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

A139
INTERACTIVE REMOTE CONSULTATION WITHOUT AUTOMATED MICROSCOPES
Tucker J, Duvall E, Grigor K, McKenzie S, McGoogan E, Bird C

Pathology Dept, Edinburgh University, UK

In telepathology, one of the major disadvantages of simple static-image mailed remote consultation is the lack of control of the remote consultant over the selection of images. Although this can be provided with remotely-driven automated microscopes, this is very expensive. We have therefore developed a less costly procedure for remote consultation based on static images which combines both mailed and interactive consultation. This uses a combination of dedicated telepathology software, video conferencing software and conventional telephony. Prior to a consultation, a document is mailed with a montage of low-power images covering the whole slide, as well as possibly diagnostic fields. During the interactive consultation, following discussion of these fields, the remote consultant scans the low-power images to select any further fields which may be needed. Under telephone and video-conferencing guidance, the local operator moves the microscope stage to the appropriate area, and then grabs images of the indicated areas, at the requested magnification. These are transmitted to the consultant using the telepathology system. The method has been tested on several types of specimen, including prostate and skin biopsies and cervical smears. For many remote consultation applications the method provides a low-cost alternative to expensive automated remote microscopy.