title: Virtual microscopy using whole-slide imaging as an enabler for teledermatopathology: A paired consultant validation study.
abstract: BACKGROUND
  There is a need for telemedicine, particularly in countries with large geographical areas and widely scattered low-density communities as is the case of the Canadian system, particularly if equality of care is to be achieved or the difference gap is to be narrowed between urban centers and more peripheral communities.
  
  
  OBJECTIVE
  1. To validate teledermatopathology as a diagnostic tool in under-serviced areas; 2. To test its utilization in inflammatory and melanocytic lesions; 3. To compare the impact of 20× (0.5 μm/pixel) and 40× (0.25 μm/pixel) scans on the diagnostic accuracy.
  
  
  METHODS
  A total of 103 dermatopathology cases divided into three arms were evaluated by two pathologists and results compared. The first arm consisted of 79 consecutive routine cases (n=79). The second arm consisted of 12 inflammatory skin biopsies (n=12) and the third arm consisted of 12 melanocytic lesions (n=12). Diagnosis concordance was used to evaluate the first arm. Whereas concordance of preset objective findings were used to evaluate the second and third arms.
  
  
  RESULTS
  The diagnostic concordance rate for the first arm was 96%. The concordance rates of the objective findings for the second and third arms were 100%. The image quality was deemed superior to light microscopy for 40× scans.
  
  
  CONCLUSIONS
  The current scanners produce high-resolution images that are adequate for evaluation of a variety of cases of different complexities.
authors.affiliation: Department of Pathology, University Health Network, Toronto General Hospital, 11 E Floor, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada.
authors.forename: Ayman
authors.initials: A
authors.lastname: Al Habeeb
authors.forename: Andrew
authors.initials: A
authors.lastname: Evans
authors.forename: Danny
authors.initials: D
authors.lastname: Ghazarian