Table 2

A survey of medical standards (level 2 and level 3) suggested or already implemented in tissue-based diagnosis

Medical Standard (level 2)

Criteria (level 3)

International/national Action

Disease order [41]

Hierarchic, 1 – 10

Proposed

Formal disease classification

ICD-O, SNO-MED

Accepted

Disease/human classification

Board discussion

Accepted for tumours (WHO classification)

Disease frequency

Not evaluated, probably >2 per month

Open

Mandatory expert consultation

Rare cancer, lymphoma

Proposed

Mandatory quality assurance

Breast cancer, Hodgkin's disease

Accepted

Image handling, exchange by DICOM 3, HL 7

General & individual regulations

Proposed

HIS, RIS communication by DICOM 3, HL 7

General & individual regulations

Proposed

Expert communication guidelines

4 – 8 images/case, <2 different magnifications/case,

Proposed

Virtual microscopy:

Diagnosis/image properties

>50 pixels/object, >40 objects/image, >256 × 256 image size

Proposed

Disease/image features

Disease – associated texture, object, structure parameters

Open

Image quality measure

Gray value deviation, image standardization (shading, gray value range, gradient)

Open

Screening/image size

Texture features: crude screening Object/structure features: classical diagnosis (H&E)

Open

Diagnosis/colour space

RGB space – classical diagnosis. HSI space – prognosis associated diagnosis, cancer scores (hormone receptor, Gleason, etc.)

Open

Kayser et al. Diagnostic Pathology 2008 3:17   doi:10.1186/1746-1596-3-17