Validation Study of Telepathology on Neuropathology Frozen Section Diagnosis in a Multi-Hospital Pathology Department
Julio Poveda, Wendong Yu, Vania Nose, Carmen Gomez-Fernandez. University of Miami, Miami, FL
Background: Telepathology is increasingly used for neuropathology intraoperative frozen section (FS) with great accuracy. In our department, two rotating on-duty neuropathologists cover neuropathology FS in 3 hospitals, located about a 15-minute walking distance from each other. When the neuropathologists cannot be physically available, a general surgical pathologist covers the neuropathology FS. Telepathology has the great potential to improve the turnaround time (TAT), in particular when there are simultaneous FS in different hospitals. Additionally, telepathology can facilitate consultation and improve patient care. We explored the feasibility of implementing dynamic telepathology for FS in our department.
Design: Our telepathology system includes an Olympus BX40 microscope, an Olympus DP71 camera and MicroSuite Pathology Edition software in the FS suite. Access to the internet and internet browser are the only requirements for the pathologist's computer terminal. For this study, 10 FS cases were randomly chosen by an assistant. The slides were transmitted in real time to 4 pathologists (2 neuropathologists and 2 general surgical pathologists) by a junior resident. Short patient history and specimen site were provided. The pathologists independently evaluated each FS slide and rendered a telepathology diagnosis (TPD). Afterward, the glass slides were reviewed and each gave a light microscope diagnosis (LMD). Neither the resident nor the pathologists knew the original FS diagnoses (FSD) or the permanent section diagnoses (PSD). There were no discrepancies between the FSD and PSD.
Results: There were 40 TPD and LMD diagnoses among the four pathologists. The overall TPD accuracy was 92.5%; the LMD accuracy was 97.5%. For 20 of the 40 TPD responses, the diagnoses were made by neuropathologists with a TPD accuracy of 95% and LMD accuracy of 100%. The general surgical pathologists TPD accuracy was 90% and an LMD accuracy of 95%. Additionally, the diagnoses rendered by the neuropathologists were quicker and more specific.
Conclusions: The diagnostic accuracy of telepathology for neuropathology FS is very similar to the conventional light microscope method. There was no overall difference between TPD and LMD. Furthermore, the neuropathologists were quicker and more specific in their diagnoses, probably related to their expertise. Telepathology is an excellent tool for the practicing pathologist that can facilitate consultation, improve turn around time, and optimize patient care.
Category: Quality Assurance
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 265, Tuesday Morning