Review of the use of telepathology for intraoperative consultation.

INTRODUCTION: The use of telepathology in intraoperative consultations has been increasing due to limited time and availability of pathologists, and the demand for increased access to pathology subspecialists in difficult cases. The five main categories of telepathology are (1) static, (2) dynamic, (3) robotic, (4) whole slide imaging (WSI), and (5) hybrid methods. The majority of these methods have been found to offer diagnostic accuracy rates similar to conventional microscopy, at the cost of slightly prolonged time to evaluate slides. AREAS COVERED: Herein we discuss the salient features of each telepathology method and provide examples of their performance reported in the literature. EXPERT COMMENTARY: Telepathology systems from any of the aforementioned categories can be employed to achieve timely and accurate diagnoses as long as they meet clinical needs and are validated for the intended use case. The decision to purchase a particular system depends on the clinical application, specific needs and budget of the laboratory, as well as the personal preference of the telepathologists involved. The adoption of telepathology practice is likely to expand in order to meet the increasing demand for subspecialist consultation and as technology advances to improve diagnostic accuracy and workflow.