Clinical trial of telepathology as an alternative modality in breast histopathology quality assurance

被引:32
|
作者
Leong, FJWM
Graham, AK
Schwarzmann, P
McGee, JO
机构
[1] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Pathol & Bacteriol, Oxford OX3 9DU, England
[2] Univ Stuttgart, Inst Phys Elekt, D-70569 Stuttgart, Germany
来源
TELEMEDICINE JOURNAL AND E-HEALTH | 2000年 / 6卷 / 04期
关键词
D O I
10.1089/15305620050503834
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Telepathology is a potential alternative to conventional histopathology. A clinical trial using a robotic telepathology system was conducted to assess the clinical and technical utility and effectiveness of telepathology in the U.K. breast screening pathology quality assurance program. Eighty-seven cases of breast disease were chosen at random from a series of 192 cases from the U.K. Breast Screening Pathology National Quality Assurance Scheme (NEQAS) collection. There were 20 benign, 23 carcinoma in situ (CIS), and 44 invasive malignant cases. The diagnostic accuracy of telepathology (TP) compared with conventional light microscopic (LM) diagnosis was 98.8%; this included a single case deferred for LM examination. The figure was similar when compared with expert consensus diagnosis (CD). In invasive tumor typing, TP accuracy was 95.4% (42/44 cases), the difference being attributable to slide color fading and would have had no impact on patient management. The accuracy of TP versus LM and expert consensus in tumor grading was 91.3% for carcinoma in situ (21/23 cases), a discordance with no relevance to patient management. TP grading of invasive tumor compared with LM diagnosis, had an accuracy of 86.4% (38/44) with a clinically significant accuracy of 97.7% (43/44). The time taken for TP diagnosis averaged 3.9 minutes per case by the end of the study. This data demonstrates that telepathology diagnostic accuracy is comparable to conventional microscopy and may therefore be envisaged as an alternative to conventional light microscopy for more rapid proficiency testing in breast screening (and perhaps other) quality assurance schemes.
引用
收藏
页码:373 / 377
页数:5
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