Journal Article
. 2002 Mar; 55(4):305-8.
doi: 10.1136/jcp.55.4.305.

Offline telepathology diagnosis of colorectal polyps: a study of interobserver agreement and comparison with glass slide diagnoses

S S Cross 1 J L Burton  A K Dubé  K M Feeley  P D Lumb  T J Stephenson  R D Start  
  • PMID: 11919218
  •     19 References
  •     3 citations


Background/Aims: Technological advances have produced telepathology systems with high quality colour images and reasonable transmission times. Most applications of telepathology have centred on the remote diagnosis of frozen sections or remote real time expert opinions. This study investigates the reproducibility and accuracy of offline telepathology as a primary diagnostic medium for routine histopathology specimens.

Methods: One hundred colorectal polyps (50 hyperplastic, 50 adenomatous) were presented in a randomised order to five histopathologists as offline images on a telepathology workstation. Six images of each case were used: the slide label, a low power scan of all material on the slide, and four higher magnification views. The times taken to prepare the images, and to make the diagnoses, were recorded. Interobserver agreement was measured with kappa statistics and compared with the glass slide diagnoses.

Results: The kappa statistics for the interobserver agreement on the telepathology images lay in the range of 0.90-1.00, which is interpreted as excellent agreement, and were significantly higher than those for the glass slide diagnoses (range, 0.84-0.98; p = 0.001). The median time taken to capture the images for a case was 210 seconds. The median time taken to make a diagnosis from the telepathology images was five seconds, which was significantly shorter than for the glass slide diagnoses (median, 13 seconds; p < 0.0005).

Conclusions: Offline telepathology has the potential to be a primary diagnostic medium for routine histopathology with a high degree of reproducibility and short diagnosis times. Further studies are required to validate offline telepathology for different types of specimens and different operators of the image capture system.

Image sampling in static telepathology for frozen section diagnosis.
V Della Mea, P Cataldi, +3 authors, C A Beltrami.
J Clin Pathol, 2000 Feb 16; 52(10). PMID: 10674035    Free PMC article.
Cost minimization analysis of telepathology.
Z Agha, R S Weinstein, B E Dunn.
Am J Clin Pathol, 1999 Oct 08; 112(4). PMID: 10510670
The UICC Telepathology Consultation Center. International Union Against Cancer. A global approach to improving consultation for pathologists in cancer diagnosis.
M Dietel, T N Nguyen-Dobinsky, P Hufnagl.
Cancer, 2000 Jul 18; 89(1). PMID: 10897017
Outpatient frozen sections by telepathology in a Veterans Administration medical center.
P J Dawson, J G Johnson, +3 authors, G F Van Buskirk.
Hum Pathol, 2000 Aug 03; 31(7). PMID: 10923913
Hybrid system for telepathology.
J Zhou, M A Hogarth, +2 authors, T S Nesbitt.
Hum Pathol, 2000 Aug 03; 31(7). PMID: 10923920
Double reading.
D B Kopans.
Radiol Clin North Am, 2000 Aug 16; 38(4). PMID: 10943273
The validity of telepathological frozen section diagnosis with ISDN-mediated remote microscopy.
U Wellnitz, P Fritz, +5 authors, P Schwarzmann.
Virchows Arch, 2000 Aug 30; 437(1). PMID: 10963380
What levels of agreement can be expected between histopathologists assigning cases to discrete nominal categories? A study of the diagnosis of hyperplastic and adenomatous colorectal polyps.
S S Cross, S Betmouni, +6 authors, T J Stephenson.
Mod Pathol, 2000 Sep 28; 13(9). PMID: 11007033
Effect of image compression on telepathology. A randomized clinical trial.
A Marcelo, P Fontelo, M Farolan, H Cualing.
Arch Pathol Lab Med, 2000 Nov 18; 124(11). PMID: 11079019
Remote frozen section service: a telepathology project in northern Norway.
I Nordrum, B Engum, +5 authors, T J Eide.
Hum Pathol, 1991 Jun 01; 22(6). PMID: 1864583
Kappa statistics as indicators of quality assurance in histopathology and cytopathology.
S S Cross.
J Clin Pathol, 1996 Jul 01; 49(7). PMID: 8813964    Free PMC article.
Telepathology: a ten-year progress report.
R S Weinstein, A K Bhattacharyya, A R Graham, J R Davis.
Hum Pathol, 1997 Jan 01; 28(1). PMID: 9013823
Dynamic-robotic telepathology: Department of Veterans Affairs feasibility study.
B E Dunn, U A Almagro, +6 authors, R S Weinstein.
Hum Pathol, 1997 Jan 01; 28(1). PMID: 9013824
Transcontinental consults in surgical pathology via the Internet.
V Eusebi, L Foschini, S Erde, J Rosai.
Hum Pathol, 1997 Jan 01; 28(1). PMID: 9013825
Diagnostic accuracy of an international static-imaging telepathology consultation service.
B E Halliday, A K Bhattacharyya, +8 authors, R S Weinstein.
Hum Pathol, 1997 Jan 01; 28(1). PMID: 9013826
Telepathology diagnosis of prostrate needle biopsies.
M H Weinstein, J I Epstein.
Hum Pathol, 1997 Jan 01; 28(1). PMID: 9013827
Grading and scoring in histopathology.
S S Cross.
Histopathology, 1998 Oct 08; 33(2). PMID: 9762541
Telepathology: assessment of the implications and applications of telepathology for practical diagnostic pathology.
C Sowter, C A Wells.
J Clin Pathol, 1999 Feb 19; 51(10). PMID: 10023331    Free PMC article.
Telepathology: a diagnostic tool for the millennium?
C A Wells, C Sowter.
J Pathol, 2000 Apr 18; 191(1). PMID: 10767711
Digital slide and virtual microscopy based routine and telepathology evaluation of routine gastrointestinal biopsy specimens.
B Molnar, L Berczi, +4 authors, Z Tulassay.
J Clin Pathol, 2003 Jun 05; 56(6). PMID: 12783970    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.
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.