Evaluation of a smartphone for telepathology: Lessons learned

Area of Science:

• Medical Imaging
• Digital Pathology
• Telemedicine

Background:

• Mobile network and smartphone penetration are increasing in developing countries, enhancing the feasibility of telemedicine.
• This study explores the use of smartphones for capturing microscopic images for expert consultation.

Purpose of the Study:

• To evaluate the utility of smartphone-captured microscopic images for telepathology consultation.
• To assess image quality, diagnostic adequacy, and pathologist confidence using smartphone technology.

Main Methods:

• Microscopic images and videos of gastrointestinal biopsy cases were captured using an iPhone 5 with a 3-D printed adapter.
• Nine international pathologists evaluated image quality, diagnostic adequacy, and diagnostic confidence via a web platform.

Main Results:

• Average ratings for image quality and diagnostic adequacy were 3 and 4 (on a 5-point scale), respectively.
• Diagnostic confidence improved with the addition of specimen overview videos.
• High correlations were observed between image quality, diagnostic confidence, and adequacy (r=0.78, 0.73, 0.72).
• High reliability among reviewers was demonstrated (Intraclass Correlation for quality, adequacy, and confidence: 0.83, 0.76, 0.92).

Conclusions:

• Smartphones offer a viable tool for pathologists in low-resource settings to conduct remote consultations.
• Further improvements in camera resolution and pathologist training could enhance the effectiveness of smartphone-based telepathology.