Information Technology in Pathology: from Telemicroscopy application up to date

Given the rapidly increasing number of ancillary technologies available to the medical community, there is a growing opportunity for their application, to address specific challenges. The development of new technologies for pathology such as robotic microscopes, and the availability of increasingly more powerful technologies for medical application is having profound impact in the research/diagnostic field in surgical Pathology [Wein_1]. In particular robotic microscopy in tandem with digital imaging stand for powerful technology to support and improve research studies and routine work in pathology field. Robotic microscopes let each microscope movement (x, y stage movements, objectives turret changes, auto-focus system, etc.) be controlled by local and/or remote computers and at the same time, images taken by video and/or photo-cameras mounted on the microscope, can be processed. The first application area where robotic microscopy has been strongly engaged was teleconsultation (remote diagnosis as first or second opinion), as reported by a considerable number of recent studies [Wolf, Dunn]. The system that we developed in our lab as telepathology application for remote frozen section service was designed to address specific constraints given by local orography and regional network [Dem_1]. This system, called STeMiSy (Static TeleMicroscopy System), has been used between a district general hospital and the central hospital in Trento during the last year. Moreover these technologies allow to manage histo-pathological glass slides as sets of digital data, thanks to completely automated systems, that acquire, store and manage digital images of the tissue on a slide. Digital representation of entire slide has been named in literature virtual slide [Wein_2][Saltz] and virtual case [Dem_2]. A virtual case is composed of a collection of digital images entirely representing a histological/cytological slide at all magnification levels, supplemented by all relevant clinical data. In comparison to glass slides it offers some advantages arising from its digital nature. Virtual case can be: a) reproduced in an indefinite number of identical copies stored in several different archives without any loss of sample technical quality in time, b) viewed and discussed simultaneously by many different distant users for different purposes without any times restriction, c) implemented with additional clinical and pathological data. This kind of approach can be considered the common basis for multiple purposes in the fields of teleconsultation, education, research (quantitative pathology), and quality control and proficiency tests [Dem_3]. Doubtless information technology through the introduction of robotic microscope, digital imaging and data mining techniques is becoming a essential component in Pathology and will arise more and more importance in every Pathology department in the next years