. 2002 Jan; 32(12):1283-99.
doi: 10.1053/hupa.2001.29643.

Telepathology overview: from concept to implementation

R S Weinstein 1 M R Descour  C Liang  A K Bhattacharyya  A R Graham  J R Davis  K M Scott  L Richter  E A Krupinski  J Szymus  K Kayser  B E Dunn  
  • PMID: 11774159
  •     35 citations


Telepathology is the practice of pathology at a distance by using video imaging and telecommunications. Significant progress has been made in telepathology. To date, 12 classes of telepathology systems have been engineered. Rapid and ultrarapid virtual slide processors may further expand the range of telepathology applications. Next-generation digital imaging light microscopes, such as miniaturized microscope arrays (MMA), may make virtual slide processing a routine laboratory tool. Diagnostic accuracy of telepathology is comparable with that of conventional light microscopy for most diagnoses. Current telepathology applications include intraoperative frozen sections services, routine surgical pathology services, second opinions, and subspecialty consultations. Three telepathology practice models are discussed: the subspecialty practice (SSP) model; the case triage practice (CTP) model; and the virtual group practice (VGP) model. Human factors influence performance with telepathology. Experience with 500 telepathology cases from multiple organs significantly reduces the video viewing time per case (P < .01). Many technology innovations can be represented as S-curves. After long incubation periods, technology use and/or efficiency may accelerate. Telepathology appears to be following an S-curve for a technical innovation.

