6th ESACP Congress, Heidelberg, April 7-11, 1999

A138
REMCON: DEMONSTRATION OF STATIC IMAGE REMOTE CONSULTATION.
Tucker J *, Busch C +, Wells C **, Spatz A ++

* Pathology Dept, Edinburgh University, ** Dept. Pathology, St. Bartholomew's Hospital, London, UK + Dept. Pathology, University Hospital, Uppsala, Sweden. ++ Dept. Pathology, Institut Gustave-Roussy, Villejuif, France

In theory, telepathology provides an easy method for pathologists to obtain second opinions on difficult cases. However, in practice difficulties arise which may limit its use. REMCON is a multicentre trial under the EEC "EUROPATH" project to test and evaluate the use of mailed remote consultation telepathology using static imaging transmission facilities between international groups of pathologists with a common interest. It was carried out using a commercially-available telepathology system with connections made via the www. Three special-interest telepathology groups were established for prostate, soft-tissue sarcoma and melanoma pathology. In all a total of 17 pathologists from 9 different European countries were actively involved. Case documents containing static images and text were exchanged for consultation with other group members via multi-media email on the Internet, and various factors such as preparation and mailing times, adequacy of images, image quality, etc. were recorded. The whole experiment was controlled and monitored using a www site. In all a total of 27 cases were prepared and 38 case report forms were completed and returned. Currently, the average case contains 8 images (~2Mb) and requires 55 minutes to prepare and 4 minutes to review. Several consultants expressed reservations concerning the adequacy of the documents for confident diagnosis; amongst the reasons given were poor image quality, insufficient images and unclear questions. It was concluded from this experiment that mailed remote images using this method must be used with caution, and that guidance should be provided to intending telepathology users regarding image quality, selection of images, and preparation of the document.