Telecytology in East Africa: a feasibility study of forty cases using a static imaging system

Abstract

We conducted a pilot study to assess the feasibility of telecytology as a diagnostic tool in difficult cases originating from a hospital in East Africa. Forty cytology cases considered difficult by a referring pathologist were posted on a telepathology website. Six pathologists independently assessed the static images. Telecytology diagnoses were compared with the consensus diagnoses made on glass slides and also with the histogical diagnoses when available. The diagnostic agreement of the six pathologists was 71-93% and tended to be higher for pathologists with more experience. Reasons for discordance included poor image quality, presence of diagnostic cells in thick areas of smears, sampling bias and screening errors. The consensus diagnoses agreed with histological diagnoses in all 17 cases in which a biopsy was performed. Diagnostic accuracy rates (i.e. telecytology diagnosis vs. histological diagnosis) for individual pathologists were 65-88%. To ensure diagnostic accuracy both referring and consulting pathologists must have adequate training in cytology, image acquisition and image-based diagnosis and the diagnostic questions of importance must be clearly communicated by the referring pathologist when posting a case.

A static-image telepathology system for dermatopathology consultation in East Africa: The Massachusetts General Hospital Experience

“…Our reported diagnostic accuracy is comparable to that reported for telecytology, in which percent agreement with consensus diagnoses on glass slides varied from a mean of 78% (range: 71%-83%) for junior pathologists (n=3, mean: 2 years of experience) to 86% (range: 82%-93%) for senior and/or subspecialized pathologists (n = 3, mean: 22 years of experience). 16 In addition to years of experience in performing glass slide diagnoses, an individual consultant's comfort level with performing diagnostic interpretations based on digital images may also affect diagnostic accuracy. 17 The level of diagnostic accuracy in our teledermatopathology study is similar to that of previous reports by others in frozen-section specimens (85% to 99%), 18-20 cytopathology specimens (80.9% to 94%), 21,22 and subspecialized surgical pathology settings, including pulmonary pathology (99%).…”

International telecytology: Current applications and future potential

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Design of New Procedures for Diagnosing Prevalent Diseases Using a Low-Cost Telemicroscopy System

“…In store-and-forward mode, the video and images are captured and stored locally, and sometime later they are shared with the specialist. [11][12][13] This mode is suitable for low connection environments and it can even work with multimedia messaging service (MMS). 14 However, it requires some training to properly focus the sample and to identify the regions of interest.…”