[Web-based learning tools in pathology].
K Glatz-Krieger, D Glatz, +2 authors, M J Mihatsch.
Pathologe, 2003 Sep 10; 24(5). PMID: 12961028
Diagnostic telepathology: long-term experience of a single institution.
Kurt Brauchli, Hermann Oberli, +8 authors, Martin Oberholzer.
Virchows Arch, 2004 Mar 17; 444(5). PMID: 15021986
[Virtual microscopy: first applications].
K Glatz-Krieger, D Glatz, M J Mihatsch.
Pathologe, 2005 Aug 13; 27(6). PMID: 16096757
Development of present and future of telepathology in Hungary.
Sándor Vári, Mária Cserneky, Anna Kádár, Béla Szende.
Pathol Oncol Res, 2005 Oct 01; 11(3). PMID: 16195772
Factors to keep in mind when introducing virtual microscopy.
Katharina Glatz-Krieger, Udo Spornitz, +2 authors, Dieter Glatz.
Virchows Arch, 2005 Dec 20; 448(3). PMID: 16362822
Grid technology in tissue-based diagnosis: fundamentals and potential developments.
Jürgen Görtler, Martin Berghoff, Gian Kayser, Klaus Kayser.
Diagn Pathol, 2006 Aug 26; 1. PMID: 16930477    Free PMC article.
Static telepathology in cancer institute of Tehran university: report of the first academic experience in Iran.
Afshin Abdirad, Babak Sarrafpour, Siavash Ghaderi-Sohi.
Diagn Pathol, 2006 Oct 05; 1. PMID: 17018157    Free PMC article.
Dynamic telecytopathology of on site rapid cytology diagnoses for pancreatic carcinoma.
Burton Kim, David C Chhieng, +5 authors, Isam E Eltoum.
Cytojournal, 2006 Dec 13; 3. PMID: 17156485    Free PMC article.
Integration and acceleration of virtual microscopy as the key to successful implementation into the routine diagnostic process.
Stephan Wienert, Michael Beil, +2 authors, Thomas Schrader.
Diagn Pathol, 2009 Jan 13; 4. PMID: 19134181    Free PMC article.
Virtual slide telepathology workstation of the future: lessons learned from teleradiology.
Elizabeth A Krupinski.
Hum Pathol, 2009 Jun 26; 40(8). PMID: 19552939    Free PMC article.
An informatics model for guiding assembly of telemicrobiology workstations for malaria collaborative diagnostics using commodity products and open-source software.
West Suhanic, Ian Crandall, Peter Pennefather.
Malar J, 2009 Jul 21; 8. PMID: 19615074    Free PMC article.
Using a visual discrimination model for the detection of compression artifacts in virtual pathology images.
Jeffrey P Johnson, Elizabeth A Krupinski, +3 authors, Ronald S Weinstein.
IEEE Trans Med Imaging, 2010 Sep 30; 30(2). PMID: 20875970    Free PMC article.
Implementation of whole slide imaging in surgical pathology: A value added approach.
Mike Isaacs, Jochen K Lennerz, +3 authors, John D Pfeifer.
J Pathol Inform, 2011 Oct 05; 2. PMID: 21969920    Free PMC article.
History and structures of telecommunication in pathology, focusing on open access platforms.
Klaus Kayser, Stephan Borkenfeld, Amina Djenouni, Gian Kayser.
Diagn Pathol, 2011 Nov 09; 6. PMID: 22059444    Free PMC article.
Telepathology for effective healthcare in developing nations.
Smita Sankaye, Sushil Kachewar.
Australas Med J, 2011 Jan 01; 4(11). PMID: 23386872    Free PMC article.
Inter- and intra-observer concordance of cyberpathology in twenty-five cases.
Tommy R Tong, Kam-Cheong Lee, +6 authors, Jessica Pik-Man Lam.
Int J Biomed Sci, 2008 Mar 01; 4(1). PMID: 23675068    Free PMC article.
The history of pathology informatics: A global perspective.
Seung Park, Anil V Parwani, +15 authors, Liron Pantanowitz.
J Pathol Inform, 2013 Jul 23; 4. PMID: 23869286    Free PMC article.
World's first telepathology experiments employing WINDS ultra-high-speed internet satellite, nicknamed "KIZUNA".
Takashi Sawai, Miwa Uzuki, +17 authors, Nathan Hopson.
J Pathol Inform, 2013 Nov 19; 4. PMID: 24244882    Free PMC article.
Digital pathology: A systematic evaluation of the patent landscape.
Ioan C Cucoranu, Anil V Parwani, +2 authors, Liron Pantanowitz.
J Pathol Inform, 2014 Jul 25; 5(1). PMID: 25057430    Free PMC article.
Subspecialty surgical pathologist's performances as triage pathologists on a telepathology-enabled quality assurance surgical pathology service: A human factors study.
Beth L Braunhut, Anna R Graham, +4 authors, Ronald S Weinstein.
J Pathol Inform, 2014 Jul 25; 5(1). PMID: 25057432    Free PMC article.
American Telemedicine Association clinical guidelines for telepathology.
Liron Pantanowitz, Kim Dickinson, +12 authors, Jordana Bernard.
J Pathol Inform, 2014 Nov 08; 5(1). PMID: 25379345    Free PMC article.
Evaluating whole slide imaging: A working group opportunity.
Darren Treanor, Brandon D Gallas, Marios A Gavrielides, Stephen M Hewitt.
J Pathol Inform, 2015 Mar 17; 6. PMID: 25774315    Free PMC article.
International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China.
Chengquan Zhao, Tao Wu, +13 authors, Liron Pantanowitz.
J Pathol Inform, 2016 Jan 06; 6. PMID: 26730353    Free PMC article.
Cytopathology whole slide images and adaptive tutorials for senior medical students: a randomized crossover trial.
Simone L Van Es, Rakesh K Kumar, +2 authors, Gary M Velan.
Diagn Pathol, 2016 Jan 10; 11. PMID: 26746436    Free PMC article.
Emerging paradigm of virtual-microscopy for histopathology diagnosis: survey of US and Canadian oral pathology trainees.
Ngozi N Nwizu, Adepitan Owosho, Kalu U E Ogbureke.
BDJ Open, 2018 Apr 03; 3. PMID: 29607083    Free PMC article.
Telepathology consultation for frozen section diagnosis in China.
Yingxin Huang, Yan Lei, +11 authors, Yongjian Deng.
Diagn Pathol, 2018 May 16; 13(1). PMID: 29759085    Free PMC article.
Clinical Application of a Real-Time Telepathology System for Frozen Section Diagnosis in Comparison With Optical Microscope.
Yu Ting Huang, Salvatore Lorenzo Renne, +5 authors, Luca Di Tommaso.
Front Med (Lausanne), 2019 Oct 23; 6. PMID: 31637244    Free PMC article.
Designing a novel hybrid healthcare teleconsultation network: a benchtop study of telepathology in Iran and a systematic review.
Mohammad Mahdi Taghipour, Mohammad Mehdi Sepehri.
BMC Med Inform Decis Mak, 2020 Aug 14; 20(1). PMID: 32787833    Free PMC article.
Systematic Review.
Invention and Early History of Telepathology (1985-2000).
Ronald S Weinstein, Michael J Holcomb, Elizabeth A Krupinski.
J Pathol Inform, 2019 Feb 21; 10. PMID: 30783545    Free PMC article.
Using Dynamic Virtual Microscopy to Train Pathology Residents During the Pandemic: Perspectives on Pathology Education in the Age of COVID-19.
Robert J Christian, Mandy VanSandt.
Acad Pathol, 2021 Apr 23; 8. PMID: 33884292    Free PMC article.
Smartpathk: a platform for teaching glomerulopathies using machine learning.
Nayze Lucena Sangreman Aldeman, Keylla Maria de Sá Urtiga Aita, +6 authors, Semíramis Jamil Hadad do Monte.
BMC Med Educ, 2021 May 01; 21(1). PMID: 33926437    Free PMC article.
Verification and Validation of Digital Pathology (Whole Slide Imaging) for Primary Histopathological Diagnosis: All Wales Experience.
M Babawale, A Gunavardhan, +24 authors, Muhammad Aslam.
J Pathol Inform, 2021 May 21; 12. PMID: 34012708    Free PMC article.
Effectiveness of a Cloud-Based Telepathology System in China: Large-Sample Observational Study.
Xianying He, Linlin Wang, +7 authors, Jie Zhao.
J Med Internet Res, 2021 Jul 31; 23(7). PMID: 34326037    Free PMC article.
Application of telepathology for neuropathologic intraoperative consultations.
Craig Horbinski, Ronald L Hamilton.
Brain Pathol, 2009 Mar 18; 19(2). PMID: 19290998    Free PMC article.
Slide Over: Advances in Slide-Free Optical Microscopy as Drivers of Diagnostic Pathology.
Yehe Liu, Richard M Levenson, Michael W Jenkins.
Am J Pathol, 2021 Nov 15; 192(2). PMID: 34774514    Free PMC article.