Use of the virtual slide and the dynamic real-time telepathology systems for a consultation and the frozen section intra-operative diagnosis in thoracic/pulmonary pathology
Use of the virtual slide and the dynamic real-time telepathology systems for a consultation and the frozen section intra-operative diagnosis in thoracic/pulmonary pathology
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DOI：
10.2478/v10042-010-0009-z
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发表时间：
2009-01-01
影响因子：
1.5
通讯作者：
Chyczewski, Lech
中科院分区：
文献类型：
--
作者：
Slodkowska, Janina;Pankowski, Juliusz;Chyczewski, Lech
我们报告了一项旨在评估基于互联网的数字显微镜的诊断准确性和可用性的研究结果：动态实时远程病理学系统（Coolscope）和虚拟显微镜（Aperio Scan Scope）系统，在肺部病理学的背景下。这些系统被应用于常规肺病理学工作流程，并用于术中冰冻切片初步诊断以及二次（咨询）诊断。为远程咨询提供的组织学材料包括肺实质样本、支气管活检和切除的肺/支气管肿瘤。对于初步诊断，可区分4类材料（304份样本）：1）肺肿瘤、切除的支气管边缘和淋巴结的冷冻切片; 2）细针抽吸[FNA]活检（TBNA; EBUS-TBNA，EUS-FNA）; 3）支气管、食管、皮肤的寡核苷酸活检; 4）脱落细胞学检查。与传统光学显微镜诊断相比，远程病理学诊断显示Coolscope和Aperio Virtual Slide模式的一致性非常高：在远程咨询组中分别为87.5%和100%。对于冷冻切片，Aperio的初步远程诊断与光学显微镜石蜡切片诊断的一致性为100%，Coolscope为97.5%。对于两种远程病理学系统，在FNA、寡核细胞活检和细胞学的远程诊断和传统切片诊断中观察到了极好的一致性（100%）。这些结果为Coolscope和基于虚拟切片的远程病理学（Aperio）系统在常规组织病理学诊断中的应用提供了一定的鼓励。
We report the results of a study designed for assessment of the diagnostic accuracy and usability of internet-based digital microscopy: the dynamic real-time telepathology system (Coolscope) and the Virtual microscopy (Aperio Scan Scope) system, in the context of pulmonary pathology. The systems were implemented to the routine pulmonary pathology workflows and used for the intra-operative frozen-section primary diagnosis as well as for the secondary (consultative) diagnosis. The histological material presented for the teleconsultations included the samples of lung parenchyma, bronchial biopsy and resected lung/bronchi tumours. For the primary diagnosis 4 categories of material can be distinguished (304 samples): 1) the frozen sections of lung tumours, resected bronchial margins and lymph nodes; 2) fine needle aspiration [FNA] biopsies (TBNA; EBUS-TBNA, EUS-FNA; 3) oligobiopses of bronchus, oesophagus, skin; and 4) exfoliative cytology. The telepathology diagnoses compared with conventional light microscopy diagnoses showed very high concordance for the Coolscope and Aperio Virtual Slide modality: 87.5% and 100%, respectively - within the group of teleconsultations. For the frozen sections, the primary telediagnoses were concordant with the light microscopy paraffin sections diagnoses in 100% for Aperio; and in 97.5% for Coolscope. An excellent agreement (100%) was seen in the telediagnoses and conventional slides diagnoses for FNA, oligobiopsies and cytology - for both telepathology systems. These results provide some encouragement for the implementation of Coolscope and virtual slide-based telepathology (Aperio) system to the routine histopathological diagnostics.