Static Image Telepathology in Routine Surgical Pathology Diagnosis: A Report on the First Experience in the Arab World from Kuwait

Objective: Telepathology (TP) diagnosis is currently practiced in several countries. The present study presents the first documented experiment of static-image TP in Kuwait and the Arab world. Materials and Methods: Paraffin or frozen tissue sections of 100 cases of routine surgical pathology consisting of 40 malignancies, 10 benign neoplasms and 50 nonneoplastic conditions were studied. Diagnostic microscopic images captured by a microscope-attached digital camera were selected by a pathologist in each case and sent with the clinical history to a second pathologist via E-mail across the Internet. The diagnosis was sent back to the referring pathologist via E-mail. The specificity, sensitivity and diagnostic accuracy of TP was calculated. Results: For malignant versus benign lesions, the diagnostic accuracy was 97% with 3 false-negative and no false-positive results (100% specificity). Correct diagnosis by exact category was 92%. The deferral rate awaiting special stains was 5%, immunohistochemistry 6%, and extra images 2%. In 2 cases (2%), there was a request for original tissue glass slides. Conclusion: A simple E-mail-based TP system provides a high diagnostic accuracy for routine surgical pathology diagnosis. It can be utilized either as a primary or a secondary diagnostic tool.