TELEPATHOLOGY TRIAL

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PRESIONE AQUI PARA VERSION EN CASTELLANO


Visit the "XXII Congreso de la SLAP"

ROUND TABLE IN INFORMATICS AND ANATOMIC PATHOLOGY

Friday 29th of October, 1999
8:00 a.m. - 12:00 m.
Room 3

SUBJECT: TELEPATHOLOGY
 
SPEAKER: Dr. Francisco G. La Rosa
Pathologist (AP/CP), Assistant Professor in Pathology and Immunology,
School of Medicine, University of Colorado HSC and
President of TelePathology Consultants, PC
Denver, Colorado U.S.A.

INVITATION

In the following pages you will find images of surgical pathology and cytology cases. Each case includes one or two pathology images accompanied by a brief clinical history and the magnification of the images. Please, examine all the cases from the list below and when you get to the last case send by e-mail all of your answers with the list of cases to submit@telepathology.com and using a single message. In your message include your name, specialty, sub-specialty, name of the institution where you work, and your e-mail address. All this information will be kept confidential and will not be used for public distribution. It is necessary that you send the answers for all cases. In case(s) that you do not have the answer include the phrase "Not Available"

CASES CONTRIBUTED (Not included in the present study): We also invite you to send us interesting pathology cases to be published in these pages. You can send your images as attached JPG files to submit@telepathology.com

OBJECTIVE

This is a study on static telepathology in which histopathology images selected by a pathologist are digitized and then sent to consultant pathologist(s) through the Internet. In contrast, dynamic telepathology uses live images in which the histological specimens are moved through a telerobotic mechanism installed in the microscope or through a telepathology assistant who receive verbal commands. Static telepathology is of low cost, at reach of populations with limited financial resources and the principal objective of this study.

The answers from the participants will be used for a statistical study in telepathology to determine the degree of precision in the diagnosis of histological images by a heterogeneous and voluntary population of pathologists with different sub-specialties and with different experiences in the use of the Internet.  This information will be used as part of a presentation on "Telepathology" during the Round Table in Informatics and Anatomic Pathology to be held this coming Friday the 29th of October during the XXII Congress of the Latin American Society of Pathology in Lima, Peru.  The results will be published later through e-mail keeping confidential the identity of the participants.

TECHNICAL INFORMATION ABOUT THE IMAGES

The images shown here have been taken with an Olympus BX-50 microscope with planachromatic lenses, using a reflex photographic camera Nikon FA ($200 US) with film Kodak Ektachrome 64 ASA Professional 135x24 ($10 US including E-6 process). The slides have been scanned and digitized with a Hewlett-Packard Photo Scanner PhotoSmart ($500) at a resolution of 1024x768 pixels. The images have been optimized in contrast, brightness and sharpness and then compressed and archived in JPEG format at an average resolution of 500x375 pixels using Adobe ImageReady version 1.0 ($100). All this process has taken an average of 3 hours for 5 cases, including the E-6 process for developing the film. In addition to the cost of the microscope and the computer used, the additional total cost of the equipment and software used has been of approximately $800 US. This is in contrast to images obtained with high definition digital cameras which actual cost is between $5,000 and $ 10,000 US. The only important advantage using a digital camera has been the saving of approximately 2 hours, that is the time needed to develop the film with the E-6 process. The scanner used here is also capable to scan and digitize at high resolution histological glass slides including an image of the whole specimen and providing images similar to those obtained with 2x objective lenses (see examples). Glass slides were mounted in a conventional 35 mm slide mount as shown in Figure 1 and Figure 2.

HOW TO SEE THE IMAGES

Be sure that your monitor is configured with a color palette of 16, 24 o 32 bits (no 256 colors) and with a resolution of at least 800x600 pixels o more (1024x768). For this go to "start" "control panel" "display" and "settings". If you use a browser such as "Internet Explorer - version 5" for Internet access to the Web, configure it to see in "Full Screen" and obtain a better view of the screen and a full vision of the images.

RELEASE OF LIABILITY

In case you consider it necessary, you may include with your answers the following text: "This is a telepathology trial done for academic and research purposes only. Any opinion, diagnosis or evaluation expressed here is solely for statistical analysis and must not be considered as a medical opinion of a disease of any patient or for the need of treatment or referral of any kind"

CASES

For a complete study you have to examine all the cases in the following list and when you get to the last one click to go to the following page to find instructions on how to submit your messages to submit@telepathology.com. Please, include your name, specialty, sub-specialty, institution where you work and your e-mail address. All this information will be kept confidential and not used for distribution.

Case 1

Case 2

Case 3

Case 4

Case 5

Case 6


RESULTS
Visit this page when you finish reviewing the cases


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