be sent via E-mail .
Images can be reviewed later .
Educational cases can easily be distributed to trainees .

28. TECHNICAL ASPECTS OF
TELEPATHOLOGY• IMAGE ACQUISITION
• STORAGE
• IMAGE COMPRESSION
• NETWORKING & LINE SPEEDS
• COMPUTER NETWORKS

29. IMAGE ACQUISITION
• By camera mounted on the top of the microscope.
• CCD(charge coupled device) sensor convert the images to
an electronic form .
• Out put from the digital video cameras is converted
back either to an analogue signal for viewing on an
television monitor or sent unchanged to a computer
hardware & software for recording.

30. STORAGE
• 1. Short term storage - hard drive
• 2. Small computer system interface (SCSI) –
It handles multiple devices such as extra hard drives
,scanners ,CD-ROM’S ,simultaneously along a single interphase.

31. IMAGE COMPRESSION
• DICOM (SM) – Digital Imaging & Communications in
Medicine Standard- provides standardized formats
for image capture & storage .
• IMAGE FORMATS -
Lossy algorithms – discard unnecessary data in the
course of compression .
Lossless algorithms – preserve data at the expense
of compressed image size .

32. • JPEG - Joint Photographics Experts Group
• GIF - Graphics Interchange Format
• PNG - Portable Network Graphics
• Flash Pix
• WSQ - Wavelet Scalar Quantitisation
• TIFF - Tagged Image File Format
• Fractals Compression

33. COMPUTER NETWORKS
• This is the key tool used by companies & institutions
world wide .
• LAN (Local area network)
• WAN (Wide area network)

34. • LAN – it is a high speed communications system designed to
link computers & data processing devices together with in a
small geographic area .EX: ATM
• Multiple LANs are linked together to form a WAN .
• Example of WAN is Telephone network, modems ,ATM , ISDN.

35. NETWORKING
• Robotic telepathology is dependent on telecommunication
transmission speed.
 Plain old Telephone Services (POTS)
 Integrated Services Digital network (ISDN)
 Asynchronous Transfer mode (ATM)
 T -1/T-3 Carriers
 Cable Modems / Digital Subscriber Lines(DSL)

36. CODEC FROM ATM TO
Video/audio & vice versa

37. MULTIPLE ONE
ON ONE VIDEO
CONFERENCING
ONE ON ONE
VIDEO
CONFERENCING
STILL IMAGES,
DOCUMENT
CONFERENCING
CAPABILITI
ES
ISDNMODEM ATM
CAPABILITIES OF WAN

39. FUTURE OF
TELEPATHOLOGY
• Currently telepathology is far from being an
alternative to conventional reporting but it
offers a new approach to diagnostic services
• The quality of the digitisation of histological
images has to improve ,the pathologists skill
in interpreting these images has to improve
until it matches the conventional images.

40. TELEPATHOLOGY
WORD.DOCX
• References
• Recent advances in histopathology 18
• internet