Abstract
Telepathology has been defined as a form of communication between medical professionals that includes the transmission of pathology images and associated clinical information for various clinical applications, including diagnosis. ROSE for EUS-FNA of the pancreas provides immediate information regarding cellular adequacy, avoiding repeated procedures and improving diagnosis. However, cytopathologist is not available for ROSE in all endoscopy units. A multi-platform mobile phone application, such as WhatsApp Messenger, could be useful as a tool for TCP, since it could enable remote real-time information exchange, avoiding unnecessary procedures. To evaluate the feasibility and the impact of TCP using WhatsApp Messenger as an auxiliary tool for ROSE in EUS-FNA of solid pancreatic lesions. We prospectively evaluated 20 patients (65% male, median age 57.5 yrs [range 36 to 86]) with pancreatic solid lesions, according to previous CT scans, referred to EUS-FNA. Patients with entirely cystic lesions were excluded. All endoscopic procedures were performed with the patient under conscious sedation with linear therapeutic echoendoscopes (Fujifilm Corporation, EG-53OUT2, Saitama, Japan) and 22G-needles (Expect, Boston Scientific Corporation). After each pass, aspirated material was spread over a glass slide and stained by the endoscopist. The glass slide was then reviewed on a microscope equipped with a mobile phone (Android Platform) in order to capture images. The most representative fields were photographed and sent by WhatsApp Messenger to the cytopathologist. The images were analyzed regarding cellular adequacy of the material and preliminary diagnosis whenever possible. The number of needle passes was determined according to initial evaluation of the cytopathologist. This initial evaluation was compared to the final pathology report (FPR) regarding cellular adequacy and diagnosis. Gold standard for diagnosis of malignancy was surgical report or 12-month follow-up. The endoscopist had training in basic cytology for slide preparing. In the initial evaluation using TCP ROSE, adequate cellularity of the glass slide was detected in 13/20 (65%), vs. 16/20 in FPR (P = 0.37). An initial diagnosis of malignancy was possible in 11/20 (55%) vs, 16/20 (80%) after FPR (P = 0.07). The final diagnosis was malignant in 16/20 (80%). Sensitivity and specificity for diagnosing malignant lesions after FPR were both 100%. The present study demonstrates the feasibility of a low-cost, Internet-based, telecytopathology system using WhatsApp Messenger to provide a rapid on-site evaluation of EUS-FNA slides in patients with solid pancreatic lesions.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
