Design and Validation of a Low-Cost Telepathology System

Meléndez-Álvarez, Bernardo F.; Robayo, O.; Gil-Guillén, Vicente Francisco; Carratalá-Munuera, M. Concepción

doi:10.1089/tmj.2017.0030

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…From 2003 to 2006, the European Union that funded the T@lemed project included telemicroscopy of malaria images being sent from local hospitals to referral centers . Low‐cost telepathology systems, including the use of open software, have since been validated . Several telecytology systems including static, dynamic and virtual imaging have also been tested for reviewing Pap tests in Colombia .…”

Section: Discussionmentioning

confidence: 99%

“…15 software, have since been validated. 16 Several telecytology systems including static, dynamic and virtual imaging have also been tested for reviewing Pap tests in Colombia. 17 However, several problems were noted that ranged from issues related to focusing difficulties and drawbacks with information technology infrastructure (e.g., Internet connectivity).…”

Section: Discussionmentioning

confidence: 99%

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Advantage of Z‐stacking for teleconsultation between the USA and Colombia

Mosquera-Zamudio

Hanna

Parra‐Medina

et al. 2018

Diagnostic Cytopathology

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Introduction There is an emerging need for telecytology in Colombia as the demand for cytopathology has increased. However, due to economic and technological constraints telecytology services are limited. Our aim was to evaluate the diagnostic feasibility of using whole slide imaging with and without Z‐stacking for telecytology in Colombia, South America. Methods Archival glass slides from 17 fine needle aspiration smears were digitized employing whole slide imaging (WSI) (Nanozoomer 2.0 HT, Hamamatsu) in one Z‐plane at 40x, and panoramic digital imaging (Panoptiq system, ViewsIQ) combining low‐magnification digital maps with embedded 40x Z‐stacks of representative regions of interest. Fourteen Colombian pathologists reviewed both sets of digital images. Diagnostic concordance, time to diagnosis, image quality (scale 1–10), usefulness of Z‐stacking, and technical difficulties were recorded. Results Image quality scored by pathologists was on average 8.3 for WSI and 8.7 for panoramic images with Z‐stacks (P = .03). However, diagnostic concordance was not impacted by image quality ranking. In the majority of cases (72.4%) pathologists deemed Z‐stacking to be diagnostically helpful. Technical issues related to Z‐stack video performance constituted only a minor proportion of technical problems reported. Slow downloads and crashing of files while viewing were mostly experienced with larger WSI files. Conclusion This study demonstrated that international telecytology for diagnostic purposes is feasible. Panoramic images had to be acquired manually, but were of suitable diagnostic quality and generated smaller image files associated with fewer technical errors. Z‐stacking proved to be useful in the majority of cases and is thus recommended for telecytology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advantage of Z‐stacking for teleconsultation between the USA and Colombia

Mosquera-Zamudio

Hanna

Parra‐Medina

et al. 2018

Diagnostic Cytopathology

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“…All systems were able to stream live video of cytology slides to remote locations at a resolution that was suitable for a pathologist’s review [ 72 ]. Meléndez-Álvarez et al designed a telepathology prototype manufactured with plastic materials made using an open design 3D printer, a conventional optical microscope, a Celestron camera attachment, open-sourced software and electronic components that are readily available in most electronic shops [ 73 ]. The prototype had a total cost of less than $910 and the resulting images were judged to be of diagnostic quality by a pathologist [ 73 ].…”

Section: Types Of Mobile Health (Mhealth) and Telemedicine Toolsmentioning

confidence: 99%

“…Meléndez-Álvarez et al designed a telepathology prototype manufactured with plastic materials made using an open design 3D printer, a conventional optical microscope, a Celestron camera attachment, open-sourced software and electronic components that are readily available in most electronic shops [ 73 ]. The prototype had a total cost of less than $910 and the resulting images were judged to be of diagnostic quality by a pathologist [ 73 ]. Utilization of free web-based teleconferencing software such as Skype, Google Hangouts, GoToMeetings, Windows Live Messenger, Fuze, and Webex, can provide a low-cost alternative to commercial live view microscopy systems [ 60 , 74 , 75 , 76 ].…”

