A prospective trial of telepathology for intraoperative consultation (frozen sections)

Winokur, Thomas S.; McClellan, Stan; Siegal, Gene P.; Redden, David T.; Gore, Prya; Lazenby, Audrey J.; Reddy, Vishnu; Listinsky, Catherine M.; Conner, David A.; Goldman, Jay P.; Grimes, G.J.; Vaughn, Gregg; McDonald, Jay M.

doi:10.1053/hupa.2000.8452

Cited by 55 publications

(29 citation statements)

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“…In the United States, Winokur et al (12) prospectively reviewed 99 intraoperative consultations from 29 tissue/organ sites. Statistical analysis indicated no significant difference between telepathology and conventional microscopy.…”

Section: Discussionmentioning

confidence: 99%

“…The cited retrospective studies do not allow conclusions on the significance of this source of error because they do not show a trend to higher levels of diagnostic accuracy compared with the prospective studies (32). Some telepathology systems rely on the transmission of macroscopic images and subsequent visual and acoustic guidance of tissue sampling by the telepathologist with the aid of technician, pathologist assistant, or surgeon (3,12). In the fields of microinvasive surgery, computer-assisted surgery, and telesurgery, sensors that allow for tactile sensation (i.e., telefeeling, telepalpation) are being developed that may be suitable for the tactile sensation needed for a remote telepathologist for FS diagnosis (32).…”

Section: Discussionmentioning

confidence: 99%

“…Several of these studies deal with a single organ system or in practices with a limited scope of pathologic specimens (4 -16). A few telepathology services are active in the United States, including those of the Armed Forces Institute of Pathology (AFIP), the University of Arizona, and the Milwaukee Veterans Administration Medical Center (12). For a variety of reasons, telepathology has not gained wide acceptance among practicing pathologists.…”

Section: Mod Pathol 2002;15(11):1197-1204mentioning

confidence: 99%

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Use of Robotic Telepathology for Frozen-Section Diagnosis: A Retrospective Trial of a Telepathology System for Intraoperative Consultation

et al. 2002

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Telepathology is the practice of digitizing histological or macroscopic images for transmission along telecommunication pathways for diagnosis, consultation, or continuing medical education. Previous studies have addressed static versus dynamic imaging in several specimen types with a wide variety of systems and communication pathways. The goal of this paper was to assess the validity of a Web-based telepathology system for frozen section consultation within the Army Medical Department. The system provides real-time, dynamic remote control of a robotic microscope over standard Internet connections. Oftentimes, a solo pathologist is called on to provide diagnostic services without the support of immediate second or expert consultation during an intraoperative consultation. The use of telepathology is attractive because it provides an opportunity for pathologists to obtain immediate consultation. For purposes of the study, 120 consecutive frozen section cases were diagnosed at a distance using the system. Intraobserver agreement between the telepathology diagnosis and glass slide diagnosis was observed. Diagnostic agreement was 100% for a wide variety of specimens. This study suggests that such a system will help support pathologists located at distant sites.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Mod Pathol 2002;15(11):1197-1204mentioning

confidence: 99%

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Use of Robotic Telepathology for Frozen-Section Diagnosis: A Retrospective Trial of a Telepathology System for Intraoperative Consultation

et al. 2002

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“…It is currently defined as electronic multimedia communication between pathologists (can also include a nonpathologist) for the purposes of primary diagnosis and diagnostic consultation second opinion [2]. Telepathology exclusive of digitized images is used for research, educational purposes, and quality assurance activities when no separate report is generated [3,4,5,6]. The emphasis is on making a diagnosis based on digitized images that may be included in a formal diagnostic report or documented in the patient record.…”

