Journal Article
. 2009 Jun; 40(8):1100-11.
doi: 10.1016/j.humpath.2009.04.011.

Virtual slide telepathology workstation of the future: lessons learned from teleradiology

Elizabeth A Krupinski 1 
Affiliations
  • PMID: 19552939
  •     65 References
  •     3 citations

Abstract

The clinical reading environment for the 21st century pathologist looks very different than it did even a few short years ago. Glass slides are quickly being replaced by digital "virtual slides," and the traditional light microscope is being replaced by the computer display. There are numerous questions that arise however when deciding exactly what this new digital display viewing environment will be like. Choosing a workstation for daily use in the interpretation of digital pathology images can be a very daunting task. Radiology went digital nearly 20 years ago and faced many of the same challenges so there are lessons to be learned from these experiences. One major lesson is that there is no "one size fits all" workstation so users must consider a variety of factors when choosing a workstation. In this article, we summarize some of the potentially critical elements in a pathology workstation and the characteristics one should be aware of and look for in the selection of one. Issues pertaining to both hardware and software aspects of medical workstations will be reviewed particularly as they may impact the interpretation process.

Medical image perception issues for PACS deployment.
Elizabeth A Krupinski.
Semin Roentgenol, 2003 Sep 30; 38(3). PMID: 14513727
Review.
Radiology speech recognition: workflow, integration, and productivity issues.
Steve Langer.
Curr Probl Diagn Radiol, 2002 Jul 26; 31(3). PMID: 12140513
Review.
Reader variability: what we can learn from computer-aided detection experiments.
Matthew Freedman, Teresa Osicka.
J Am Coll Radiol, 2007 Apr 07; 3(6). PMID: 17412100
Review.
Digital imaging standards and system interoperability.
U J Balis.
Clin Lab Med, 1997 Jun 01; 17(2). PMID: 9243076
Three novel lossless image compression schemes for medical image archiving and telemedicine.
J Wang, G Naghdy.
Telemed J, 2000 Aug 25; 6(2). PMID: 10957738
A novel automated screening and interpretation process for cervical cytology using the internet transmission of low-resolution images: a feasibility study.
John H Eichhorn, Timothy A Brauns, +2 authors, David C Wilbur.
Cancer, 2005 Jun 07; 105(4). PMID: 15937917
[Physiological mechanisms of the etiology of visual fatigue during work involving visual stress].
T A Korniushina.
Vestn Oftalmol, 2000 Oct 14; 116(4). PMID: 11031876
The use of digital images in pathology.
P N Furness.
J Pathol, 1998 Jan 10; 183(3). PMID: 9422979
Review.
Choosing a radiology workstation: technical and clinical considerations.
Elizabeth A Krupinski, Maria Kallergi.
Radiology, 2007 Jan 19; 242(3). PMID: 17229874
Review.
An array microscope for ultrarapid virtual slide processing and telepathology. Design, fabrication, and validation study.
Ronald S Weinstein, Michael R Descour, +15 authors, Peter H Bartels.
Hum Pathol, 2005 Jan 26; 35(11). PMID: 15668886
The influence of a perceptually linearized display on observer performance and visual search.
E A Krupinski, H Roehrig.
Acad Radiol, 2000 Jan 25; 7(1). PMID: 10645452
Digital radiography image quality: image processing and display.
Elizabeth A Krupinski, Mark B Williams, +8 authors, Society for Imaging Informatics in Medicine.
J Am Coll Radiol, 2007 Jun 05; 4(6). PMID: 17544140
Review.
Transcontinental communication and quantitative digital histopathology via the Internet; with special reference to prostate neoplasia.
R Montironi, D Thompson, +7 authors, P H Bartels.
J Clin Pathol, 2002 May 31; 55(6). PMID: 12037030    Free PMC article.
Is computer use a risk factor for myopia?
D O Mutti, K Zadnik.
J Am Optom Assoc, 1996 Sep 01; 67(9). PMID: 8888885
Review.
Reinventing radiology in the digital age. Part II. New directions and new stakeholder value.
James H Thrall.
