Invention and Early History of Telepathology (1985-2000)

Abstract

This narrative-based paper provides a first-person account of the early history of telepathology (1985-2000) by the field's inventor, Ronald S. Weinstein, M. D. During the 1980s, Dr. Weinstein, a Massachusetts General Hospital-trained pathologist, was director of the Central Pathology Laboratory (CPL) for the National Cancer Institute-funded National Bladder Cancer Project, located at Rush Medical College in Chicago, IL. The CPL did post therapy revalidations of surgical pathology and cytopathology diagnoses before outcomes of the completed clinical trials were published. The CPL reported that interobserver variability was invalidating inclusion of dozens of treated bladder cancer patients in published reports on treatment outcomes. This problem seemed ripe for a technology-assisted solution. In an effort to solve the interobserver variability problem, Dr. Weinstein devised a novel solution, dynamic-robotic telepathology, that would potentially enable CPL uropathologists to consult on distant uropathology cases in real-time before their assignment to urinary bladder cancer, tumor stage, and grade-specific clinical trials. During the same period, universities were ramping up their support for faculty entrepreneurism and creating in-house technology transfer organizations. Dr. Weinstein recognized telepathology as a potential growth industry. He and his sister, Beth Newburger, were a successful brother-sister entrepreneur team. Their PC-based education software business, OWLCAT™, had just been acquired by Digital Research Inc., a leading software company, located in California. With funding from the COMSAT Corporation, a publically traded satellite communications company, the Weinstein-Newburger team brought the earliest dynamic-robotic telepathology systems to market. Dynamic-robotic telepathology became a dominant telepathology technology in the late 1990s. Dr. Weinstein, a serial entrepreneur, continued to innovate and, with a team of optical scientists at The University of Arizona's College of Optical Sciences, developed the first sub-1-min whole-slide imaging system, the DMetrix DX-40 scanner, in the early 2000s.

Keywords: Digital pathology; The University of Arizona; innovation; medical education; pathology; telepathology; virtual pathology.

Figure 1

Unpublished data that launched the creation of dynamic-robotic telepathology in 1984

Figure 2

Still pictures taken from a video recording of the “Armed Forces Institute of Pathology's Col. Earle Ash Lecture: May 22, 1986.” Introduction of the word “telepathology” into the English language. (a) Col. Robert McMeekam, Armed Forces Institute of Pathology Director, welcomes the invited audience to Dr. Weinstein's lecture. (b) Fred W. Stewart, M. D., Chief of Surgical Pathology at Memorial Sloan Kettering Cancer Center in New York City introduces the Col. Earle Ash Lecturer. (c) Dr. Weinstein, at the very moment in the Col. Earle Ash Lecture, that he used the word “telepathology” for the first time in public. (d) Recreation of the Kodachrome slide being shown at the moment Dr. Weinstein used the word “telepathology”

Figure 3

Historic pictures of the first US national demonstration of satellite-enabled robotic-dynamic telepathology, August 20, 1986. An Army Base Hospital in El Paso, TX, was linked to COMSAT Corporation Headquarters, in Washington, DC using an SBS-3 satellite. [31] (a) Dr. Weinstein (standing) briefing the press during a predemonstration press conference at COMSAT Corporate Headquarters. (b) Alexander A. Miller, III, M. D., a pathologist in Washington, DC, operating the Corabi robotically controlled motorized light microscope at an Army Base Hospital, in El Paso. (c) Invited guests at the robotic telepathology demonstration in the Board Room of the COMSAT Corporation Headquarters in Washington, DC. Vivian Pinn-Wiggins, MD, the Chair of Pathology at Howard Medical School is in the foreground. [3132] (d) NBC television newscaster reporting on the first national telepathology demonstration. Photos courtesy of R. S. Weinstein personal collection

Figure 4

Public recognition of telepathology. (a) Dr. Weinstein being honored at Armed Forces Institute of Pathology for his pioneering work in creating the field telepathology, on May 22, 1986. (b) American and European pioneers in robotic telepathology meet for the first time at the University of Tromsø, in Tromsø, Norway, in 1993. L to R - R. S. Weinstein, K. J. Bloom (United States), and I. Nordrum (standing) and T. Ide, M. D. (seated) (Norway). (c) Drs. A. Bhattacharyya and R. S. Weinstein, in Tucson, AZ, rendering the first USA-China static-image surgical telepathology diagnosis in Hangzhou, China, on October 3, 1993. [373854] (d) Bruce E. Dunn, M. D., in Milwaukee, WI (3^rd from the left, white lab coat) in 1996 receiving a US Department of Veterans Affairs “Hammer Award” for innovation in telepathology from US Vice President Al Gore (5^th from the left)

Figure 5

International leaders in telepathology meeting in Kyoto, Japan, October 21, 2000, Front Row, L - R: T. Sawai (Japan) J. Szymas (Poland), K. Kayser (Germany), Y. Tsuchihashi (Japan), R. S. Weinstein (United States), and J. McGee (England). J Gilbertson (United States) is the tall attendee near the center in the back row. Missing from the photo: Y. Yagi (Japan and the United States)