Robotic telepathology for intraoperative remote diagnosis using a still-imaging-based system

Area of Science:

• Medical Informatics
• Pathology
• Digital Health

Background:

• Intraoperative frozen section analysis is critical for timely surgical decisions.
• Remote diagnostic capabilities are increasingly important in modern healthcare.
• Telepathology systems aim to bridge geographical gaps in expert pathological assessment.

Purpose of the Study:

• To evaluate the efficacy of a static imaging telemicroscopy system (STeMiSy) for remote intraoperative frozen section diagnosis.
• To compare the performance of STeMiSy with traditional light microscopy (LM) in a real-world setting.
• To determine if STeMiSy can meet the time and accuracy requirements for routine frozen section services.

Main Methods:

• Three pathologists reviewed 70 frozen section cases (210 diagnoses) using both STeMiSy and LM.
• STeMiSy utilized a robotic microscope for remote, near real-time control.
• Diagnostic concordance, deferred diagnosis rates, and diagnostic accuracy were assessed against consensus diagnoses.

Main Results:

• Clinically important concordance between STeMiSy and LM was 98.6% (overall 95.2%).
• Diagnostic accuracy for STeMiSy was 95.2%, closely matching LM's 96.2%.
• Mean viewing time per slide was 3.6 minutes, with an overall diagnosis time of 6.2 minutes, meeting intraoperative standards.

Conclusions:

• Static imaging telemicroscopy systems are a viable alternative for remote frozen section services.
• STeMiSy performance is comparable to dynamic telepathology systems and traditional methods.
• This technology can support routine intraoperative pathology consultations, enhancing accessibility and efficiency.