engleski

Experience based approach to interactive versus "store and forward" telepathology

One of the major controversies in telepathology is whether still or live image transfer and analysis gives better results (1). Live images communication (also termed dynamic telepathology) gives to the receiving pathologist an opportunity of on-line scanning the material in a way similar to that on the microscope. This is especially true if the system includes a remote robotic microscope. By this way a high level of user comfort is achieved, combined with high diagnostic quality (2). To operate such a system, triple ISDN or broad band communication channels are needed, which is currently not commercially feasible in most instances. To overcome this problem, some of the currently proposed systems combine low resolution live images for scanning with high quality still images for detail analysis. However the technological requirements for all these systems also include sophisticated communication channels of at least double ISDN capacity. If we transmit high resolution, high quality images, only broad band channels can provide ample capacity for approximately live transmission. Although ISDN is currently broadly introduced in many EU countries, these type of communication channels are currently not generally available in most other countries. Especially developing or transition countries, which would possibly benefit most from telemedicine/telepathology introduction lack this type of connections. Still image systems which can be operated also on ordinary telephone lines or using Internet. mostly give the opportunity of high quality images transmission and analysis, but with limited, time consuming, capability of scanning the specimen, actually not used in practice. This can result in serious diagnostic difficulties or even errors due to not representative sampling. In our studies we approached two, what we felled as most important, weak points in still image telepathology � slide scanning and long operation time. Still image telepathology can be performed in two ways � on-line (interactive) or by store and forward concept. We have developed and tested a new tool facilitating scanning of specimens in high resolution, still image mode of transmission by applying on-line or store and forward mode of communication. From our results we gained the insight that for most diagnostic purposes and specially for consultation telepathology, the � store and forward� concept gives an better cost-benefit ratio than interactive live communication. This is especially true if the communication goes over very long distances (e.g. Zagreb-Umtata). In this case, from our experience we would suggest Internet as the most appropriate communication.

telepathology; store and forward

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