Recent development and perspectives of virtual slides (VS) and telepathology in Europe

Present stage Telepathology started in Europe in the 1980s. It was implemented in closed communication systems and focussed on frozen section service [1,2]. Open systems embedded in open source software replaced the early communication about 10 years ago. They became to age, and nearly all of them closed [3]. A new era started with the medical electronic communication expert system (MECES, http://www.diagnomx.eu) and the Virtual International Pathology Institute (VIPI,http://www.diagnomx. eu/vipi) that combine an internal communication network with external information nodes. It uses acoustic and visual information transfer as well as information sources at different levels such as access to libraries, image content information analysis, and diagnosis assistants [3]. It also incorporates VS, which are available from different companies. Although delivered in noncongruent formats certain medical platforms (MECES) and open access scientific journals (journal of diagnostic pathology (http://www.diagnosticpathology.org)) can handle VS via their specific viewers. VS implementation in routine tissue – based diagnosis is on its way. Most companies try to specifically connect their VS scanners to laboratory information systems (LIS) and / or to digital radiology imaging systems (picture archiving and communication system (PACS)) [4,5]. VS are provided with their own specific image analyzing system that focuses on evaluation of suitable immunohistochemistry scores such as Her2_neu or hormone receptors in breast cancer. Obligatory VS standards are still missing [6,7].