Telepathology using TPS

AIMS: The telepathology system TPS is the result of a joint development of the Institute of Pathology and the Department of Prenatal Diagnostics and Therapy of the Charité Berlin together with Leica Microsystems Wetzlar. This system is implemented on several workstations of pathologists within the institute and in two frozen section labs. We present the general design and the application of the TPS, which is used for second opinions in conventional histology and in frozen sections as well as for primary diagnostic in frozen sections and for fetal autopsies. MATERIAL AND METHODS: The TPS is strictly case oriented. It may be used for teleconsultation and telediagnostic, because it allows handling of static and dynamic imaging (PAL 762 x 508 x 3 colour resolution, ITU standard H.263, H.264). Pathologists have the possibility to control the remote microscope and to contact the partner using videoconference (ITU standard H.323). Case and image data are archived in an SQL database. The connection between two partners may be realised using LAN or ISDN lines (minimal 2 B channels). We analysed overall accuracy and adaptability to pathologists workflow in the different application fields. RESULTS: The TPS has a case engine for the handling and archiving of the telepathological cases. Every connection between two partners is based on the transmission of a complete case including clinical data, previous findings and macroscopic findings including macroscopic images, overview images and microscopic images with possible annotations. The daily practice showed that these features are necessary for a routine application as well as for legal reasons. CONCLUSIONS Our experiences show that the design of the TPS allows the routine use for a second opinion and frozen section diagnostic. It opens the possibility to integrate telepathology in the ordinary working place of a pathologist.