Della Mea V, Cataldi P, Boi S, Finato N, Dalla Palma P, Beltrami C A
Institute of Pathology, University of Udine, Italy.
J Clin Pathol. 1999 Oct;52(10):761-5. doi: 10.1136/jcp.52.10.761.
A frozen section diagnostic service is often not directly available in small rural or mountain hospitals. In these cases, it could be possible to provide frozen section diagnosis through telepathology systems. Telepathology is based on two main methods: static and dynamic. The former is less expensive, but involves the crucial problem of image sampling.
To characterise the differences in image sampling for static telepathology when undertaken by pathologists with different experience.
As a test field, a previously studied telepathology method based on multimedia email was adopted. Using this method, three pathologists with different levels of experience sampled images from 155 routine frozen sections and sent them to a distant pathology institute, where diagnoses were made on digital images. After the telepathology diagnoses, the glass slides of both the frozen sections and the definitive sections were sent to the remote pathologists for review.
Four of 155 transmissions were considered inadequate by the remote pathologist. In the remaining 151 cases, the telepathology diagnosis agreed with the gold standard in 146 (96.7%). There was no significant divergence between the three pathologists in their sampling of the images. Each case comprised five images on average, acquired in four minutes. The overall time for transmission was about 19 minutes.
The results suggest that in routine frozen section diagnosis an inexperienced pathologist can sample images sufficiently well to permit remote diagnosis. However, as expected, the internet is too unreliable for such a time dependent task. An improvement in the system would involve integrated real time features, so that there could be interaction between the two pathologists.
在小型乡村或山区医院，通常无法直接提供冰冻切片诊断服务。在这些情况下，通过远程病理学系统提供冰冻切片诊断是可行的。远程病理学基于两种主要方法：静态和动态。前者成本较低，但存在图像采样的关键问题。
描述不同经验的病理学家进行静态远程病理学时图像采样的差异。
作为测试领域，采用了一种先前研究过的基于多媒体电子邮件的远程病理学方法。使用这种方法，三名经验水平不同的病理学家从155例常规冰冻切片中采集图像，并将其发送到远方的病理研究所，在那里对数字图像进行诊断。远程病理学诊断后，将冰冻切片和最终切片的玻璃切片都发送给远程病理学家进行复查。
远程病理学家认为155次传输中有4次不充分。在其余151例病例中，远程病理学诊断与金标准相符的有146例（96.7%）。三名病理学家在图像采样方面没有显著差异。每个病例平均包含五张图像，采集时间为四分钟。传输总时间约为19分钟。
结果表明，在常规冰冻切片诊断中，经验不足的病理学家也能充分采集图像以进行远程诊断。然而，正如预期的那样，互联网对于这样一项依赖时间的任务来说太不可靠了。系统的改进将涉及集成实时功能，以便两名病理学家之间能够进行互动。
