Robotic and Virtual Slide Telepathology.

摘要

To date, we have reviewed several frozen section (FS) pathology cases in a retrospective fashion with remote, robotic real-time telepathology (TP). The telepathologist is given the usual clinical information with regard to organ site, sex and age of the patient and any pertinent clinical/radiographic information that was available on the surgical pathology tissue examination request form at the time of the intraoperative consultation. Each case is evaluated by TP without prior knowledge of the FS or final diagnosis and could be given a diagnosis or deferred if image/technical quality is sub-optimal. All slides used in the TP evaluation are later reviewed by conventional light microscopy by the same pathologist to assess intraobserver agreement between the TP and FS diagnosis. Later, all diagnoses are compared with the original FS and final diagnosis to assess interobserver agreement Diagnostic errors were classified as interpretation errors if differences between TP and FS diagnosis are obtained, and as sampling errors, if discrepancies between the FS slides and slides prepared from formalin-fixed, paraffin-embedded tissues are seen. Agreements between the telepathology and glass slide diagnosis were reviewed and compared with the final diagnosis in conjunction with routine monthly intradepartmental quality assurance programs (new FS diagnosis versus final diagnosis). The Trestle Corporation (Newport Beach, CA) MedMicroscopy system has been initially installed at three referring institutions throughout the AMEDD. Initial installation sites include Walter Reed Army Medical Center (Washington, DC), Ireland Army Community Hospital (Fort Knox, Kentucky), Womack Army Medical Center (Fort Bragg, North Carolina) and Landstuhl Regional Medical Center (Landstuhl, Germany). Cases are transmitted from the daily workload. The use of consecutive cases eliminated bias related to case complexity.