Telepathology
Personal Introduction to telepathology
In the late 1960's I was a participant in a 'telemedicine' experiment
in which Dr. Kenneth Bird at Massachusetts General Hospital in Boston created
a 'television' linkage between the hospital and Logan Airport four miles
away.
In 1979 I bought a RadioShack TRS-80 computer and taught myself to program
in Basic.
In the 1980's I was a consultant to an Elsevier backed effort to develop
digital image based diagnostic tools for pathologists. Elsevier formed a
company, Eidetics Knowledge Systems, but withdrew support abruptly in 1987.
In 1987 HyperCard, a novel software platform was released by Apple.
I taught myself the hypertext programing language. In the same year I convinced
WB Saunders to provide me with the full text of Robbins Pathology in digital
form; Merck to do the same with the Merck Manual; and Gavin Borden of Garland
Publishing to do the same with Albert's Molecular Biology of the Cell. I
wrote a software package which could incorporate these books and others
and they became the basis of Keyboard Publishing, which produced textbooks,
quizbanks and image atlases in digital and analog forms.
It became apparent that a revolution in text and image management was
underway.
During the late 1980's and early 1990's a variety of telepathology systems
were developed, the most advanced of which under the guidance of Dr. Ronald
Weinstein and colleagues, now in Arizona.
At Robert Wood Johnson our basic research programs in the department
focused on structural biology and much of our data were derived from light
and electron microscopes and X-ray crystallography. While the basic scientists
in the department were making daily analyses of biology using microscopes,
so were the surgical pathologists as they examined slides of tissues.
We decided to address the clinical diagnostic issue by addressing several
issues, including image resolution, image compression, reliability of surgical
pathology diagnoses on a computer monitor, transmissibility and storage.
These experiments, some of which have been published (Foran
DJ, Winkelmann DA, Goodell LA, Trelstad RL. A Network-based Prototype for
Interactive Telemedicine and Automated Management of Distributed, Clinical
Databases. J Clinical Engineering. 25:383-391, 1996.)( Foran DJ , Meer P,
Papathomas TV, Gong L, Kulikowski CA, Marsic I, Trelstad RL. Assessment
of Subjective Criteria for Image Compression in Diagnostic Telepathology.
Proc. IEEE International Conference on Image Processing. 1: 873-878, 1996.)
clearly indicated that technical issues were manageable.
These experiences have lead us to explore ways in which computers can
be used in distance learning and in diagnosis at a distance. We have paid
particular attention to the major challenge of indexing images by content,
a subject which will occupy a significant part of the lecture.