Expert pathology consultation through the Internet: melanoma versus benign melanocytic tumours

Twenty consecutive cases of melanocytic lesions were chosen from the archives of the Institute of Anatomic Pathology at Santa Chiara Hospital, Trento. Representative images were acquired at a spatial resolution of 512 × 512 pixels, saved in JPEG format and delivered to the remote pathologist by multimedia Internet electronic mail. Six cases were diagnosed as benign melanocytic lesions by the local pathologist. Of the 20 cases transmitted, each with an average of 5.3 images, the remote pathologist suggested a diagnosis of malignancy in nine cases while 10 cases were thought to be benign. In one case the images were not considered sufficient for diagnosis. Overall, the diagnostic agreement between local and remote pathologist was 79% (κ=0.58, P=0.002). This preliminary study suggest that telepathology by Internet electronic mail can be a valuable tool for remote consultation in dermatopathology, as well as for other diagnostic fields where expert consultation is necessary.