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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A074
Introduction and Aim: The University Hospital Charité consists of
three campuses located in different parts of Berlin. A part of the Institute
of Pathology belongs to each campus. In all these places intraoperative
frozen section diagnostic takes place. Experts in special fields of pathology
are not present at the same time in all parts of the institute. We tried to
use telepathology to solve the problem of a fast second opinion for frozen
sections. Material and Methods: At two of the three frozen section
laboratories a computer controlled microscope with motor driven slide
platform and lens revolver as well as autofocus was established. The video
and audio signals have been transferred online in TV-quality using ATM
network. Therefore three ATM-Audio-Video-Codecs have been established.
The image size was 786*625 Pixel. We used a 3-chip TV camera (Sony 930p).
The microscope is controlled by a separate ISDN line or via Internet using
Timbuktu application sharing. The remote pathologist has the possibility to
talk with the referring pathologist and also with the surgeon during
operation. Results: The quality of the real time transferred pictures
was sufficient. Primary diagnoses of frozen sections could successfully be
done in 90%. The time, which was necessary to present a sufficient second
opinion, varied between 1 and 10 minutes. Within a special trial we tried
to present a remote diagnosis instead of a second opinion. In comparison
with the "direct diagnoses" at the microscope revealed a difference only
in 1 of 85 cases. To solve difficult cases online exchange of frozen as
well as routine specimens appeared to be very helpful and elucidating.
Conclusions: Telepathology is a promising tool to support routine
and research work of pathologists. Future technical developments with
highly enlarged data storage and data bases, with intelligent connections
to other disciplines, e.g. radiology, genetics, surgery, patient data base
etc., and easy to handle software will certainly contribute to a broad
acceptance in the near future.
SECOND OPINION TELEPATHOLOGY ON FROZEN SECTIONS BASED ON A ATM-NETWORK
Hufnagl P, Nguyen-Dobinsky TN, Dietel M
Institute of Pathology, Rudolf-Virchow-Haus, Charité,
Berlin, Germany