Department of Pathology, Massachusetts General Hospital, Boston, 02114, USA.
Anal Cell Pathol (Amst). 2012;35(1):25-30. doi: 10.3233/ACP-2011-0032.
The practice of pathology in the developing world presents challenges in terms of limited resources, shortages of trained personnel, and lack of continuing education programs. Telepathology holds promise as a means of diagnostic and educational support.
We donated multiheaded teaching microscopes equipped with digital cameras to four hospitals in Eastern Africa and trained local pathologists on their use. Static images of challenging cases were posted on a web-based telepathology platform. A U.S.-based pathologist reviewed images in consultation with subspecialist colleagues.
Over a period of 40 months, 109 cases were submitted for second opinion consultation, including 29 dermatopathology cases (26.6%), 14 hematopathology cases (12.8%), and 13 cases each (11.9%) in cytopathology and bone and soft tissue pathology. Static images enabled a complete or partial diagnosis in 100/109 cases (91.7%). Factors precluding a definitive diagnosis included absence of confirmatory immunophenotyping, technical issues, or lack of clinical history. Case responses included a diagnosis and discussion, including differential diagnosis, references, and treatment recommendations.
Static digital telepathology is a simple, cost-effective, reliable and efficient means to provide diagnostic and educational support to pathologists in the developing world. Additional training may help overcome technical factors precluding a definitive diagnosis in certain cases.
发展中国家的病理学实践在资源有限、缺乏训练有素的人员以及缺乏继续教育项目方面存在挑战。远程病理学有望成为一种诊断和教育支持手段。
我们向东非的四家医院捐赠了配备数字摄像头的多头教学显微镜，并培训了当地的病理学家使用方法。有挑战性的病例的静态图像被发布在基于网络的远程病理学平台上。一位美国病理学家与亚专科同事一起对图像进行了复查。
在 40 个月的时间里，有 109 个病例提交了二次诊断咨询，其中包括 29 个皮肤病理学病例（26.6%）、14 个血液病理学病例（12.8%）、细胞学和骨与软组织病理学各 13 个病例（11.9%）。109 例中的 100 例（91.7%）通过静态图像能够做出完整或部分诊断。妨碍明确诊断的因素包括缺乏确认免疫表型、技术问题或缺乏临床病史。病例回复包括诊断和讨论，包括鉴别诊断、参考文献和治疗建议。
静态数字远程病理学是向发展中国家的病理学家提供诊断和教育支持的一种简单、具有成本效益、可靠且高效的方法。进一步的培训可能有助于克服某些病例中妨碍明确诊断的技术因素。
