APMIS zyxwvutsrqp 99: zyxwvutsrq 808-814, 1991 Long distance image transfer: First results of its zyxw use in histopathologicaldiagnosis K. KAYSER’, M. OBERHOLZER’, G. WEIDE’, I. WEIDE4 and H. v. EBERSTEIN’ ‘Department of Pathology, Thoraxklinik, Heidelberg, ’Institute of Pathology, University of Basel, Basel, ‘Institute of Toxicology, E. Merck, Darmstadt, 41nstitute of Toxicology, Boehringer, Ingelheim Kayser, K., Oberholzer, M., WeiDe, G., WeiDe, I. zyxwvu & v. Eberstein, H. Long distance image transfer: First results of its use in histopathological diagnosis. APMIS 99: 808-814, 1991. Histopathological images were transferred by use of normal telephone lines between three pathology institutes located in three different cities in the FRG. Images were digitized using a colour TV camera and stored in a special computerized image transmission system. The stored image was transferred and visualized on a (receiver) colour TV screen after dialing the telephone number connected to the receiver image transmission system. An additional telephone dialogue was activated by use of a normal acoustic telephone, and the diagnostic difficulties of the underlying image were discussed. Diagnostic assistance was possible in all transferred cases as well as histopathological diagnosis. Resolution of the images was set at 512x512 pixelx8 bit. Image transfer time was 3.2 min on average. The differences between the original and transferred image were measured by “retransfer” of the original image and by subtracting the two images from each other. No major transfer errors could be measured. Key words: Histopathological diagnosis; image transfer; telephone image transmission system; image analysis. K. Kayser, Department of Pathology, Thoraxklinik, Amalienstr. 5, D-6900 Heidelberg, FRG. Histopathological diagnosis i.e. the recognition and classification of certain two-dimensional biological structures has revealed its increasing importance in a modern health care system. Al- though many diagnostic tests and several imag- ing modalities are introduced into the health care system every year, the examination of small biopsies taken from nearly every part of the body without any major risk for the patient is still one of the medical techniques with the highest diagnostic sensitivity and specificity. A detailed cancer diagnosis is not possible without histological classification and grading of the dis- ease, information closely related to therapy and prognosis for several malignancies. The grading of cancer and preneoplastic lesions can be per- Received October 19, 1990. Accepted March 7, 1991. formed with automated image analysing sys- tems, and is more reproducible and more stan- dardized than conventional grading by pathol- ogists (2, 7, 8). A correct histopathological diagnosis depends upon several factors: correct sampling, adequate tissue processing, good staining qualities, de- tailed visual examination, and adequate knowl- edge on the part of the pathologist. Due to the increased clinical knowledge of diseases, diag- nostic pathologists are under a corresponding pressure to subdivide formerly unique histo- pathological diagnoses. In addition, the size of biopsy specimens is decreasing, especially after the introduction of flexible fibreoptic endo- scopes. Increasing costs necessitate a reduction in the time required for correct diagnosis. There- fore, the need to consult trained specialists is increasing every year, and a not entirely negli- gible part of a day’s work is taken up by sending 808