![]() |
6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A124
Diagnosis in telepathology with robotic microscopes has proven in many
fieldtests to achieve similar results as the conventional inspection under
the microscope. This is due to the advanced status of todays telepathology
equipment with remotely controllable microscopes allowing a comfortable
inspection of histological specimens. In telecytology the situation
unfortunately differs from that in histology. In cytology very often the
complete slide must be inspected with high magnification (10x to 40x) to
evaluate details in cell structures, whereas in histology mostly only
selected areas are of interest, additionally mostly only low magnifications
(1,25x to 5x) with big fields of view are applied. PAP smear screening with
telemicroscopy for instance would require about 4.000 fields of view.
Assuming image transmission via 8 ISDN channels about 100 min. are necessary
to transmit all fields of a slide! Such intervals are inacceptable. Ways out
of this dilemma are the restriction to slides with only few cells or to make
a preselection of areas of the slide assumed to contain diagnostically
important material. This leads to the well known situation of a prescreening
scenario, where the expert has not to inspect all areas or slides. In a pilot
study with 104 well diagnosed PAP smears of different degrees of malignancy,
suspicious areas in the slides were selected, and only these areas have been
investigated by the remote senior cytotechnician. In the results of the study
3 slides were diagnosed false positive (incl. 2 IIID) and 9 false negative
(incl. 5 IIID). Accompanying findings like bacteria etc. were reported in 73
slides in correspondence to the conventional report and in 33 cases with
deviations. In conclusion can be stated, that telecytology achieves
acceptable results if the amount of data on a slide is handled appropriately.
IS TODAY'S TELEPATHOLOGY EQUIPMENT ALSO APPROPRIATE FOR TELECYTOLOGY?
- A PILOT STUDY WITH PAP SMEARS
Schwarzmann P, Schenck U, Binder B
Inst.Physikalische Elektronik, Stuttgart, Germany