Invention and Early History of Telepathology (1985-2000)

Abstract

This narrative-based paper provides a first-person account of the early history of telepathology (1985–2000) by the field's inventor, Ronald S. Weinstein, M. D. During the 1980s, Dr. Weinstein, a Massachusetts General Hospital-trained pathologist, was director of the Central Pathology Laboratory (CPL) for the National Cancer Institute-funded National Bladder Cancer Project, located at Rush Medical College in Chicago, IL. The CPL did post therapy revalidations of surgical pathology and cytopathology diagnoses before outcomes of the completed clinical trials were published. The CPL reported that interobserver variability was invalidating inclusion of dozens of treated bladder cancer patients in published reports on treatment outcomes. This problem seemed ripe for a technology-assisted solution. In an effort to solve the interobserver variability problem, Dr. Weinstein devised a novel solution, dynamic-robotic telepathology, that would potentially enable CPL uropathologists to consult on distant uropathology cases in real-time before their assignment to urinary bladder cancer, tumor stage, and grade-specific clinical trials. During the same period, universities were ramping up their support for faculty entrepreneurism and creating in-house technology transfer organizations. Dr. Weinstein recognized telepathology as a potential growth industry. He and his sister, Beth Newburger, were a successful brother–sister entrepreneur team. Their PC-based education software business, OWLCAT™, had just been acquired by Digital Research Inc., a leading software company, located in California. With funding from the COMSAT Corporation, a publically traded satellite communications company, the Weinstein-Newburger team brought the earliest dynamic-robotic telepathology systems to market. Dynamic-robotic telepathology became a dominant telepathology technology in the late 1990s. Dr. Weinstein, a serial entrepreneur, continued to innovate and, with a team of optical scientists at The University of Arizona's College of Optical Sciences, developed the first sub-1-min whole-slide imaging system, the DMetrix DX-40 scanner, in the early 2000s.

Optimising rapid on‐site evaluation‐assisted endobronchial ultrasound‐guided transbronchial needle aspiration of mediastinal lymph nodes: The real‐time cytopathology intervention process

“…In certain clinic or hospital settings the use of telepathology has the potential to provide satisfactory assessments of adequacy 15 . When cytology images are viewed on a high‐resolution computer screen, accurate interpretations are feasible.…”

Tissue Multiplex Analyte Detection in Anatomic Pathology – Pathways to Clinical Implementation

“…Over 2 decades ago, whole slide scanners that create high resolution images from standard pathology tissue slides were marketed for research and educational purposes, with the perceived promise (and among some, fear) that they would someday augment or even replace manual microscopy in diagnostic practice. Such was born, as an extension of efforts around telepathology for remote diagnosis in the 1980s and 1990s, the field of "digital pathology" (Soenksen, 2009;Weinstein et al, 2019). Slide digitization enabled quantitation of tissue parameters by image analysis, described above.…”

Diagnostic digital pathology implementation: Learning from the digital health experience

“…There has been an increasing interest in the ability to provide remote diagnostics since the earliest descriptions of telepathology. 24 , 25 A literature search for the most used terms: “Digital Pathology”, “Telepathology” and “Whole Slide Imaging”, between 1986–2019, shows a steep rise in publications from 2012, and also demonstrates the change in preference for terminology to “Digital Pathology”, Figure 1(a) . In the rest of this essay, I will therefore use the term “digital pathology” as an umbrella term to cover all three terms, bearing in mind that whilst these terms are used interchangeably some authors regard WSI as the process of creating a replica of a glass slide and telepathology as the service component of digital pathology.…”