Kayser K, Beyer M, Blum S, Kayser G
Department of Pathology, Thoraxklinik, Heidelberg, Germany.
Folia Neuropathol. 2000;38(2):79-83.
Telepathology is the diagnostic work of a pathologist at a distance. It includes specific application fields which require specific system solutions. These comprise: a. frozen section service; b. expert consultations; c. remote control measurements, and d. education and training. Applications but, in addition, all aspects of diagnosis, especially those involved in the daily work flow of a pathologist. The image quality, transfer rates, and screen resolution of telepathology systems are sufficient for an additional or primary judgment of histological slides and cytological smears. It is, therefore, possible to include this technique into intralaboratory quality control of all steps of diagnostic procedures and to use this technique for quality assurance and control. Diagnostic quality is not a well defined term, and depends, in addition to external circumstances, on the diagnosis itself. The diagnostic quality can be maintained or even improved by use of telepathology systems. They can serve for control of image quality, access to various information sources, simultaneous transfer of images and diagnosis, and continuous education of the involved pathologists. For example, in continuous education and training, as a first step the pathologist should have access to an image data bank storing images related to the specific case, for example images taken from the same organ and from patients of similar age. The final stage would be an intra-diagnostic learning from the specific case; i.e. the time difference between questionnaires for a difficult diagnosis and the final diagnosis will become a minimum. Automated storing of the specific and diagnosis-associated images of the case will permit an open diagnostic system which will itself adjust to the micro-environment of the department of pathology. Although this future scenario has not been implemented to our knowledge, there is little doubt the development in telepathology will promote the technical procedures in the environment of a diagnostic pathologist. Telepathology is, therefore, not a substitute of conventional diagnostic procedures but a real improvement in the world of pathology.
远程病理学是病理学家在远距离进行的诊断工作。它包括需要特定系统解决方案的特定应用领域。这些领域包括:a. 冰冻切片服务;b. 专家会诊;c. 远程控制测量,以及d. 教育与培训。此外,远程病理学还涉及诊断的各个方面,尤其是病理学家日常工作流程中所涉及的方面。远程病理学系统的图像质量、传输速率和屏幕分辨率足以对组织学切片和细胞学涂片进行辅助或初步判断。因此,有可能将这项技术纳入诊断程序所有步骤的实验室内部质量控制,并将其用于质量保证和控制。诊断质量不是一个定义明确的术语,除外部环境外,还取决于诊断本身。使用远程病理学系统可以维持甚至提高诊断质量。它们可用于控制图像质量、访问各种信息源、同时传输图像和诊断结果,以及对相关病理学家进行持续教育。例如,在持续教育和培训中,作为第一步,病理学家应能够访问一个图像数据库,该数据库存储与特定病例相关的图像,例如取自同一器官和年龄相仿患者的图像。最后阶段将是从特定病例中进行诊断内学习;即,对于疑难诊断,问卷与最终诊断之间的时间差将变得最小。对病例的特定和与诊断相关的图像进行自动存储将允许一个开放的诊断系统,该系统将自行适应病理科的微观环境。尽管据我们所知,这种未来的设想尚未实现,但毫无疑问,远程病理学的发展将推动诊断病理学家环境中的技术程序。因此,远程病理学不是传统诊断程序的替代品,而是病理学领域的一项真正改进。