The design and use of a computer-based digital image acquisition, management, and communications system for conferencing in pathology.

The Roche ImageManager is a PC computer-based system, running under Windows 3.1. This system allows the storage, viewing, printing, and transmission of, and conferencing on large sets of high resolution, color images from various sources. Images may be acquired at resolutions up to 3072 x 2320 pixels under software control, and transmitted for conferencing or stored in the database using JPEG compression. Each image is stored with associated information, text notes, annotations, and a "thumbnail" image. The stored information may be searched for matching images, for example representative images of a particular disease for training, or images to be reviewed for a particular patient. Images may be transmitted with all associated information between sites which have telephone service, worldwide. Support is being added for LAN use with a multi-user database, ISDN and Switch56 communications, and remote microscope control. Interactive conferencing allows rapid transmission of low resolution images for specimen scanning, viewing of multiple high resolution still images, and real-time interactive pointers for detailed discussions of image features. The ImageManager is being used and evaluated for conferencing and training purposes. A study was performed by Roche Biomedical Laboratories to compare the ability of pathologists to make a diagnosis on complex cases using transmitted images vs. routine microscopic examination. The effectiveness of the system in providing images of a sufficient quality to allow diagnosis in a private practice setting will be presented.