A microscope that emails medical images

A team of Chinese and U.S. researchers has successfully applied for a patent for a virtual telemicroscope. It is the only one of its kind capable of emailing electronic slides. It has been specifically designed to allow 'off-site pathologists to diagnose cancer or other diseases in patients living in remote locations around the world,' like China, where many hospitals don't have on-site pathologists. Real systems based on this patent have already been deployed. And the results of the first clinical trials are pretty encouraging. Telepathologists reached the same level of diagnostic accuracy as pathologists using standard light microscopy. Using this software, telepathologists were able to remotely deliver their diagnosis in about 15 minutes. But read more...

A team of Chinese and U.S. researchers has successfully applied for a patent for a virtual telemicroscope. It is the only one of its kind capable of emailing electronic slides. It has been specifically designed to allow 'off-site pathologists to diagnose cancer or other diseases in patients living in remote locations around the world,' like China, where many hospitals don't have on-site pathologists. Real systems based on this patent have already been deployed. And the results of the first clinical trials are pretty encouraging. Telepathologists reached the same level of diagnostic accuracy as pathologists using standard light microscopy. Using this software, telepathologists were able to remotely deliver their diagnosis in about 15 minutes. But read more...

Structure of the virtual telemicroscope

You can see above a diagram of the functional structure of the virtual telemicroscope system patented by the researchers. (Credit: Virginia Anderson and Jiang Gu).

This system was developed by Virginia Anderson, associate Department of Pathology at SUNY Downstate, and Jiang Gu, dean and chairman of pathology at Beijing Medical University. A Chinese company, Motic, has already built "a microscope with a robotic stage that scans whole slides at various magnifications and then creates compressed images that can be emailed all over the world."

Here is how the system works. "The Motic telepathology system utilizes a computer and microscope, which enables interactive communication on a user network. A robot scans the whole tissue sample on the microscope. Subsequent images corresponding to the selected area of the specimen are linked at higher magnifications. The patented software turns an ordinary computer into a virtual microscope. High magnification images are compressed and linked to the low power scanned glass slide that is stored as a virtual slide file. Images can then be emailed and analyzed by pathologists at remote locations. Once received, Internet independent images can be stored and viewed as part of the electronic medical record or medical student teaching file."

So far, the SUNY Downstate Medical Center system "produces the only virtual slides that can be emailed around the world. Moreover, it is also the least expensive, Internet independent solution for expert consultation." The researchers already have started clinical trials using this telemicroscope.

The results of these clinical trials have been published by Human Pathology, an Elsevier scientific journal, under the name "Assessment of diagnostic accuracy and feasibility of dynamic telepathology in China" (Volume 39, Issue 2, Pages 236-242, February 2008).

Here is a link to the abstract, which starts like this. "To assess the feasibility, including diagnostic accuracy and time cost, of a real-time telepathology system with pathologic slides, 600 cases covering a wide spectrum of lesions from 16 organ systems were tested. The "correct" diagnosis (gold standard) was established as a consensus by 2 experienced pathologists. The cases were first examined by 4 pathologists at different levels of experience with dynamic telepathology. Cases were then reviewed by the same pathologists using light microscopy in a blinded fashion 3 weeks to 2 months later. A diagnosis, together with reading times for telepathology and light microscopy, was recorded for each case.

The diagnostic accuracy by telepathology was over 90% for all for pathologists. And results were obtained after short amounts of time. "Most cases (510 or 85%) were diagnosed in 15 to 40 minutes by telepathology, with a mean of 17.0 minutes. The time needed to review a slide by telepathology was 3 to 4 times longer than that of standard light microscopy."

Here is the conclusion of the researchers. "Our results showed that robotic telepathology is sufficiently accurate for primary diagnosis in surgical pathology, but modifications in laboratory protocols, telepathology hardware, and internet speed are needed to reduce the time necessary for diagnosis by telepathology before this method may be deemed suitable for use in a busy practice."

Now, let's look at the patent awarded to the researchers. This invention has simply been called "Virtual telemicroscope" and received the U.S. patent number 7,292,251 on November 6, 2007. Here is link to the text of the patent, thanks to the FreePatentsOnline service. If you want to also see the drawings associated with this patent, here is a link to a PDF version (36 pages, 2.25 MB), thanks to the pat2pdf free service. The above figure was extracted from this document.

Here is an excerpt of the abstract for this patent. "A method and system that uses a computer system as a telemicroscope. [...] Images are transmitted to a remote user via a computer network thereby allowing the user to view the images with different magnification levels without compromising in image clarity (Computer station one and computer station two). The transmitted images are viewed in a dynamic manner, permitting the user to navigate, enlarge, measure, compare, annotate and exam the digitized images on a virtual slides displayed on a computer screen (Image analysis measurement). The operation of the system closely mimics that of a light microscope."

It's still quite difficult for me to understand the obfuscated jargon of patents lawyers. How is it for you?

Anyway, you can try the virtual telemicroscope for free if you want. You just need to visit one online courseware page at SUNY Downstate Medical Center about this Virtual Telemicroscope. From there, you can download the software and install it on your computer running Windows (no Vista version). Then, you'll be able to access and navigate through 'virtual' slides.

Sources: SUNY Downstate Medical Center news release, March 17, 2008; and various websites

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