Massone Cesare, Brunasso Alexandra M G, Campbell Terri M, Soyer H Peter
Department of Dermatology, Medical University of Graz, Graz, Austria.
Am J Dermatopathol. 2008 Oct;30(5):446-50. doi: 10.1097/DAD.0b013e3181822057.
Teledermatopathology may involve real-time transmission of images from distant locations to consulting pathologists by the remote manipulation of a robotic microscope. Alternatively, the static store-and-forward option involves the single-file transmission of subjectively preselected and captured areas of microscopic images by a referring physician. The recent introduction of virtual slide systems (VSS) involves the digitization of whole slides at high resolution thus enabling the user to view any part of the specimen at any magnification. Such technology has surmounted previous restrictions caused by the size of preselected areas and specimen sampling for telepathology. In terms of client access, these VSS may be stored on a virtual slide server, made available on the Web for remote consultation by pathologists via an integrated virtual slide client network. Despite store-and-forward teledermatopathology being the most frequently used and less expensive approach to teledermatopathology, VSS represents the future in this discipline. The recent pilot studies suggest that the use of remote expert consultants in diagnostic dermatopathology can be integrated into daily routine, teleconsultation, and teleteaching. The new technology enables rapid and reproducible diagnoses, but despite its usability, VSS is not completely feasible for teledermatopathology of inflammatory skin diseases as the performance seems to be influenced by the availability of complete clinical data. Improvements in the diagnostic facility will no doubt follow from further development of the VSS, the slide processor, and of course training in the use of virtual microscope. Undoubtedly, as technology becomes even more sophisticated in the future, VSS will overcome the present drawbacks and find its place in all facets of teledermatopathology.
远程皮肤病理学可通过对机器人显微镜的远程操作，将远处的图像实时传输给会诊病理学家。或者，静态存储转发方式则是由转诊医生对主观预选并采集的显微镜图像区域进行单文件传输。近期引入的虚拟切片系统（VSS）可对整张切片进行高分辨率数字化处理，从而使用户能够以任何放大倍数查看标本的任何部分。此类技术克服了以往因远程病理学预选区域大小和标本采样所造成的限制。在客户端访问方面，这些虚拟切片系统可存储在虚拟切片服务器上，通过集成的虚拟切片客户端网络在网上供病理学家进行远程会诊。尽管存储转发远程皮肤病理学是远程皮肤病理学中最常用且成本较低的方法，但虚拟切片系统代表了该领域的未来。近期的试点研究表明，在诊断性皮肤病理学中使用远程专家会诊可融入日常工作、远程会诊和远程教学。这项新技术能够实现快速且可重复的诊断，然而，尽管其具有可用性，但对于炎症性皮肤病的远程皮肤病理学而言，虚拟切片系统并不完全可行，因为其性能似乎受到完整临床数据可用性的影响。随着虚拟切片系统、切片处理器的进一步发展，以及当然还有虚拟显微镜使用方面的培训，诊断设施无疑会得到改进。毫无疑问，随着未来技术变得更加先进，虚拟切片系统将克服当前的缺点，并在远程皮肤病理学的各个方面占据一席之地。
