Journal Article
. 2015 May; 6:18.
doi: 10.4103/2153-3539.156168.

Distance reporting in digital pathology: A study on 950 cases

Aleksandar Vodovnik 1 
  • PMID: 25969793
  •     10 References
  •     14 citations


Background: Increased workload, case complexity, financial constraints, and staffing shortages justify wider implementations of digital pathology. One of its main advantages is distance reporting.

Aim: A feasibility study was conducted at our institution in order to achieve comprehensive pathology services available by distance.

Methods: One senior pathologist reported 950 cases (3,650 slides) by distance during 19 weeks. Slides were scanned by ScanScope AT Turbo (Aperio) and digital images accessed through SymPathy (Tieto) on a 14" laptop. Mobile phone, mobile broadband, broadband over Wi-Fi and broadband were used for internet connections along with a virtual private network technology (VPN). Lync (Microsoft) was tested for one case consultation and resident's teaching session. Larger displays were accessed when available. Effects of ergonomics and working flexibility on the user experience were observed. Details on network speed, frequency of technical issues, data usage, scanning, and turnaround, were collected and evaluated. Turnaround was compared to in-office microscopic reporting, measured from the registration to sign off.

Results: Network speeds varied 1-80 Mbps (median download speed 8-65 Mbps). 20 Mbps were satisfactory for the instant upload of digital images. VPN, image viewer, and laptop failed on two occasions each. An estimated data usage per digital image was 10 MB (1-50 MB). Two cases (15 slides) were deferred to microscopic slides (0.21/0.41%) due to scanty material and suboptimal slide quality. Additional nine cases (15 slides) needed to be rescanned for various reasons (0.95/0.41%). Average turnaround was shorter, and the percentage of cases reported up to 3 days higher (3.13 days/72.25%) comparing with in-office microscopic reporting (3.90 days/40.56%). Larger displays improved the most user experience at magnifications over ×20.

Conclusions: Existing IT solutions at our institution allow efficient and reliable distance reporting for the core pathology services in histology and cytology. Stable network speeds, fully integrated laboratory information management system, technical reliability, working flexibility, larger displays, and shorter turnaround contributed to the overall satisfaction with distance reporting. A further expansion of our pathology services available by distance, diagnostic and educational, rely on gaining experience in digital reporting and marginal IT investment. Adjustments to the organization of pathology services may follow to fully benefit from the implementation of digital pathology.

Keywords: Digital pathology; distance reporting; turnaround.

