Digital pathology in Europe: coordinating patient care and research efforts.

The COST Action IC0604 "Telepathology Network in Europe" (EURO-TELEPATH) is an initiative of the COST (European Cooperation in the field of Scientific and Technical Research) framework, supported by the Seventh Framework Programme for research and technological development (FP7), of the European Union will be running from 2007 to 2011 and is aimed to coordinate research efforts to develop the most adequate technological framework for the management of multimedia electronic healthcare records (data and images) applied to Anatomic Pathology. Sixteen countries are participating in EURO-TELEPATH. Activities are organized in four Working Groups (WGs): WG1 - Pathology Business Modeling, WG2 - Informatics Standards in Pathology, WG3 - Images: Analysis, Processing, Retrieval and Management, and WG4 - Technology and Automation in Pathology. During the first year of work, the collaboration between software engineers, computer scientists, pathologists and other clinicians has been essential to detect three main areas of interest in digital pathology research: virtual microscopy scanning solutions, health informatics standards, and image processing and analysis. Research in these areas is essential to a correct approach to telepathology, including primary diagnosis, and secondary or teleconsultation services. Managing microscopic pathology images (virtual slides) is a challenge to existing information systems, mainly due to its large size, large number, and complex interpretation. Regarding interoperability, the integration of pathology reports and images into eHealth records is an essential objective that research groups should consider. Promoting participation in standards bodies (DICOM, IHE, HL7, IHTSDO) is an essential part of the project work. Understanding the business process of pathology departments in daily practice, including healthcare, education, research, and quality control activities, is the starting point to be sure that standardization efforts converge with user needs. Following a recent IHE proposal, coordination with public health services like national or regional tumor registries must also be supported. Virtual or digital slides are fostering the use of image processing and analysis in pathology not only for research purposes, but also in daily practice. Nowadays, further discussion is needed on the adequacy of current existing technical solutions, including for instance quality of images obtained by scanners, or the efficiency of image analysis applications.