Image standardization in tissue – based diagnosis

Basic conception Virtual microscopy, i.e., the microscopic diagnostics on images derived from completely digitized glass slides has to be distinguished into (1) human performance and (2) automated machine algorithms. Both methods can result in diagnostic errors that have to be graded (or scored) according to their clinical signifi cance. A proposed system includes 10 diff erent scores, reaching from main signifi cant errors {normal abnormal tissue, (0)} to {identical fi ndings (10)}. Th e system developed by Mireskandari et al 1 is appropriate for and has been tested in telepathology sessions to grade diff erences between primary and secondary diagnosis. Th e procedure can be embedded into a general hierarchic standardization method which includes three levels {aim, methodology, and specifi c limitations} 2 . Th ree diff erent “columns”, i.e., legal, medical, and technical aspects can be implemented into the hierarchy. Specifi c aspects of microscopic images can be added to well known communication standards such as DICOM 3, HL 7, or HTTP. Image quality standards have to include parameters that describe accuracy of object segmentation, correct image illumination or shading, and equalize the gray value distribution. Additional standards have to give regulations for image display (size and resolution of image display systems), minimum number, size, and magnifi cations of transmitted image compartments, and color distributions. Simple questions, for example which color space is appropriate for which color distribution, have also to be answered in an unequivocal manner.