Abstract The purpose of this study was to present a new method for handling histological/cytological cases. Thanks to the introduction of information technology in pathology, including the amenities afforded by robotic microscopes and digital imaging, tissue slides can be represented and evaluated using digital techniques in or- der to construct virtual cases through completely auto- mated procedures. A virtual case (VC) is composed of a collection of digital images representing a histological/ cytological slide at all magnification levels together with all relevant clinical data. In the present study, we de- scribe an automated system to manage robotic micro- scope and image acquisition for the proper construction of VCs. These can then be viewed on a computer by means of an interface (“user-friendly”) that allows one to select the more appropriate fields and to examine them at different magnifications, rapidly going from panoramic views to high resolution and vice versa. In comparison with glass slides, VCs have several advantages arising from their digital nature and can be considered a com- mon platform for a wide range of applications such as teleconsultation, education, research, and quality control and proficiency tests. Keywords Robotic microscopy · Teleconsultation · Education · Quality control Introduction Given the rapidly increasing number of ancillary tech- nologies available to the medical community, there is a growing opportunity for their application, to address spe- cific challenges. The development of new technologies for pathology such as robotic microscopes, and the avail- ability of increasingly more powerful technologies for medical application is having profound impact in both the research and diagnostic fields of pathology [9]. Rob- otic microscopy has important applications in teleconsul- tation/remote diagnosis, as reported in a considerable number of recent studies [9, 5 10]. Robotic microscopes let each microscope movement (x, y stage movements, objectives turret changes, auto-focus system, etc.) be controlled by local and/or remote computers, and, at the same time, images taken by video and/or photo cameras mounted on the microscope can be processed. In this study, we have presented a system for the management of these techniques, allowing a completely automated system for digital representation of the materi- al on a slide, i.e., for the construction of a virtual case (VC). A VC is composed of a collection of digital images entirely representing a histological/cytological slide at all magnification levels, supplemented by all relevant clini- cal data. VCs can be considered the common basis for multiple purposes in the fields of teleconsultation, educa- tion, research, and quality control and proficiency tests. The system we present here has been completely devel- oped in the Telemedicine and Medical Informatics Labo- ratory (ITC-irst), with the aim of supporting research studies in the field of quantitative pathology. Materials and methods Acquisition system and VC construction The VC acquisition system consists of a software integrated envi- ronment that manages external devices (robotic microscope, auto- focus system, and acquisition board) through Dynamic Linked Libraries, allowing the automatic digital representation of an entire tissue sample. As a slide is located on the motorized stage of the microscope and a few acquisition parameters are selected (acquisition objec- tive, filters, lamp intensity), the acquisition system proceeds auto- matically with the VC construction. VC construction is performed in three phases: (1) acquisition of the entire tissue at a selected F. Demichelis ( ✉ ) · S. Forti Istituto Trentino di Cultura – Istituto per la Ricerca Scientifica e Tecnologica (ITC-irst), Via Sommarive 18, 38050 Povo Trento, Italy e-mail: michelis@itc.it Tel.: +39-461-314458, Fax: +39-461-810851 M. Barbareschi · P. Dalla Palma Department of Pathology, Ospedale S. Chiara, Trento, Italy Virchows Arch (2002) 441:159–164 DOI 10.1007/s00428-001-0561-1 ORIGINAL ARTICLE F. Demichelis · M. Barbareschi · P. Dalla Palma S. Forti The virtual case: a new method to completely digitize cytological and histological slides Received: 19 April 2001 / Accepted: 19 August 2001 / Published online: 12 December 2001 © Springer-Verlag 2001