Virtual microscopy and public-key cryptography for Internet telepathology

Abstract

The Internet is a potentially inexpensive, widely available medium for telepathology, but there are concerns about its reliability and security. Using a digital camera, 41 photomicrographs of transbronchial biopsies, at x 100 optical magnification, were captured and digitized at 2700 x 3400 pixel, 24 bit/pixel resolution. The image files were saved in JPEG format at medium compression, attached to text files with patient information, encrypted for security in the S/MIME format using a digital signature and digital envelope, and transmitted by email. Received email files were decrypted automatically and the images viewed with standard software. Telepathology diagnoses were compared with original interpretations. The images averaged 810 kByte in size. The encryption and decryption did not cause significant delays in overall transmission time and, together with transmission, did not produce noticeable image degradation. The received image files could be viewed in a manner that simulated light microscopy. There was agreement between telepathology and original diagnoses in 92% of the cases. All the discrepancies were due to inadequate area selection because the pathological features of interest were present in histological levels other than those photographed. The use of high-resolution digital photomicrography, the Internet and public-key cryptography offers an effective and relatively inexpensive method of telepathology consultation. The method is best suited for the diagnosis of small biopsy specimens that require the transmission of only a few digital images that represent the majority of the biopsy materials.

Telecytology of fine‐needle aspiration biopsies of the pancreas: A study of well‐differentiated adenocarcinoma and chronic pancreatitis with atypical epithelial repair changes

“…[12][13][14] Six images from each case were photographed at Cedars Sinai Medical Center by VN, using ϫ100 magnification and tiled into a large image using PhotoShop 4.0 software (Adobe Systems, San Jose, CA) ( Fig. 1).…”

“…We report a study of 27 patients with mass lesions of the pancreas with static telecytology using high-resolution digital images and methods of virtual microscopy described previously for the study of skin, gastrointestinal, lung, and other biopsy materials. [12][13][14] …”

Evaluation of static telepathology in veterinary diagnostic cytology

“…Static telepathology (also known as offline or store and forward) by Internet e-mail, is the simplest and least expensive form of telepathology, and has been considered an alternative in human pathology. Most published studies have used surgical pathology specimens, including frozen and paraffin sections [3][4][5][6][7][8][9][10][11][12] ; only a few have considered telecytologic diagnosis. [13][14][15][16][17][18][19][20][21] The aim of this study was to test whether telediagnosis through Internet e-mail could be applied in veterinary diagnostic cytology.…”

Virtual slide telepathology workstation of the future: lessons learned from teleradiology

“…Most studies to date in telepathology have been more concerned with assessing the concordance of diagnosis between the original specimen slides and the digitized or photographed versions of them [1–14]. For the most part, these studies have found concordance rates well above 90%, and telepathology is becoming fairly well established in many clinical settings.…”