Validation of whole slide imaging for primary diagnosis in surgical pathology.
Thomas W Bauer, Lynn Schoenfield, +3 authors, Walter H Henricks.
Arch Pathol Lab Med, 2013 Jan 18; 137(4). PMID: 23323732
Validating whole-slide imaging for consultation diagnoses in surgical pathology.
Thomas W Bauer, Renee J Slaw.
Arch Pathol Lab Med, 2014 May 21; 138(11). PMID: 24840034
Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.
Jonhan Ho, Stefan M Ahlers, +6 authors, Anil V Parwani.
J Pathol Inform, 2014 Sep 25; 5(1). PMID: 25250191    Free PMC article.
Tracking with virtual slides: a tool to study diagnostic error in histopathology.
Darren Treanor, Chee Hooi Lim, +2 authors, Phil Quirke.
Histopathology, 2009 Jul 21; 55(1). PMID: 19614765
Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital pathology experiences 2006-2013.
Sten Thorstenson, Jesper Molin, Claes Lundström.
J Pathol Inform, 2014 May 21; 5(1). PMID: 24843825    Free PMC article.
Working at the microscope: analysis of the activities involved in diagnostic pathology.
Rebecca Randell, Roy A Ruddle, +2 authors, Darren Treanor.
Histopathology, 2011 Dec 20; 60(3). PMID: 22176210
Going fully digital: Perspective of a Dutch academic pathology lab.
Nikolas Stathonikos, Mitko Veta, André Huisman, Paul J van Diest.
J Pathol Inform, 2013 Jul 17; 4. PMID: 23858390    Free PMC article.
Digital pathology consultations-a new era in digital imaging, challenges and practical applications.
Gonzalo Romero Lauro, William Cable, +4 authors, Liron Pantanowitz.
J Digit Imaging, 2013 Jan 30; 26(4). PMID: 23359091    Free PMC article.
Validating whole slide imaging for diagnostic purposes in pathology: guideline from the College of American Pathologists Pathology and Laboratory Quality Center.
Liron Pantanowitz, John H Sinard, +8 authors, College of American Pathologists Pathology and Laboratory Quality Center.
Arch Pathol Lab Med, 2013 May 03; 137(12). PMID: 23634907    Free PMC article.
Highly Cited. Review.
Virtual slide telepathology with scanner systems for intraoperative frozen-section consultation.
Silvia Ribback, Steffen Flessa, +2 authors, Frank Dombrowski.
Pathol Res Pract, 2014 Mar 29; 210(6). PMID: 24674453
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.
Diagnostic time in digital pathology: A comparative study on 400 cases.
Aleksandar Vodovnik.
J Pathol Inform, 2016 Mar 10; 7. PMID: 26955502    Free PMC article.
Routine Digital Pathology Workflow: The Catania Experience.
Filippo Fraggetta, Salvatore Garozzo, +2 authors, Esther Diana Rossi.
J Pathol Inform, 2018 Feb 09; 8. PMID: 29416914    Free PMC article.
Complete Routine Remote Digital Pathology Services.
Aleksandar Vodovnik, Mohammad Reza F Aghdam.
J Pathol Inform, 2018 Dec 07; 9. PMID: 30505622    Free PMC article.
Digital Microscopy, Image Analysis, and Virtual Slide Repository.
Famke Aeffner, Hibret A Adissu, +8 authors, Kristin Wilson.
ILAR J, 2018 Dec 12; 59(1). PMID: 30535284    Free PMC article.
Validation of a digital pathology system including remote review during the COVID-19 pandemic.
Matthew G Hanna, Victor E Reuter, +21 authors, Meera Hameed.
Mod Pathol, 2020 Jun 24; 33(11). PMID: 32572154    Free PMC article.
Implementation of Digital Pathology Offers Clinical and Operational Increase in Efficiency and Cost Savings.
Matthew G Hanna, Victor E Reuter, +9 authors, S Joseph Sirintrapun.
Arch Pathol Lab Med, 2019 Jun 08; 143(12). PMID: 31173528    Free PMC article.
The Use of Screencasts with Embedded Whole-Slide Scans and Hyperlinks to Teach Anatomic Pathology in a Supervised Digital Environment.
Mary Wong, Joseph Frye, Stacey Kim, Alberto M Marchevsky.
J Pathol Inform, 2019 Jan 05; 9. PMID: 30607306    Free PMC article.
Whole-Slide Imaging Allows Pathologists to Work Remotely in Regions with Severe Logistical Constraints Due to Covid-19 Pandemic.
Daniel S Liscia, Donata Bellis, +3 authors, Umberto Dianzani.
J Pathol Inform, 2020 Oct 13; 11. PMID: 33042599    Free PMC article.
Remote Reporting from Home for Primary Diagnosis in Surgical Pathology: A Tertiary Oncology Center Experience during the COVID-19 Pandemic.
Vidya Rao, Rajiv Kumar, +17 authors, Sangeeta Desai.
J Pathol Inform, 2021 May 21; 12. PMID: 34012707    Free PMC article.
Digital Versus Optical Diagnosis of Follicular Patterned Thyroid Lesions.
Ayat Aloqaily, Antonio Polonia, +4 authors, Catarina Eloy.
Head Neck Pathol, 2020 Nov 01; 15(2). PMID: 33128731    Free PMC article.
Diagnostic concordance and discordance in digital pathology: a systematic review and meta-analysis.
Ayesha S Azam, Islam M Miligy, +4 authors, David R J Snead.
J Clin Pathol, 2020 Sep 17; 74(7). PMID: 32934103    Free PMC article.
Systematic Review.
Remote Reporting During a Pandemic Using Digital Pathology Solution: Experience from a Tertiary Care Cancer Center.
Veena Ramaswamy, B N Tejaswini, Sowmya B Uthaiah.
J Pathol Inform, 2021 Jul 17; 12. PMID: 34267985    Free PMC article.
Integrated digital pathology at scale: A solution for clinical diagnostics and cancer research at a large academic medical center.
Peter J Schüffler, Luke Geneslaw, +29 authors, Thomas J Fuchs.
J Am Med Inform Assoc, 2021 Jul 15; 28(9). PMID: 34260720    Free PMC article.