Radiology, 2005 Sep 27; 237(1). PMID: 16183921
Compression guidelines for diagnostic telepathology.
D J Foran, P P Meer, T Papathomas, I Marsic.
IEEE Trans Inf Technol Biomed, 1997 Mar 01; 1(1). PMID: 11020810
The application of the MPEG-4 standard to telepathology images for electronic patient records.
Georg A Brox, Janis L Huston.
J Telemed Telecare, 2003 Sep 04; 9 Suppl 1. PMID: 12952709
Digital storage of glass slides for quality assurance in histopathology and cytopathology.
Francesca Demichelis, Vincenzo Della Mea, +2 authors, Carlo Alberto Beltrami.
J Telemed Telecare, 2002 Jul 05; 8(3). PMID: 12097174
Review.
Compression of fluorescence microscopy images based on the signal-to-noise estimation.
Tytus Bernas, Elikplimi K Asem, J Paul Robinson, Bartek Rajwa.
Microsc Res Tech, 2006 Jan 18; 69(1). PMID: 16416411
Efficient transmission of compressed data for remote volume visualization.
Karthik Krishnan, Michael W Marcellin, Ali Bilgin, Mariappan S Nadar.
IEEE Trans Med Imaging, 2006 Sep 14; 25(9). PMID: 16967804
Classification of breast lesions with multimodality computer-aided diagnosis: observer study results on an independent clinical data set.
Karla Horsch, Maryellen L Giger, +3 authors, R Edward Hendrick.
Radiology, 2006 Jul 26; 240(2). PMID: 16864666
Calibrating screens for continuous colour displays.
A J Shepherd.
Spat Vis, 1997 Jan 01; 11(1). PMID: 9304753
Review.
Automatic delineation of malignancy in histopathological head and neck slides.
Mutlu Mete, Xiaowei Xu, Chun-Yang Fan, Gal Shafirstein.
BMC Bioinformatics, 2007 Dec 06; 8 Suppl 7. PMID: 18047716    Free PMC article.
Comparative evaluation of JPEG and JPEG2000 compression in quantitative digital subtraction radiography.
A Fidler, B Likar, F Pernus, U Skaleric.
Dentomaxillofac Radiol, 2002 Nov 09; 31(6). PMID: 12424637
Accommodation responses and ageing.
G Heron, W N Charman, L S Gray.
Invest Ophthalmol Vis Sci, 1999 Nov 05; 40(12). PMID: 10549647
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
Eye-movement study and human performance using telepathology virtual slides: implications for medical education and differences with experience.
Elizabeth A Krupinski, Allison A Tillack, +7 authors, Ronald S Weinstein.
Hum Pathol, 2006 Nov 30; 37(12). PMID: 17129792
Medical image compression by cosine and wavelet transforms.
J Puniene, V Punys, J Punys.
Stud Health Technol Inform, 2001 Feb 24; 77. PMID: 11187522
Signal analysis and compression performance evaluation of pathological microscopic images.
A Okumura, J Suzuki, +2 authors, T Ashihara.
IEEE Trans Med Imaging, 1998 Apr 09; 16(6). PMID: 9533571
Virtual microscopy: high resolution digital photomicrography as a tool for light microscopy simulation.
C L Felten, J S Strauss, D H Okada, A M Marchevsky.
Hum Pathol, 1999 Apr 20; 30(4). PMID: 10208472
Semi-automated imaging system to quantitate estrogen and progesterone receptor immunoreactivity in human breast cancer.
G M Sharangpani, A S Joshi, +5 authors, S H Barsky.
J Microsc, 2007 May 31; 226(Pt 3). PMID: 17535263
Reinventing radiology in the digital age. Part III. Facilities, work processes, and job responsibilities.
James H Thrall.
Radiology, 2005 Nov 24; 237(3). PMID: 16304102
Image bank, diagnostic codification and telediagnosis in hematology.
G Flandrin.
Leuk Lymphoma, 1997 Mar 01; 25(1-2). PMID: 9130618
Optimized delivery radiological reports: applying Six Sigma methodology to a radiology department.
