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Concordance Between Telepathologic Diagnosis and Conventional Histopathologic Diagnosis
A Multiobserver Store-and-Forward Study on 20 Skin Specimens
D. Piccolo, MD;
H. Peter Soyer, MD;
W. Burgdorf, MD;
R. Talamini, MD;
K. Peris, MD;
L. Bugatti, MD;
V. Canzonieri, MD;
L. Cerroni, MD;
S. Chimenti, MD;
G. De Rosa, MD;
G. Filosa, MD;
R. Hoffmann, MD;
I. Julis, MD;
H. Kutzner, MD;
L. Manente, MD;
C. Misciali, MD;
H. Schaeppi, MD;
M. Tanaka, MD;
W. Tyler, MD;
B. Zelger, MD;
H. Kerl, MD
Arch Dermatol. 2002;138:53-58.
Objective To study the validity and feasibility of transferring images of cutaneous
biopsy specimens via e-mail to remote physicians active in dermatopathology
for teleconsultation.
Design Twenty skin specimens previously diagnosed at the Department of Dermatology,
University of Graz, Austria, were subsequently sent for teleconsultation using
the store-and-forward method. For each case, 3 or 4 images at different magnifications
were sent by e-mail to 16 colleagues (11 dermatopathologists and 5 pathologists)
in 15 centers in 6 different countries. Six weeks later each observer received
the hematoxylin-eosin–stained specimens to render a conventional diagnosis.
Setting Dermatopathology and pathology units within institutional and private
settings.
Material Twenty small skin biopsy specimens of cutaneous diseases were selected
randomly from a study set of 80.
Main Outcome Measure Concordance between telepathologic diagnoses and conventional histopathologic
diagnoses of 20 skin specimens.
Results On average, 78% of the telediagnoses were correct (range, 60%-95%),
whereas 85% of the conventional diagnoses were correct (range, 60%-95%). A
perfect diagnostic concordance was obtained in 7 (35%) of 20 cases, and a
significant difference was identified in only 1 case.
Conclusions Results suggest that telepathology performed by physicians active in
dermatopathology may serve as a reliable technique for the diagnosis of cutaneous
diseases when experts in dermatopathology are not available locally. Furthermore,
teledermatopathology is attractive because it provides an opportunity to obtain
timely consultation on difficult cases.
From the Departments of Dermatology of the University of L'Aquila,
L'Aquila, Italy (Drs Piccolo and Peris); University of Graz, Graz, Austria
(Drs Soyer, Cerroni, and Kerl); General Hospital, Jesi, Italy (Drs Bugatti
and Filosa); University of Tor Vergata, Rome, Italy (Dr Chimenti); Philipp
University, Marburg, Germany (Dr Hoffmann); BioLab Laboratory for Histopathology,
Prague, Czech Republic (Dr Julis); Gemeinschaftspraxis, Friedrichshafen, Germany
(Dr Kutzner); University of Bologna, Bologna, Italy (Dr Misciali); General
Hospital, Salzburg, Austria (Dr Schaeppi); Keio University, Tokyo, Japan (Dr
Tanaka); and University of Innsbruck, Innsbruck, Austria (Dr Zelger); from
Tutzing, Germany (Dr Burgdorf); the Departments of Epidemiology (Drs Talamini
and Filosa) and Pathology (Dr Canzonieri), Centro di Riferimento Oncologico,
Aviano, Italy; and the Departments of Pathology of the University Federico
II, Naples, Italy (Dr DeRosa); General Hospital S. Filippo Neri, Rome (Dr
Manente); and the Geisinger Medical Center, Danville, Pa (Dr Tyler).
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