Virtual slide telepathology workstation-of-the-future: lessons learned from teleradiology.

The clinical reading environment for the twenty-first century pathologist looks very different than it did even a few short years ago. Glass slides are quickly being replaced by digital "virtual slides" and the traditional light microscope is being replaced by the computer display. There are numerous questions that arise however when deciding exactly what this new digital display viewing environment be like. Choosing a workstation for daily use in the interpretation of digital pathology images can be a very daunting task. Radiology went digital nearly 20 years ago and faced many of the same challenges so there are lessons to be learned from these experiences. One major lesson is that there is no "one size fits all" workstation so users must consider a variety of factors when choosing a workstation. In this article, we summarize some of the potentially critical elements in a pathology workstation and the characteristics one should be aware of and look for in the selection of one. Issues pertaining to both hardware and software aspects of medical workstations will be reviewed particularly as they may impact the interpretation process.

[1]  J Wang,et al.  Three novel lossless image compression schemes for medical image archiving and telemedicine. , 2000, Telemedicine journal : the official journal of the American Telemedicine Association.

[2]  Vincent Molinié,et al.  Télépathologie à moindre coût , 2001 .

[3]  R P Singson,et al.  Virtual microscopy and the Internet as telepathology consultation tools. A study of gastrointestinal biopsy specimens. , 1999, American journal of clinical pathology.

[4]  Paul A. Fontelo,et al.  Effect of Image Compression on Telepathology , 2009 .

[5]  Hans Roehrig,et al.  Using a human visual system model to optimize soft-copy mammography display: influence of display phosphor. , 2003, Academic radiology.

[6]  P H Bartels,et al.  Transcontinental communication and quantitative digital histopathology via the Internet; with special reference to prostate neoplasia. , 2002, Journal of clinical pathology.

[7]  Cesare Massone,et al.  Teledermatopathology: A Controlled Study About Diagnostic Validity and Technical Requirements for Digital Transmission , 2006, The American Journal of dermatopathology.

[8]  U J Balis,et al.  Digital imaging standards and system interoperability. , 1997, Clinics in laboratory medicine.

[9]  A. Bovik,et al.  A universal image quality index , 2002, IEEE Signal Processing Letters.

[10]  Gerhard Müller,et al.  Telepathology and Imaging Spectroscopy as a New Modality in Histopathology , 1999, MIE.

[11]  S Forti,et al.  Telepathology using Internet multimedia electronic mail: remote consultation on gastrointestinal pathology , 1996, Journal of telemedicine and telecare.

[12]  Stefan Winkler,et al.  JPEG vs. JPEG 2000: an objective comparison of image encoding quality , 2004, SPIE Optics + Photonics.

[13]  Francisco Raúl Sánchez-Román,et al.  Factores de riesgo para la astenopía en operadores de terminales de computadoras , 1996 .

[14]  David C Wilbur,et al.  A novel automated screening and interpretation process for cervical cytology using the internet transmission of low‐resolution images , 2005, Cancer.

[15]  James H Thrall Reinventing radiology in the digital age. Part II. New directions and new stakeholder value. , 2005, Radiology.

[16]  K. Doi,et al.  Current status and future potential of computer-aided diagnosis in medical imaging. , 2005, The British journal of radiology.

[17]  Stefano Forti,et al.  Digital Storage of Glass Slides for Quality Assurance in Histopathology and Cytopathology , 2002, Journal of telemedicine and telecare.

[18]  Michael D Feldman,et al.  Beyond morphology: whole slide imaging, computer-aided detection, and other techniques. , 2008, Archives of pathology & laboratory medicine.

[19]  Teresa Osicka,et al.  Reader variability: what we can learn from computer-aided detection experiments. , 2006, Journal of the American College of Radiology : JACR.

[20]  Zhou Wang,et al.  Why is image quality assessment so difficult? , 2002, 2002 IEEE International Conference on Acoustics, Speech, and Signal Processing.

[21]  Daniel Malacara,et al.  Color Vision and Colorimetry: Theory and Applications , 2002 .

[22]  E. Krupinski,et al.  Eye-movement study and human performance using telepathology virtual slides: implications for medical education and differences with experience. , 2006, Human pathology.

[23]  Paul S. Fisher,et al.  Image quality measures and their performance , 1995, IEEE Trans. Commun..

[24]  Gloria Bueno García,et al.  Critical Comparison of 31 Commercially Available Digital Slide Systems in Pathology , 2006, International journal of surgical pathology.

[25]  Li Lan,et al.  Classification of breast lesions with multimodality computer-aided diagnosis: observer study results on an independent clinical data set. , 2006, Radiology.

