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Rogers L, Galezowski A, Ganshorn H, Goldsmith D, Legge C, Waine K, Zachar E, Davies JL. The use of telepathology in veterinary medicine: a scoping review. J Vet Diagn Invest 2024; 36:490-497. [PMID: 38742388 PMCID: PMC11185107 DOI: 10.1177/10406387241241270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant advances in information technology and telecommunications coupled with the pandemic have led to unprecedented sophistication, accessibility, and use of telepathology in human and veterinary medicine. Furthermore, telepathology can connect veterinary practices to distant laboratories and provide support for underserved animals and communities. Through our scoping review, we provide an overview of how telepathology is being used in veterinary medicine, identify gaps in the literature, and highlight future areas of research and service development. We searched MEDLINE, CAB Abstracts, and the gray literature, and included all relevant literature. Despite the widespread use of digital microscopy in large veterinary diagnostic laboratories, we identified a paucity of literature describing the use of telepathology in veterinary medicine, with a significant gap in studies addressing the validation of whole-slide imaging for primary diagnosis. Underutilization of telepathology to support postmortem examinations conducted in the field was also identified, which indicates a potential area for service development. The use of telepathology is increasing in veterinary medicine, and pathologists must keep pace with the changing technology, ensure the validation of innovative technologies, and identify novel uses to advance the profession.
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Affiliation(s)
- Lindsay Rogers
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Angelica Galezowski
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Heather Ganshorn
- Library and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Dayna Goldsmith
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn Legge
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Katie Waine
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Erin Zachar
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L. Davies
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
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Lin O, Alperstein S, Barkan GA, Cuda JM, Kezlarian B, Jhala D, Jin X, Mehrotra S, Monaco SE, Rao J, Saieg M, Thrall M, Pantanowitz L. American Society of Cytopathology Telecytology validation recommendations for rapid on-site evaluation (ROSE). J Am Soc Cytopathol 2024; 13:111-121. [PMID: 38310002 DOI: 10.1016/j.jasc.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/06/2023] [Indexed: 02/05/2024]
Abstract
Telecytology has multiple applications, including rapid onsite evaluation (ROSE) of fine-needle aspiration (FNA) specimens. It can enhance cytopathology practice by increasing productivity, reducing costs, and providing subspecialty expertise in areas with limited access to a cytopathologist. However, there are currently no specific validation guidelines to ensure safe practice and compliance with regulations. This initiative, promoted by the American Society of Cytopathology (ASC), intends to propose recommendations for telecytology implementation. These recommendations propose that the validation process should include testing of all hardware and software, both separately and as a whole; training of all individuals who will participate in telecytology with regular competency evaluations; a structured approach using retrospective slides with defined diagnoses for validation and prospective cases for verification and quality assurance. Telecytology processes must be integrated into the laboratory's quality management system and benchmarks for discrepancy rates between preliminary and final diagnoses should be established and monitored. Special attention should be paid to minimize discrepancies that downgrade malignant cases to benign (false positive on telecytology). Currently, billing and reimbursement codes for telecytology are not yet available. Once, they are, recommendation of the appropriate usage of these codes would be a part of the recommendations. These proposed guidelines are intended to be a resource for laboratories that are considering implementing telecytology. These recommendations can help to ensure the safe and effective use of telecytology and maximize its benefits for patients.
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Affiliation(s)
- Oscar Lin
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Susan Alperstein
- Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, New York, New York
| | - Güliz A Barkan
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Jacqueline M Cuda
- Department of Pathology and Laboratory Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Brie Kezlarian
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Darshana Jhala
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Pittsburgh, Pennsylvania
| | - Xiaobing Jin
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Swati Mehrotra
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Sara E Monaco
- Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania
| | - Jianyu Rao
- Department of Pathology and Laboratory, UCLA Health, Los Angeles, California
| | - Mauro Saieg
- Department of Pathology, Santa Casa Medical School, Sao Paulo, Brazil
| | - Michael Thrall
- Department of Pathology, Houston Methodist Hospital, Houston, Texas
| | - Liron Pantanowitz
- Department of Pathology and Laboratory Services, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Piccione J, Baker K. Digital Cytology. Vet Clin North Am Small Anim Pract 2022; 53:73-87. [DOI: 10.1016/j.cvsm.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Digital Cytology in Exotic Practice: Tips to Optimize Diagnosis. Vet Clin North Am Exot Anim Pract 2022; 25:663-678. [PMID: 36122945 DOI: 10.1016/j.cvex.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Digitization has enhanced the utility of cytology in private practice by allowing for rapid sample receipt and analysis, leading to better informed real-time patient care. Despite many advantages of digital cytology, understanding its limitations is required to avoid common pitfalls. A strong foundation in sample preparation and imaging techniques is also required to obtain high-quality diagnostic samples. By optimizing these factors, the benefits of digital cytology are maximized, allowing for the practice of high-quality point-of-care medicine that best addresses the needs of the patient and pet owner in a rapid time frame.
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Archondakis S. The Use of Static Telecytology Applications for Accreditational Purposes. ACTA ACUST UNITED AC 2020. [DOI: 10.4018/ijrqeh.2020070102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study aims to examine the feasibility of developing a proficiency testing scheme for cytology labs wishing to be accredited according to ISO 15189:2012, by using low cost telemedical applications. Two hundred forty-eight fine-needle aspiration specimens from patients preoperatively aspirated under ultrasonographic guidance and 208 pap smears with histological confirmation were retrospectively selected from the department's registry. Three diagnostic categories of cytological reports were used. Ten characteristic images from each case were transferred via file transfer protocol to password-protected accounts for remote review by three independent cytopathologists. Contributor's and reviewer's diagnoses were collected, recorded and statistically evaluated. No significant difference in diagnostic accuracy could be detected between the diagnoses proffered on the basis of digitized images and conventional slides.
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Archondakis SK. Remote Evaluation of Short Videos Captured by Static Telecytological Applications for Obtaining Expert Opinions. ACTA ACUST UNITED AC 2020. [DOI: 10.4018/ijrqeh.2020070104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over the last decade, cytopathology laboratories wishing to achieve an automated and seamless workflow process, to diminish turnaround times and to improve their diagnostic accuracy have successfully adopted information technologies and automation. New types of cameras and microscopes, connected to computers, have made possible image capture and transmission (telecytology). New innovative information technologies, including e-health and telemedical applications, constitute a valuable tool for interlaboratory collaboration and quality improvement. New applications are expected to enhance the opportunities for improvement in the field of cytological data management and sharing. In this article, we emphasize on the possible use of short videos captured by static telecytology applications in a modern cytopathology laboratory wishing to establish an effective interlaboratory comparison system and obtain expert opinions in diagnostically challenging cases from distant consultants with well recognized diagnostic competence and experience in the field of thyroid cytology.
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