Speiser Jodi J, Hughes Ian, Mehta Vikas, Wojcik Eva M, Hutchens Kelli A
Department of Pathology, Loyola University Medical Center, Maywood, IL.
Am J Dermatopathol. 2014 Jan;36(1):54-7. doi: 10.1097/DAD.0b013e3182863186.
: Dermatopathology has relatively few studies regarding teledermatopathology and none have addressed the use of new technologies, such as the tablet PC. We hypothesized that the combination of our existing dynamic nonrobotic system with a tablet PC could provide a novel and cost-efficient method to remotely diagnose dermatopathology cases. 93 cases diagnosed by conventional light microscopy at least 5 months earlier by the participating dermatopathologist were retrieved by an electronic pathology database search. A high-resolution video camera (Nikon DS-L2, version 4.4) mounted on a microscope was used to transmit digital video of a slide to an Apple iPAD2 (Apple Inc, Cupertino, CA) at the pathologist's remote location via live streaming at an interval time of 500 ms and a resolution of 1280/960 pixels. Concordance to the original diagnosis and the seconds elapsed to reaching the diagnosis were recorded. 24.7% (23/93) of cases were melanocytic, 70.9% (66/93) were nonmelanocytic, and 4.4% (4/93) were inflammatory. About 92.5% (86/93) of cases were diagnosed on immediate viewing (<5 seconds), with the average time to diagnosis at 40.2 seconds (range: 10-218 seconds). Of the cases diagnosed immediately, 98.8% (85/86) of the telediagnoses were concordant with the original. Telepathology performed via a tablet PC may serve as a reliable and rapid technique for the diagnosis of routine cases with some diagnostic caveats in mind. Our study established a novel and cost-efficient solution for those institutions that may not have the capital to purchase either a dynamic robotic system or a virtual slide system.
皮肤病理学领域关于远程皮肤病理学的研究相对较少,且尚无研究涉及平板电脑等新技术的应用。我们推测,将现有的非机器人动态系统与平板电脑相结合,可为远程诊断皮肤病理学病例提供一种新颖且经济高效的方法。通过电子病理数据库搜索,检索出参与研究的皮肤病理学家至少在5个月前通过传统光学显微镜诊断的93例病例。安装在显微镜上的高分辨率摄像机(尼康DS-L2,版本4.4)用于以500毫秒的间隔时间和1280/960像素的分辨率,通过实时流将载玻片的数字视频传输到病理学家远程位置的苹果iPad2(苹果公司,库比蒂诺,加利福尼亚州)。记录与原始诊断的一致性以及做出诊断所花费的时间。24.7%(23/93)的病例为黑素细胞性,70.9%(66/93)为非黑素细胞性,4.4%(4/93)为炎症性。约92.5%(86/93)的病例在即时查看时(<5秒)即可诊断,平均诊断时间为40.2秒(范围:10 - 218秒)。在即时诊断的病例中,98.8%(85/86)的远程诊断与原始诊断一致。通过平板电脑进行的远程病理学检查可能是一种可靠且快速的技术,用于诊断常规病例,但需牢记一些诊断注意事项。我们的研究为那些可能没有资金购买动态机器人系统或虚拟载玻片系统的机构建立了一种新颖且经济高效的解决方案。