Section: Types Of Mobile Health (Mhealth) and Telemedicine Toolsmentioning

confidence: 99%

Long-Range Diagnosis of and Support for Skin Conditions in Field Settings

Williams

Kovarik

2018

TropicalMed

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Skin diseases are a significant cause of morbidity and mortality worldwide; however, access to dermatology services are critically limited, particularly in low- to middle-income countries (LMIC), where there is an overall shortage of physicians. Implementation of long-range technological support tools has been growing in an effort to provide quality dermatology care to even the most remote settings globally. eHealth strategies can provide realistic healthcare solutions if implemented in a feasible and sensitive way, customizing tools to address the unique needs and resource limitations of the local setting. This article summarizes the various types of telemedicine and mobile health (mHealth) tools and their practical applications and benefits for patient care. The challenges and barriers of teledermatology are discussed, as well as steps to consider when implementing a new teledermatology initiative. eHealth arguably offers one of the most flexible and realistic tools for providing critically needed access to dermatology skills in underserved LMICs.

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“…Previous studies have mainly focused on the construction and optimization of telepathology systems or analysis of the effect of system use, with a limited sample [ 17 - 22 ], and to date, there are no unified criteria to evaluate a telepathology system. Perron et al [ 23 ] evaluated diagnostic concordance and the turnaround time of a telepathology system.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a Cloud-Based Telepathology System in China: Large-Sample Observational Study

He¹,

Wang²,

Wang³

et al. 2021

J Med Internet Res

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Background Whole-slide imaging allows the entire slide to be viewed in a manner that simulates microscopy; therefore, it is widely used in telepathology. However, managing the large digital files needed for whole-slide imaging is difficult. To solve this problem, we set up the Chinese National Cloud-Based Telepathology System (CNCTPS). CNCTPS has been running for more than 4 years and has accumulated a large amount of data. Objective The main purpose of this study was to comprehensively evaluate the effectiveness of the CNCTPS based on a large sample. The evaluation indicators included service volume, turnaround time, diagnosis accuracy, and economic benefits. Methods Details of 23,167 cases submitted to the CNCTPS from January 2016 to December 2019 were collected to analyze the service volume, turnaround time, and economic benefits. A total of 564 patients who visited the First Affiliated Hospital of Zhengzhou University and obtained final diagnoses were followed up to analyze the diagnostic accuracy of the CNCTPS. Results From 2016 to 2019, the service volume of the CNCTPS increased from 2335 to 9240, and the number of participating hospitals increased from 60 to 74. Consultation requests from county-level hospitals accounted for 86.57% (20,287/23,167). A total of 17,495 of 23,167 cases (75.52%) were confirmed, including 12,088 benign lesions, 5217 malignant lesions, and 190 borderline lesions. Of the cases, 3.85% (893/23,167) failed to be diagnosed for reasons such as poor slice quality and incomplete sampling. The median turnaround time was 16.93 hours and was shortened yearly (between 2018 and 2019: adjusted P=.01; other groups: adjusted P<.001); 82.88% cases were diagnosed in 48 hours. There was a discrepancy between the diagnosis and final diagnosis for 11 cases, including 4 false-positive cases and 7 false-negative cases. The sensitivity and specificity were 97.66% and 98.49%, respectively. The diagnostic accuracy of the system was 98.05%, with no statistical difference from the final diagnosis in the hospital (P=.55). By using this system, a total of US $300,000 was saved for patients every year. Conclusions The novel cloud-based telepathology system has the potential to relieve the shortage of pathologists in primary hospitals. It can also simultaneously reduce medical costs for patients in China. It should, therefore, be further promoted to enhance the efficiency, quantity, and quality of telepathology diagnoses.

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Design and Validation of a Low-Cost Telepathology System

Cited by 6 publications

References 23 publications

Advantage of Z‐stacking for teleconsultation between the USA and Colombia

Advantage of Z‐stacking for teleconsultation between the USA and Colombia

Long-Range Diagnosis of and Support for Skin Conditions in Field Settings

Effectiveness of a Cloud-Based Telepathology System in China: Large-Sample Observational Study

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