2005 Scientific Session Abstracts
Live Dynamic Telepathology with Robotic Microscopy for Remote Surgical Specimen Imaging
J. Mark Tuthill (mtuthil1@hfhs.org) 1, Paul Tranchida 1, Bruce Jones 1, David Chen 1, Jack Zeineh 2, Richard Zarbo 1. 1Department of Pathology, Henry Ford Medical Center, Detroit, MI; 2Trestle Corporation, Irvine, CA.
Content: Live dynamic telepathology using robotic microscopy is a relatively recent development in telemedicine. The decrease in costs of computer and imaging technology coupled with the advances in network speeds now allows for real-time digital imaging system with remote microscope control. Working with a corporate partner (Trestle Holding Corp, Irvine, CA), our department has deployed a live dynamic telepathology system enabling pathologists to remotely examine gross surgical specimens and glass slides in real-time.
Technology: Gross and microscopic imaging workstations were deployed on computers running Microsoft Windows 2000. The gross station is connected to a video camera (Wolfvision Incorporated, Burlingame, CA). The microscopic workstation is connected to an Olympus BX-51 microscope (Olympus America, Melville, NY) with attached digital camera, a motorized stage, and focus controls. Each station has dedicated image server and image viewing software (MedServer and MedMicroscopy, Trestle Corporation). MedMicroscopy was installed on pathologists' workstations for case viewing. Secure remote access to the network was accomplished using Virtual Private Network technology.
Design: Gross and microscopic workstations were assigned Internet addresses making them available for telepathology through the MedServer program. Clients connect to either workstation by running the MedMicroscopy application. On accessing the grossing server, the pathologist could view live video of the specimen being manipulated by an assistant, make annotations, adjust the image settings, as well as saving static image files for documentation. From the microscopic server, the same functionality was available plus real-time control of the microscope such as stage movement, focus, and objective lens selection. To test system validity, and to train users, we had pathologists compare gross and histologic images on the telepathology systems to in-person observation and light microscopic examination.
Results: Initial results show that diagnostic accuracy and pathologist comfort level quickly begin to rival direct gross examination and light microscopy. The system was easy to deploy with client access requiring only the MedMicroscopy application. Pathologists found the application simple to use with controls pathologists are familiar with on traditional microscopes. Training was accomplished in less than 30 minutes. Image quality, speed of control, and usability were such that the technology quickly became transparent to the users allowing them to focus on diagnosis.
Conclusion: Live dynamic telepathology with robotic telemicroscopy is a mature, turnkey solution providing a reliable and accurate method for pathologists to examine gross and microscopic specimens from remote locations. Initial assessment of accuracy is comparable to traditional methods of tissue examination.