Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology)
1 UICC-TPCC, Institute of Pathology, Charite, Berlin, Germany
2 IBM DeepComputing, Brussels, Belgium
3 Institute of Pathology, Research Center Borstel, Borstel, Germany
4 Department of Telemedicine, Institute of Pathology, Charite, Berlin, Germany
5 Institute of Pathology, University Freiburg, Freiburg, Germany
Diagnostic Pathology 2008, 3:17 doi:10.1186/1746-1596-3-17Published: 18 April 2008
Progress in automated image analysis, virtual microscopy, hospital information systems, and interdisciplinary data exchange require image standards to be applied in tissue-based diagnosis.
To describe the theoretical background, practical experiences and comparable solutions in other medical fields to promote image standards applicable for diagnostic pathology.
Theory and experiences
Images used in tissue-based diagnosis present with pathology – specific characteristics.
It seems appropriate to discuss their characteristics and potential standardization
in relation to the levels of hierarchy in which they appear. All levels can be divided
into legal, medical, and technological properties. Standards applied to the
first level include regulations or aims to be fulfilled. In
legal properties, they have to regulate features of privacy, image documentation, transmission, and
medical properties, features of disease – image combination, human – diagnostics, automated information
extraction, archive retrieval and access; and in
technological properties features of image acquisition, display, formats, transfer speed, safety, and system
dynamics. The next lower
second level has to implement the prescriptions of the upper one, i.e. describe how they are implemented.
Legal aspects should demand secure encryption for privacy of all patient related data, image archives
that include all images used for diagnostics for a period of 10 years at minimum,
accurate annotations of dates and viewing, and precise hardware and software information.
Medical aspects should demand standardized patients' files such as DICOM 3 or HL 7 including history
and previous examinations, information of image display hardware and software, of
image resolution and fields of view, of relation between sizes of biological objects
and image sizes, and of access to archives and retrieval.
Technological aspects should deal with image acquisition systems (resolution, colour temperature, focus,
brightness, and quality evaluation procedures), display resolution data, implemented
image formats, storage, cycle frequency, backup procedures, operation system, and
external system accessibility. The lowest
third level describes the permitted limits and threshold in detail. At present, an applicable
standard including all mentioned features does not exist to our knowledge; some aspects
can be taken from radiological standards (PACS, DICOM 3); others require specific
solutions or are not covered yet.
The progress in virtual microscopy and application of artificial intelligence (AI) in tissue-based diagnosis demands fast preparation and implementation of an internationally acceptable standard. The described hierarchic order as well as analytic investigation in all potentially necessary aspects and details offers an appropriate tool to specifically determine standardized requirements.