Robotic telepathology: efficacy and usability in pulmonary pathology

Area of Science:

• Pulmonary Pathology
• Digital Pathology
• Medical Imaging

Background:

• Robotic telepathology is established in the USA for case referral but less common in the UK.
• Pulmonary histopathology diagnosis relies on accurate interpretation of lung biopsy specimens.

Purpose of the Study:

• To assess the accuracy and efficiency of robotic telepathology for primary diagnosis in pulmonary pathology.
• To compare diagnostic accuracy and time per case between robotic telepathology and conventional light microscopy for lung biopsies.

Main Methods:

• A single pathologist reviewed 40 pulmonary pathology cases (20 bronchoscopic, 20 surgical) using robotic telepathology.
• Cases were subsequently reviewed using conventional light microscopy in a blinded, randomized manner.
• Diagnostic accuracy, initial diagnosis time, and overall time per case were recorded.

Main Results:

• Robotic telepathology demonstrated accuracy comparable to conventional microscopy, with minor discrepancies in two bronchoscopic and one surgical case.
• Telepathology was significantly slower: 14 times slower for bronchoscopic biopsies and 5 times slower for surgical specimens.
• Average time per slide was 7 min 21 s (telepathology) vs. 32 s (conventional) for bronchoscopic biopsies, and 6 min 13 s vs. 1 min 10 s for surgical specimens.

Conclusions:

• Robotic telepathology is accurate for primary diagnosis in pulmonary histopathology.
• Modifications to laboratory protocols and telepathology hardware are necessary to reduce the time disparity.
• Improvements are needed for telepathology to be viable in high-volume referral settings.