Telepathology is a branch of telemedicine and pathology that consists in the exchange of pathology images through telecommunication with the purposes of diagnosis, consultation, research and/or education. The use of telepathology is of great importance in management of patients since it allows fast diagnosis and inter-consultations among specialist pathologists located in every part of the world.

There are two basic methods of telepathology. Static telepathology consists in the capture and digitalization of a group of macroscopic and/or microscopic images selected by a pathologist or pathologist assistant, which are then transmitted through electronic means to a telepathologist. This transmission is usually done by electronic mail (e-mail) or by a file transfer protocol (FTP). With e-mail, the image files are sent as attached files in a message containing the basic information about the case. The FTP is used to send files directly into a web server from which the telepathologist can download them. An alternative method is to include both the images and the information about the case in a web page and give simultaneous access to several pathologists in different parts of the world.

Dynamic telepathology consists in the direct and instant (live) electronic communication between a center that sends the pathology images and another center that receives such images. For this, the microscope that sends the images may be equipped with a telerobotic system that is remotely operated by the telepathologist who makes the diagnosis. This robotic system may include one or more of the following elements: movement of the microscopic plate, changing objectives, focusing and light adjustment. Some of these systems provide the telepathologist with an overview image of the specimen at low resolution, including the coordinates of the slide. This is accompanied by images at medium resolution, which show the constantly changing microscopic fields according to the movement of the plate. This is followed by still images at high resolution from the fields chosen by the telepathologist. Some computer programs include simultaneous image and sound of the person(s) operating each system (teleconference). A modality of dynamic telepathology, in the absence of a telerobotic system, is to use a telepathologist assistant who operates the microscope in the remote location and moves the plate following telephone instructions from the telepathologist.

Nowadays, dynamic telepathology has great limitations, since it has to be accomplished between centers using the same operating system (software). In addition, the cost of the equipment and the computer programs fluctuate between $20,000 and $100,000 US and they are affordable only by large hospital and/or academic institutions. The actual cost of a good high-resolution digital camera is between $5,000 and $10,000 US.


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