Telepathology is a descriptive word for an important field—the practice of pathology at a distance.
And it happens to be poised to change the face of healthcare. With improvements in telecommunications technology, digital pathology is becoming more practical with each day. Without the need for an onsite pathologist, rapid and accurate diagnoses can be made virtually anywhere in the world.
So, let’s look at the three main methods used today by telepathologists, as well as the pros and cons of each.
1. Virtual Slide Telepathology Systems
Virtual slide systems are quickly becoming the superior technology for telepathology services.
A virtual slide system works by scanning and digitizing an entire slide. The beauty of whole slide imaging is that the consultant pathologist is able to examine the histopathology slide remotely, and yet the analysis suffers no diminution in quality.
Basically, the system uses an automated digital slide scanner to scan and reproduce a digital file of the physical, glass slide. These scanners are a very high-tech version of your typical household scanner. The rig includes a slide loader, microscopes with differing objectives, digital cameras, robotic manipulators, and accompanying software.
If the pathologist uses a high-throughput scanner, it’s possible to create one or even more virtual slides per minute. The files themselves are stored on computer servers. These files can then be accessed and examined remotely over the internet by the consulting pathologist.
The Pros of Using Virtual Slide Systems
Virtual slide systems have proven to be very well suited to telepathology applications. The major reason for this is that the digitized slides are of high resolution. They can also be examined easily and thoroughly, and at various magnifications.
In fact, virtual slides are easier to study and manipulate than the genuine article, and this makes them ideal for telepathology. Given adequate slide preparation, diagnosis with virtual slides is speedier and more accurate than with other methods.
The Cons of Using Virtual Slide Systems
Of course, the use of virtual slide systems in digital pathology is not entirely without its drawbacks.
First of all, the necessary equipment is very expensive and can be out of the reach of many laboratories. Virtual slide systems also tend to produce enormous image files, and storing them can represent an added expense.
Then there’s the issue of long scan times or the possibility of issues with proper coverslip placement. Still, virtual slides are becoming increasingly popular in telepathology.
2. Real-Time Telepathology Systems
A real-time system, also known as robotic telepathology, allows the pathologist to remotely manipulate the actual tissue slide.
Real-time systems use a robotic lab microscope, with an attached digital camera connected to a networked computer. Using software controls on a computer, the pathologist can remotely pan around the slide or zoom in and out of desired areas.
There are also forms of real-time telepathology that involve attaching a high-res analog video camera to a microscope. The live video feed of the slide is piped to a computer monitor at the pathologist’s location, using encrypted software. This is essentially a kind of video conference, where the pathologist can direct the lab technician to move the slides as needed.
The Pros of Using Real-Time Systems
There are many benefits to real-time telepathology. For instance, the consulting pathologist has access to the entire slide. Also, the operator can toggle the robotic systems to provide fast and accurate panning and magnification.
The image quality is good, and it all comes without the cumbersome need to create and store large digital images. This cuts down on expenses and can lead to speedier diagnoses.
It’s also been shown that diagnostic accuracy for robotic telepathology typically nears 100%.
The Cons of Using Real-Time Systems
Among the disadvantages of using real-time systems are expensive technology and signal lag-time.
As with virtual slide technology, real-time systems require expensive equipment. There’s also the need to invest in integrated software at both ends, as well as high-bandwidth technology.
Robotic telepathology works best with a local area network (LAN). But if this technology is used at times of high internet traffic, there’s a greater likelihood of slowdowns and lag-time.
3. Image-Based Telepathology Systems
Image-based systems, or static telepathology, represents the least expensive and the easiest to use of the three telepathology systems.
Essentially, image-based or “store-and-forward” telepathology uses the simplest technology to capture images. A digital image is created of whatever pathology needs to be examined. This includes histology sections, parasites, culture plates, gross specimen slides, blood and tissue smears, etc.
The image is shared either through email, or stored on shared computer networks or servers. Audio and video files can also be shared in addition to the image files. Image-based telepathology is the more primitive form because it consists of little more than sharing image files.
The consulting pathologist can then study the image file and make a diagnosis. Or the image can be shared among many pathologists during an online discussion.
The Pros of Using Image-Based Systems
The major advantage of using image-based telepathology is its ease and low cost. There is no need for large and expensive equipment, as the technology is very straightforward.
The image files used in this technique are also very small, in contrast to those captured and maintained by virtual slide systems. This means there are no added expenses from storing enormous image files.
The Cons of Using Image-Based Systems
There are several drawbacks to static telepathology, and all have to do with the manifest limitations of the technique.
For one thing, the pathologist can sometimes only work with a single, relatively low-res image file. There is no possibility of remote control, and sampling errors and limited points of view can hamper accurate diagnosis.
So while less expensive, the limits of image-based systems tend to mitigate that benefit.
The Future of Healthcare
Telepathology represents the future of healthcare. Without ever leaving the office, world-renowned pathologists can diagnose patients on the other side of the planet.
If you’re looking for telepathology solutions, we’re here to help. Contact us today to learn more.
