Cost-Effective Dynamic Telepathology in the Mohs Surgery Laboratory Utilizing iChat AV Videoconferencing Software

Abstract

BACKGROUND Dynamic telepathology is the real-time transmission of histologic images from one pathologist to another by means of telecommunications technology. OBJECTIVE The objective was to determine whether dynamic telepathology can be accomplished accurately and inexpensively by use of readily available off-the-shelf consumer products and software. METHODS We attached a standard, consumer-grade, digital video camera to a microscope in the Mohs surgery laboratory and then transmitted via the Internet real-time histologic video images and audio to a consultant dermatopathologist by means of iChat AV videoconferencing software (Apple Computer Inc., Cupertino, CA). In the first part of the study, 20 unknown formalin-fixed, paraffin-embedded slides from tumors typically seen in a Mohs practice were evaluated by the consultant dermatopathologist. In the second part of the study, the Mohs surgeon consulted the dermatopathologist on 20 Mohs frozen section slides in which the surgeon had a particular question (e.g., “Is this part of a pilosebaceous unit or is this basal cell carcinoma?”). RESULTS The video images were adequate for pathologic interpretation. There was agreement between conventional light microscopy and dynamic telepathology diagnosis in 19 of 20 tumors. There was complete agreement for all 20 Mohs frozen section consultations. CONCLUSION Dynamic telepathology can be accomplished accurately and inexpensively by use of readily available consumer products and software.