Section: Introductionmentioning

confidence: 99%

TeleCyP (Telecytopathology): Real-Time Fine-Needle Aspiration Interpretation

2012

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Objective: To assess the application of TeleCyP for real-time fine-needle aspiration interpretation (RFI) necessary for case management and specimen triage. Study Design: Twenty-two endobronchial ultrasound (EBUS)-guided mediastinal and pulmonary cases were included in the learning phase to determine the time and efficiency of TeleCyP. Slides were scanned by a cytopathology fellow in real time, and high-speed transmitted images over a secure network were interpreted by a cytopathologist while maintaining audio communication. In the validation phase, an additional 38 pancreas cases from endoscopic ultrasound (EUS) were evaluated recapitulating the RFI scenario from the learning phase. The cytopathologist was blinded to the results of the diagnosis in both phases. Results: The time to provide assessment of specimen adequacy and a preliminary diagnosis was 53 s in the learning phase and 49 s in the validation phase. There was 100% correlation between RFI and TeleCyP assessment for specimen adequacy. TeleCyP particularly posed challenges in providing definitive interpretation on EUS-fine-needle aspiration of some of the pancreatic solid masses (11%, 4/36). Conclusion: TeleCyP can serve as a powerful alternative, time-efficient strategy to provide RFI, and for specimen triaging which is critical for personalized medicine and patient management.

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“…The number of patients included was a little higher than that used by other similar studies. [12][13][14][15][16] Among the dermatoses evaluated, there was a predominance of neoplasms and infectious-contagious diseases, representing the profile of the skin diseases diagnosed in the institution where the work was conducted. It was 16 observed that Consultant 1's agreement rate in relation to analysis of the slides under an optical microscope and image analysis was 88.1% (95% CI = 81.5% -93.1%).…”

Section: Discussionmentioning

confidence: 99%

Reprodutibilidade do diagnóstico histopatológico de dermatoses por fotomicrografias digitais versus microscopia óptica convencional

Schettini

Ferreira

Schettini

et al. 2011

An. Bras. Dermatol.

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FUNDAMENTOS: A telepatologia é considerada boa alternativa para consultas de segunda opinião. Sua implementação é desejável, mas estudos que confirmem sua aplicação prática são necessários. OBJETIVOS: Analisar a concordância entre os diagnósticos histopatológicos de dermatoses feitos com base em microfotografias digitais em comparação com a microscopia convencional. MÉTODOS: As lâminas de 135 pacientes foram avaliadas por dois consultores por meio de microscópio. Após quatro semanas, os mesmos consultores avaliaram 1.738 microfotografias digitais obtidas dessas lâminas. Estimou-se a taxa geral de concordância intraobservadores e interobservadores e obteve-se o índice Kappa com a categorização das dermatoses: dermatoses neoplásicas, dermatoses infectocontagiosas e não infectocontagiosas. RESULTADOS: A concordância do Consultor 1, que analisou lâminas ao microscópio versus imagens, foi de 88,1% (IC 95% = 81,5% - 93,1%). O Consultor 2 obteve concordância de 80,7% (IC 95% = 73,1% - 87%). A concordância interconsultores ao microscópio foi de 81,5% (IC 95% = 73,9% - 87,6%). A mesma análise por meio de microfotografias mostrou concordância de 85,9% (IC 95% = 78,9% - 91,3%). O índice Kappa, que avalia as dermatoses categorizadas, foi de 98,6% para o Consultor 1, de 93,1% para o Consultor 2, de 95,8% para interconsulta por imagens e de 95,9% para interconsultas ao microscópio óptico. Todos esses valores são considerados ótimos. CONCLUSÃO: A avaliação das microfotografias apresentou ótimo nível de reprodutibilidade quando comparada à microscopia tradicional, sendo uma opção viável para consultas de segunda opinião em dermatopatologia

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A prospective trial of telepathology for intraoperative consultation (frozen sections)

Cited by 55 publications

References 0 publications

Use of Robotic Telepathology for Frozen-Section Diagnosis: A Retrospective Trial of a Telepathology System for Intraoperative Consultation

Use of Robotic Telepathology for Frozen-Section Diagnosis: A Retrospective Trial of a Telepathology System for Intraoperative Consultation

TeleCyP (Telecytopathology): Real-Time Fine-Needle Aspiration Interpretation

Reprodutibilidade do diagnóstico histopatológico de dermatoses por fotomicrografias digitais versus microscopia óptica convencional

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