Expert pathology consultation through the Internet: Melanoma versus benign melanocytic tumours

Abstract

Twenty consecutive cases of melanocytic lesions were chosen from the archives of the archives of the institute of Anatomic Pathology at Santa Chiara Hospital, Trento. Representative images were acquired at a spatial resolution of 512 x 512 pixels, saved in IPEG format and delivered to the remote pathologist by multimedia internet electronic mail. Six cases were diagnosed as benign melanocytic lesions by the local pathologist. Of the 20 cases transmitted, each with an average of 5.3 images, the remote pathologist suggested a diagnosis of malignancy in nine cases while 10 cases were thought to be benign. In one case the images were not considered sufficient for diagnosis. Overall, the diagnostic agreement between local and remote pathologist was 79% (kappa = 0.58, P = 0.002). This preliminary study suggest that telepathology by internet electronic mail can be a valuable tool for remote consultation in dematopathology, as well as for other diagnostic fields where expert consultation is necessary.

Diagnostic accuracy of second-opinion diagnoses based on still images

“…[4][5][6][7][8][9][10][11][12][13] These studies differ in many aspects. The number of cases varies from 20 to 1045, the case materials are either consecutive, including mixed or organ-specific routine cases, or are selected by other means, and the level of diagnostic challenge varies.…”

“…The diagnostic accuracy of histological diagnosis based on still images compared with glass slides from paraffin-embedded material has been reported to range from 52% to 96%. [4][5][6][7][8][9][10][11][12][13] The number of studies is limited, the available studies have varying designs and case composition, and few of these studies included second opinion cases. Thus, more studies are warranted.…”

Telepathology in the Diagnosis of Routine Dermatopathologic Entities

“…Dawson et al 5 showed similar results by frozen section in a Veterans Affairs hospital setting. Della Mea et al 10 showed a statistic of 0.79 between 2 pathologists in a study of 20 melanocytic lesions. Piccolo et al 11 showed a telepathology concordance rate of 78% that improved to 85% with conventional microscopy in a series that involved 20 various dermatologic entities.…”

Feasibility and diagnostic agreement in teledermatopathology using a virtual slide system

“…The feasibility of both SAF and real-time teledermatopathology has already been proven in previous studies, mainly on nonmelanoma skin cancer or on melanocytic lesions, with less emphasis on inflammatory skin diseases [1,[6][7][8][9][10][11]. These studies suggest that diagnostic efficacy and accuracy in teledermatopathology may be particularly weak when examining entities that require the identification of subtle architectural arrangements or delicate cytologic features, as in inflammatory skin diseases [1,[6][7][8][9][10][11].…”

“…These studies suggest that diagnostic efficacy and accuracy in teledermatopathology may be particularly weak when examining entities that require the identification of subtle architectural arrangements or delicate cytologic features, as in inflammatory skin diseases [1,[6][7][8][9][10][11].…”