title: Virtual slide telepathology with scanner systems for intraoperative frozen-section consultation.
abstract: Telepathology provides pathology services over a distance using digital imaging and telecommunication for primary diagnostic practice, including intraoperative frozen sections. Virtual slide technology provides digitizing of histological slides by scanner systems and improved remote assessment substantially. In this retrospective study, diagnostic accuracy of intraoperative frozen sections assessed as virtual slide was determined. Tissue assessment was mainly requested for urological, gynecological and dermatological resections. Issues of time consumption, cost and cost effectiveness of this diagnostic method are discussed. 1204 intraoperative frozen sections were conducted in the course of this study at our department over a period of 2.5 years. 98.59% of all intraoperative frozen sections were accurately diagnosed in the initial telepathological assessment. Tumor affection was present in 15.6% of frozen sections, in 174 instances already assessed in the initial slides (sensitivity 92.6%). Discrepant diagnoses compared to the final diagnosis occurred in 1.41%. Our determined averaged time for virtual slide technology of 10.58±8.19min can be ranged in well. Our study did not allow a full economic assessment, but some preliminary insights are pointed out. The quality of services is highly acceptable and the investment costs and the labor cost of virtual slide technology are lower than those of robotic microscopy.
authors.affiliation: Institut für Pathologie, Universitätsmedizin Greifswald, Germany. Electronic address: silvia.ribback@uni-greifswald.de.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ribback
authors.affiliation: Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Ernst-Moritz-Arndt-Universität Greifswald, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Flessa
authors.affiliation: Klinik für Urologie, Asklepios Klinik Pasewalk, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Gromoll-Bergmann
authors.affiliation: Institut für Pathologie, Universitätsmedizin Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Evert
authors.affiliation: Institut für Pathologie, Universitätsmedizin Greifswald, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Dombrowski
mesh_terms: D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005260:Female; D005629:Frozen Sections / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000295:instrumentation*; D008297:Male; D009369:Neoplasms / Q000191:economics / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012017:Referral and Consultation / Q000191:economics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D019113:Telepathology / Q000191:economics / Q000295:instrumentation*; D013997:Time Factors; D013996:Time and Motion Studies; D057188:Workflow
keywords: Cost-effectiveness; Diagnostic accuracy; Intraoperative frozen section; Virtual slide