Enrico Cavagna, Riccardo Berletti, +2 authors, Giuseppe Barbato.
Radiol Med, 2003 Jul 02; 105(3). PMID: 12835644
Virtual microscopy and public-key cryptography for Internet telepathology.
J S Strauss, C L Felten, D H Okada, A M Marchevsky.
J Telemed Telecare, 2000 Jan 11; 5(2). PMID: 10628020
Beyond morphology: whole slide imaging, computer-aided detection, and other techniques.
Michael D Feldman.
Arch Pathol Lab Med, 2008 May 10; 132(5). PMID: 18466019
Impact of PACS and voice-recognition reporting on the education of radiology residents.
Antonio J Gutierrez, Mark E Mullins, Robert A Novelline.
J Digit Imaging, 2005 Apr 14; 18(2). PMID: 15827832    Free PMC article.
Human performance studies of the video microscopy component of a dynamic telepathology system.
R S Weinstein, K J Bloom, E A Krupinski, L S Rozek.
Zentralbl Pathol, 1992 Dec 01; 138(6). PMID: 1297431
Enhanced visualization processing: effect on workflow.
E A Krupinski, M Radvany, +4 authors, R VanMetter.
Acad Radiol, 2001 Nov 28; 8(11). PMID: 11721812
Routine surgical telepathology in the Department of Veterans Affairs: experience-related improvements in pathologist performance in 2200 cases.
B E Dunn, H Choi, +3 authors, R S Weinstein.
Telemed J, 2000 Jul 25; 5(4). PMID: 10908448
Teledermatopathology: a controlled study about diagnostic validity and technical requirements for digital transmission.
Bernd Leinweber, Cesare Massone, +7 authors, Josef Smolle.
Am J Dermatopathol, 2006 Oct 03; 28(5). PMID: 17012916
Digital imaging in pathology: the case for standardization.
Yukako Yagi, John R Gilbertson.
J Telemed Telecare, 2005 May 20; 11(3). PMID: 15901437
[Low cost telepathology].
V Molinié, B Epardeau, +3 authors, A C Baglin.
Ann Pathol, 2001 Oct 31; 21(4). PMID: 11685140
Designing better radiology workstations: impact of two user interfaces on interpretation errors and user satisfaction.
Adrian Moise, M Stella Atkins.
J Digit Imaging, 2005 Apr 14; 18(2). PMID: 15827830    Free PMC article.
Automated classification of inflammation in colon histological sections based on digital microscopy and advanced image analysis.
Levente Ficsor, Viktor Sebestyén Varga, +2 authors, Bela Molnar.
Cytometry A, 2008 Jan 30; 73(3). PMID: 18228558
Virtual microscopy and the Internet as telepathology consultation tools. A study of gastrointestinal biopsy specimens.
R P Singson, S Natarajan, J K Greenson, A M Marchevsky.
Am J Clin Pathol, 1999 Jun 11; 111(6). PMID: 10361515
Practical telepathology using a digital camera and the internet.
Eung Seok Lee, In Sun Kim, +4 authors, Anthony S-Y Leong.
Telemed J E Health, 2002 Jun 25; 8(2). PMID: 12079605
Carpal tunnel syndrome and cubital tunnel syndrome: work-related musculoskeletal disorders in four symptomatic radiologists.
Lynne Ruess, Stephen C O'Connor, +4 authors, Alan Hedge.
AJR Am J Roentgenol, 2003 Jun 24; 181(1). PMID: 12818826
[Use of telepathology to provide rapid diagnosis of neurosurgical specimens].
D Crimmins, D Crooks, A Pickles, K Morris.
Neurochirurgie, 2005 Aug 19; 51(2). PMID: 16107083
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.
Telepathology and imaging spectroscopy as a new modality in histopathology.
S G Vari, G Müller, J M Lerner, R D Naber.
Stud Health Technol Inform, 2000 Mar 21; 68. PMID: 10724872
[Risk factors for asthenopia among computer terminal operators].
F R Sánchez-Román, C Pérez-Lucio, +2 authors, M Jiménez-Villarruel.
