Robotic telepathology: efficacy and usability in pulmonary pathology
Robotic telepathology: efficacy and usability in pulmonary pathology
复制标题
DOI：
10.1002/path.1112
复制
发表时间：
2002-06-01
影响因子：
7.3
通讯作者：
McGee, JO
中科院分区：
文献类型：
--
作者：
Leong, FJWM;Nicholson, AG;McGee, JO
机器人远程病理学作为一种病例转诊方法在美国已得到广泛应用，但在英国较少使用。本研究使用涵盖广泛肺部病理学的病例，评估了其在初级诊断中的应用及其在诊断准确性和每个病例时间方面的功能，适用于小活检和开放性肺活检/切除。一名病理学家使用机器人远程病理学以盲法方式审查了 40 例病例（20 例支气管镜和 20 例外科肺活检/切除标本）。 John Radcliffe 和皇家布朗普顿医院之间通过 10 Mb/s LAN 连接到互联网（由联合学术网络支持）。然后对这些病例进行随机分组，并用传统光学显微镜进行第二次审查。记录诊断、达到诊断的初始时间以及每个病例的总时间。在两个支气管镜活检病例中，远程病理学和传统光学显微镜之间存在临床显着差异，一个可能归因于用户经验不足，另一个归因于图像捕获速度或数字图像质量。在外科肺活检和切除术中，存在一种不同的观点：通过远程病理学，病例被认为可能是间皮瘤，而这被认为可能性较小。在光学显微镜下。在这两种情况下，在临床管理之前都要求进行免疫组织化学检查。在检查支气管镜活检时，远程病理学比传统光学显微镜慢 14 倍。每张载玻片平均花费的时间为 7 分 21 秒，而传统光学显微镜每张载玻片花费的时间为 32 秒。在评估开放性肺活检和切除术时，远程病理学的速度为 6 分 13 秒，而传统光学显微镜的速度为 1 分 10 秒，慢了五倍。这项研究表明，机器人远程病理学对于肺组织病理学的初步诊断是准确的，但需要对实验室协议和远程病理学硬件进行修改，以减少远程病理学和传统光学显微镜之间的时间差，以便远程病理学可以在繁忙的转诊实践框架内使用。版权所有 (C) 2002 John Wiley Sons, Ltd.
Robotic telepathology is well established in the USA as a method of case referral, but is less frequently used in the UK. Using cases covering a broad spectrum of pulmonary pathology, this study assessed its application in primary diagnosis and its functionality in terms of accuracy of diagnosis and time per case, for both small biopsies and open lung biopsies/resections. Forty cases (20 bronchoscopic and 20 surgical lung biopsy/resection specimens) were reviewed in blinded fashion by a single pathologist using robotic telepathology. Connection between the John Radcliffe and Royal Brompton Hospitals was via 10 Mb/s LAN to the Internet (supported by the Joint Academic Network). The cases were then randomized and reviewed a second time with conventional light microscopy. Diagnosis, initial time to reach diagnosis, and overall time per case were recorded. In two bronchoscopic biopsy cases, there were clinically significant differences between telepathology and conventional light microscopy, one probably attributable to user inexperience and the other to either speed of image capture or digital image quality. In the surgical lung biopsies and resections, there was one variation of opinion: with telepathology a case was considered to be probably mesothelioma, whereas this was thought less likely. on light microscopy. In both instances, immunohistochemistry was requested prior to clinical management. Telepathology was 14 times slower than conventional light microscopy when examining bronchoscopic biopsies. The average time spent per slide was 7 min 21 s, compared with 32 s per slide with conventional light microscopy. When assessing open lung biopsies and resections, telepathology was five times slower, at 6 min 13 s compared with 1 min 10 s with conventional light microscopy. This study showed that robotic telepathology is accurate for primary diagnosis in pulmonary histopathology, but modifications in both laboratory protocols and telepathology hardware are needed to decrease the time difference between telepathology and conventional light microscopy, for telepathology to be usable within the framework of a busy referral practice. Copyright (C) 2002 John Wiley Sons, Ltd.