[26]  Elizabeth A Krupinski,et al.  Digital radiography image quality: image processing and display. , 2007, Journal of the American College of Radiology.

[27]  Elizabeth A. Krupinski,et al.  Measurement of visual strain in radiologists , 2008, SPIE Medical Imaging.

[28]  E A Krupinski,et al.  The influence of a perceptually linearized display on observer performance and visual search. , 2000, Academic radiology.

[29]  E A Krupinski,et al.  Enhanced visualization processing: effect on workflow. , 2001, Academic radiology.

[30]  Sun Kook Yoo,et al.  Clinical Evaluation of Compression Ratios using JPEG2000 on Computed Radiography Chest Images , 2002, Journal of Digital Imaging.

[31]  Lucila Ohno-Machado,et al.  Diagnostic accuracy of chest X-rays acquired using a digital camera for low-cost teleradiology , 2004, Int. J. Medical Informatics.

[32]  Ming Gao,et al.  Computer-aided prostrate cancer diagnosis using image enhancement and JPEG2000 , 2003, SPIE Optics + Photonics.

[33]  B Likar,et al.  Comparative evaluation of JPEG and JPEG2000 compression in quantitative digital subtraction radiography. , 2002, Dento maxillo facial radiology.

[34]  Michael W. Marcellin,et al.  Efficient transmission of compressed data for remote volume visualization , 2006, IEEE Transactions on Medical Imaging.

[35]  J Punys,et al.  Medical image compression by cosine and wavelet transforms. , 2000, Studies in health technology and informatics.

[36]  R S Weinstein,et al.  Human performance studies of the video microscopy component of a dynamic telepathology system. , 1992, Zentralblatt fur Pathologie.

[37]  James O. Larimer,et al.  Evaluation of human vision models for predicting human observer performance , 1997, Medical Imaging.

[38]  Elizabeth A. Krupinski,et al.  The innovative bundling of teleradiology, telepathology, and teleoncology services , 2007, IBM Syst. J..

[39]  James H Thrall,et al.  Reinventing radiology in the digital age. Part III. Facilities, work processes, and job responsibilities. , 2005, Radiology.

[40]  Sadayasu Ono,et al.  Signal analysis and compression performance evaluation of pathological microscopic images , 1997, IEEE Transactions on Medical Imaging.

[41]  B. Molnár,et al.  Digital slide and virtual microscopy based routine and telepathology evaluation of routine gastrointestinal biopsy specimens , 2003 .

[42]  Patrick C. Teo,et al.  Perceptual image distortion , 1994, Electronic Imaging.

[43]  R S Weinstein,et al.  Routine surgical telepathology in the Department of Veterans Affairs: experience-related improvements in pathologist performance in 2200 cases. , 1999, Telemedicine journal : the official journal of the American Telemedicine Association.

[44]  William Mackenzie,et al.  On Asthenopia, or Weak-Sightedness , 1843, Edinburgh medical and surgical journal.

[45]  Eero P. Simoncelli,et al.  Image quality assessment: from error visibility to structural similarity , 2004, IEEE Transactions on Image Processing.

[46]  A J Shepherd,et al.  Calibrating screens for continuous colour displays. , 1997, Spatial vision.

[47]  Elizabeth A. Krupinski,et al.  Perceptually optimized compression of mammograms , 2002, SPIE Medical Imaging.

[48]  Ivan Marsic,et al.  Compression guidelines for diagnostic telepathology , 1997, IEEE Transactions on Information Technology in Biomedicine.

[49]  D. Mutti,et al.  Is computer use a risk factor for myopia? , 1996, Journal of the American Optometric Association.

[50]  Georg A Brox,et al.  The application of the MPEG-4 standard to telepathology images for electronic patient records , 2003, Journal of telemedicine and telecare.

[51]  A M Marchevsky,et al.  "Virtual microscopy" and the internet as telepathology consultation tools: diagnostic accuracy in evaluating melanocytic skin lesions. , 1999, The American Journal of dermatopathology.

[52]  D. Crimmins,et al.  Intérêt de la télépathologie dans le diagnostic rapide des spécimens neurochirurgicaux , 2005 .

[53]  F R Sánchez-Román,et al.  [Risk factors for asthenopia among computer terminal operators]. , 1996, Salud publica de Mexico.

[54]  Elizabeth A. Krupinski,et al.  Effects of grayscale window/level parameters on breast lesion detectability , 2003, SPIE Medical Imaging.

[55]  Giuseppe Barbato,et al.  Optimized delivery radiological reports: applying Six Sigma methodology to a radiology department. , 2003, La Radiologia medica.

[56]  P N Furness,et al.  The use of digital images in pathology , 1997, The Journal of pathology.