Salud Publica Mex, 1996 May 01; 38(3). PMID: 8757544
Pulmonary nodules: estimation of malignancy at thin-section helical CT--effect of computer-aided diagnosis on performance of radiologists.
Kazuo Awai, Kohei Murao, +7 authors, Yasuyuki Yamashita.
Radiology, 2006 Feb 10; 239(1). PMID: 16467210
Clinical evaluation of compression ratios using JPEG2000 on computed radiography chest images.
Min-Mo Sung, Hee-Joung Kim, +5 authors, Hyung-Sik Yoo.
J Digit Imaging, 2002 Sep 26; 15(2). PMID: 12297972    Free PMC article.
Image quality assessment: from error visibility to structural similarity.
Zhou Wang, Alan Conrad Bovik, Hamid Rahim Sheikh, Eero P Simoncelli.
IEEE Trans Image Process, 2004 Sep 21; 13(4). PMID: 15376593
Highly Cited.
"Virtual microscopy" and the internet as telepathology consultation tools: diagnostic accuracy in evaluating melanocytic skin lesions.
D H Okada, S W Binder, +2 authors, A M Marchevsky.
Am J Dermatopathol, 1999 Dec 23; 21(6). PMID: 10608244
Application of virtual microscopy in clinical cytopathology.
D M Steinberg, S Z Ali.
Diagn Cytopathol, 2001 Dec 18; 25(6). PMID: 11747236
Critical comparison of 31 commercially available digital slide systems in pathology.
Marcial García Rojo, Gloria Bueno García, +2 authors, Manuel Carbajo Vicente.
Int J Surg Pathol, 2006 Oct 17; 14(4). PMID: 17041192
Current status and future potential of computer-aided diagnosis in medical imaging.
K Doi.
Br J Radiol, 2005 May 27; 78 Spec No 1. PMID: 15917443
Review.
Diagnostic accuracy of chest X-rays acquired using a digital camera for low-cost teleradiology.
Agnieszka Szot, Francine L Jacobson, +7 authors, Hamish S F Fraser.
Int J Med Inform, 2004 Mar 24; 73(1). PMID: 15036080
Telepathology using Internet multimedia electronic mail: remote consultation on gastrointestinal pathology.
V Della Mea, S Forti, +5 authors, C A Beltrami.
J Telemed Telecare, 1996 Jan 01; 2(1). PMID: 9375039
Using a human visual system model to optimize soft-copy mammography display: influence of display phosphor.
Elizabeth Krupinski, Jeffrey Johnson, Hans Roehrig, Jeffrey Lubin.
Acad Radiol, 2003 Feb 14; 10(2). PMID: 12583567
Computer-aided diagnosis in thoracic CT.
Qiang Li, Feng Li, +6 authors, Kunio Doi.
Semin Ultrasound CT MR, 2005 Nov 09; 26(5). PMID: 16274004
Review.
Telepathology overview: from concept to implementation.
R S Weinstein, M R Descour, +9 authors, B E Dunn.
Hum Pathol, 2002 Jan 05; 32(12). PMID: 11774159
Review.
On Asthenopia, or Weak-Sightedness.
William Mackenzie.
Edinb Med Surg J, 1843 Jul 01; 60(156). PMID: 30330617    Free PMC article.
Optimizing the pathology workstation "cockpit": Challenges and solutions.
Elizabeth A Krupinski.
J Pathol Inform, 2010 Oct 30; 1. PMID: 21031008    Free PMC article.
Understanding visual search patterns of dermatologists assessing pigmented skin lesions before and after online training.
Elizabeth A Krupinski, Joseph Chao, +2 authors, Clara Curiel-Lewandrowski.
J Digit Imaging, 2014 Jun 19; 27(6). PMID: 24939005    Free PMC article.
A novel method for morphological pleomorphism and heterogeneity quantitative measurement: Named cell feature level co-occurrence matrix.
Akira Saito, Yasushi Numata, +5 authors, Yoichiro Yamamoto.
J Pathol Inform, 2016 Oct 01; 7. PMID: 27688927    Free PMC article.