Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future

doi:10.1016/j.humpath.2009.04.006

Human Pathology

Volume 40, Issue 8, August 2009, Pages 1057-1069

https://doi.org/10.1016/j.humpath.2009.04.006 Get rights and content

Summary

Telepathology, the practice of pathology at a long distance, has advanced continuously since 1986. Today, fourth-generation telepathology systems, so-called virtual slide telepathology systems, are being used for education applications. Both conventional and innovative surgical pathology diagnostic services are being designed and implemented as well. The technology has been commercialized by more than 30 companies in Asia, the United States, and Europe. Early adopters of telepathology have been laboratories with special challenges in providing anatomic pathology services, ranging from the need to provide anatomic pathology services at great distances to the use of the technology to increase efficiency of services between hospitals less than a mile apart. As to what often happens in medicine, early adopters of new technologies are professionals who create model programs that are successful and then stimulate the creation of infrastructure (ie, reimbursement, telecommunications, information technologies, and so on) that forms the platforms for entry of later, mainstream, adopters. The trend at medical schools, in the United States, is to go entirely digital for their pathology courses, discarding their student light microscopes, and building virtual slide laboratories. This may create a generation of pathology trainees who prefer digital pathology imaging over the traditional hands-on light microscopy. The creation of standards for virtual slide telepathology is early in its development but accelerating. The field of telepathology has now reached a tipping point at which major corporations now investing in the technology will insist that standards be created for pathology digital imaging as a value added business proposition. A key to success in teleradiology, already a growth industry, has been the implementation of standards for digital radiology imaging. Telepathology is already the enabling technology for new, innovative laboratory services. Examples include STAT QA surgical pathology second opinions at a distance and a telehealth-enabled rapid breast care service. The innovative bundling of telemammography, telepathology, and teleoncology services may represent a new paradigm in breast care that helps address the serious issue of fragmentation of breast cancer care in the United States and elsewhere. Legal and regulatory issues in telepathology are being addressed and are regarded as a potential catalyst for the next wave of telepathology advances, applications, and implementations.

Section snippets

Background

Two previous Telepathology Symposiums have been published in Human Pathology, in 1997 and 2001 [1], [2]. Each of these symposiums included articles that have become “classics” in the field of telepathology and are among the most widely cited articles in the telepathology literature. The first Telepathology Symposium, in 1997, marked the 10th anniversary of the publication of the first articles in English, using the term “telepathology” [3], [4]. The second Telepathology Symposium marked our

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^☆: Disclosures: Ronald S. Weinstein, MD, is a cofounder of DMetrix, Inc, and has equity in the company. Lynne C. Richter, M.T. (ASCP), has been a consultant to DMetrix and has equity. Doctor Weinstein was Scientific Director of Apollo, Inc, from 2001 to 2005. He also founded UltraClinics, Inc, and has equity in the company.

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Special Section on TelepathologyOverview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future☆

Summary

Section snippets

Background

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Mod Pathol

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Telepathology and the networking of pathology diagnostic services

Arch Pathol Lab Med

The S-Curve framework. Predicting the future of anatomic pathology

Arch. Pathol Lab Med

Time for a reality check

Arch Pathol Lab Med

Special Section on Telepathology
Overview of telepathology, virtual microscopy, and whole slide imaging: prospects for the future☆