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Analytical Cellular Pathology
Volume 21, Issue 3-4, Pages 229-235
http://dx.doi.org/10.1155/2000/768578

Diagnosis of Congenital Heart Malformations – Possibilities for the Employment of Telepathology

Cornelia Tennstedt,1 Kathrin Sunkel-Wehrstedt,2 Martin Vogel,3 and Peter Hufnagl4

1Department of Pathology, Charité, Medical Faculty of the Humboldt University, Berlin, Germany
2Department of Pathology, Charité, Medical Faculty of the Humboldt University, Berlin, Germany
3Unit of Paediatric Pathology and Placentology, Department of Pathology, Charité, Medical Faculty of the Humboldt University, Berlin, Germany
4Department of Pathology, Charité, Medical Faculty of the Humboldt University, Berlin, Germany

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Goal: In a study of 10 autopsy cases with congenital cardiac malformations we investigated whether obtaining a second opinion by means of telepathology could satisfy quality standards for the diagnosis of cardiac malformations and what the advantages and disadvantages of such a procedure might be. Material: The investigatory samples were 10 formalin‐fixed hearts with complex malformations from 9 fetuses and one newborn on which autopsies had been performed at the Pathological Institute of the Charité Hospital. The requests for a second opinion, which included text and image data, were sent in the form of Microsoft PowerPoint presentations to 5 experts in 4 countries. Per case the number of images that were sent was between 3 and 7. The size of the files was between 439 and 942 kb. The time required for preparation of the cases for sending them to the specialists was between 1 and 2 hours: this encompassed the time for putting the notation on the images, compressing them, creating a file that included both the images and the clinical data and then sending the case file. Results: All 10 cardiac malformations were correctly identified. In 8 of the 10 cases at least one expert had questions. After these questions had been answered and further images had been sent final correct diagnoses were made in all cases. All experts said that the quality of the images was very good. Use of a standardized findings questionnaire, which also included the marking of anatomic structures and of pathological findings in the images, proved useful. Standardized findings forms facilitate orientation during interpretation of the cases and should be used generally to avoid misunderstandings in telepathological communication. Conclusions: In general it is possible to obtain an effective and reliable diagnosis of congenital heart malformations by means of telepathology. It is far quicker to get a second opinion by this means than by conventional means.