[57]  Mutlu Mete,et al.  Automatic delineation of malignancy in histopathological head and neck slides , 2007, BMC Bioinformatics.

[58]  Elizabeth A. Krupinski,et al.  Visual discrimination model for digital mammography , 1999, Medical Imaging.

[59]  Hee-Joung Kim,et al.  Clinical evaluation of JPEG2000 compression for digital mammography , 2002 .

[60]  Stefan Winkler,et al.  Perceptual distortion metric for digital color video , 1999, Electronic Imaging.

[61]  P. Fontelo,et al.  Effect of image compression on telepathology. A randomized clinical trial. , 2000, Archives of pathology & laboratory medicine.

[62]  Korniushina Ta Physiological mechanisms of the etiology of visual fatigue during work involving visual stress , 2000 .

[63]  Syed Z. Ali,et al.  Application of virtual microscopy in clinical cytopathology , 2001, Diagnostic cytopathology.

[64]  J. Paul Robinson,et al.  Compression of fluorescence microscopy images based on the signal‐to‐noise estimation , 2006, Microscopy research and technique.

[65]  Elizabeth A Krupinski,et al.  Medical image perception issues for PACS deployment. , 2003, Seminars in roentgenology.

[66]  Antonio J. Gutierrez,et al.  Impact of PACS and Voice-Recognition Reporting on the Education of Radiology Residents , 2004, Journal of Digital Imaging.

[67]  M Mcneill Kevin,et al.  Practical Methods of Color Quality Assurance for Telemedicine Systems , 2002 .

[68]  Kunio Doi,et al.  Computer-aided diagnosis in thoracic CT. , 2005, Seminars in ultrasound, CT, and MR.

[69]  Maria Kallergi,et al.  Choosing a radiology workstation: technical and clinical considerations. , 2007, Radiology.

[70]  A M Marchevsky,et al.  Virtual microscopy: high resolution digital photomicrography as a tool for light microscopy simulation. , 1999, Human pathology.

[71]  G Flandrin Image bank, diagnostic codification and telediagnosis in hematology. , 1997, Leukemia & lymphoma.

[72]  M. Stella Atkins,et al.  Designing Better Radiology Workstations: Impact of Two User Interfaces on Interpretation Errors and User Satisfaction , 2005, Journal of Digital Imaging.

[73]  James O. Larimer,et al.  X-ray image system design using a human visual model , 1996, Medical Imaging.

[74]  Levente Ficsor,et al.  Automated classification of inflammation in colon histological sections based on digital microscopy and advanced image analysis , 2008, Cytometry. Part A : the journal of the International Society for Analytical Cytology.

[75]  Yukako Yagi,et al.  Digital imaging in pathology: the case for standardization , 2005, Journal of telemedicine and telecare.

[76]  Kyle J. Myers,et al.  Foundations of Image Science , 2003, J. Electronic Imaging.

[77]  R S Weinstein,et al.  Telepathology overview: from concept to implementation. , 2001, Human pathology.

[78]  A M Marchevsky,et al.  Virtual microscopy and public-key cryptography for Internet telepathology , 1999, Journal of telemedicine and telecare.

[79]  Elizabeth A. Krupinski,et al.  MTF correction for optimizing softcopy display of digital mammograms: use of a vision model for predicting observer performance , 2003, SPIE Medical Imaging.

[80]  Takeshi Nakaura,et al.  Pulmonary nodules: estimation of malignancy at thin-section helical CT--effect of computer-aided diagnosis on performance of radiologists. , 2006, Radiology.

[81]  Alan Hedge,et al.  Carpal tunnel syndrome and cubital tunnel syndrome: work-related musculoskeletal disorders in four symptomatic radiologists. , 2003, AJR. American journal of roentgenology.

[82]  John R Davis,et al.  An array microscope for ultrarapid virtual slide processing and telepathology. Design, fabrication, and validation study. , 2004, Human pathology.

[83]  Sheldon M. Ebenholtz,et al.  Oculomotor Systems and Perception , 2001 .

[84]  S H Barsky,et al.  Semi‐automated imaging system to quantitate estrogen and progesterone receptor immunoreactivity in human breast cancer , 2007, Journal of microscopy.

[85]  Andrew P. Bradley,et al.  Perceptual quality metrics applied to still image compression , 1998, Signal Process..

[86]  W N Charman,et al.  Accommodation responses and ageing. , 1999, Investigative ophthalmology & visual science.

[87]  Eung Seok Lee,et al.  Practical telepathology using a digital camera and the internet. , 2002, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[88]  Steve Langer,et al.  Radiology speech recognition: workflow, integration, and productivity issues. , 2002, Current problems in diagnostic radiology.