Comparing Conventional and Telepathological Diagnosis in Routine Frozen Section Service

  • Peter Hufnagl Charité - Universitätsmedizin Berlin
  • Hans Guski Charité - Universitätsmedizin Berlin
  • Jörg Hering Vivantes Clinic Berlin
  • Thomas Schrader University of Applied Sciences, Brandenburg
  • Klaus Kayser Charité - Universitätsmedizin Berlin
  • Cornelia Tennstedt-Schenck Practice for Pathology Mühlhausen
  • Manfred Dietel Charité - Universitätsmedizin Berlin
  • Klaus-Jürgen Winzer Charité - Universitätsmedizin Berlin


Aims: In a prospective randomised study the diagnostic accuracy of frozen section service of conventional and telepathological procedures was compared for routine breast surgery.
Material and Methods:In the telepathological approach the surgeon performed the gross examination and macroscopic cutting directly supervised via videoconference by a pathologist. Then a technician prepared the frozen sections and the staining. The on-line histological diagnosis was done using a remote controlled robotic microscope. The images were transferred to the computer screen of the pathologist. In the conventional mode, the pathologist himself manually performed the gross and microscopic tissue examination in the same laboratory. The material was restricted to breast specimens and the number of participating surgeons was limited in order to obtain comparable results. All in all, 81 routine frozen sections of the breast were included in the study within seven months.
Results: The overall diagnostic concordance of both approaches with the definite diagnosis based upon paraffin embedded tissue was calculated to 95,1 % (77/81 cases). The telepathology arm revealed 94,3 % (33/ 35 cases), and the conventional arm 95,7% (44/46 cases). Two cases of each arm remained uncertain. The median diagnostic time was calculated to 9 minutes in the conventional mode and to 17 minutes for telepathology. Not included are median 3 minutes for transportation and 12 minutes for slide preparation.
Discussion: Telepathology can replace successfully conventional performance of frozen section service within the same range of diagnostic accuracy.


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Author Biographies

Peter Hufnagl, Charité - Universitätsmedizin Berlin
Institute of Pathology
Hans Guski, Charité - Universitätsmedizin Berlin
Institute of Pathology
Jörg Hering, Vivantes Clinic Berlin
Clinic Neukölln
Klaus Kayser, Charité - Universitätsmedizin Berlin
Institute of Pathology
Manfred Dietel, Charité - Universitätsmedizin Berlin
Institute of Pathology
Klaus-Jürgen Winzer, Charité - Universitätsmedizin Berlin
Department of Gynecology


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How to Cite
HUFNAGL, Peter et al. Comparing Conventional and Telepathological Diagnosis in Routine Frozen Section Service. Diagnostic Pathology, [S.l.], v. 2, n. 1, june 2016. ISSN 2364-4893. Available at: <>. Date accessed: 20 feb. 2024. doi:


Frozen section service, Telepathology, Remote telemicroscopy, Breast surgery, Randomised study