Remote AI Supported E-Multidisciplinary Oncology Conference in Breast Cancer as a Technology and Method to Optimize Outcomes in the Peripheries.

AIM: Feasibility-reliability control of Telemedicine Systems (TS) integrated with Multimedia Systems (MS) and Artificial intelligence (AI) for remote e-Multidisciplinary Oncology Conference in Breast Cancer. MATERIAL AND METHODS: Forty (n1=40) patients suffering from breast surgical oncology malignant (n2=32) and non-malignant (n3=8) diseases classified to seven categories: Nipple Discharge, Dominant Breast Mass, Occult Breast Lesion, Early Breast Carcinoma, Advanced Breast Carcinoma, Recurrent Breast Carcinoma) and treated clinically with the standard diagnostic (Mammography, US, MRI, Cytology, Pathology, BRCA1/2 Mutation Predisposition and Breast Cancer Risk Analysis) surgical, auxiliary therapeutic methods. Then clinical decisions compared to those proposed remotely by the virtual AI supported e-Oncology Conference for each patient. RESULTS: In four (n4=4) out of forty patients (TS, MS and AI) supported decision making and surgical treatment proposal including postoperative Radiotherapy proposal was not as clear as expected. Non-output answer for non-malignant breast pathologies (n3=8) was accurately indicated by (MS and AI). Mean accuracy of (TS, MS and AI) for: 1.Surgical Operative Planning including Rad=94.1%, 2.Chem=96.8%, 3.Horm=96.7% [In 95%, (Confidence interval: 85-99%)]. CONCLUSION: High feasibility-reliability of the virtual AI supported e-Multidisciplinary Oncology Conference for remote decision making and surgical planning and for optimum outcomes in Breast Cancer treatment makes it a clinical necessity especially for the periphery of Hellas.

E-Multidisciplinary Oncology Conference for Liver Cancer as a Technology and Method to Optimize Personalization and Outcomes in the Peripheries.

AIM: To search feasibility and reliability of Telemedicine Systems (TS) in the remote multidisciplinary oncology conference for decision making and treatment of liver lesions. MATERIAL AND METHODS: By an experimental TS, twenty six (n=26) specialists based on a series of five (N=5) simulated remote image examinations, assessed sensitivity-specificity of the remote examination of the Liver (L) for neoplastic diseases and damages (Virtual Examination=VE). RESULTS: Analysis showed injuries (sensitivity=96%), injuries of the capsula (sensitivity=91.7%), hematomas (sensitivity=91,7%), non-neoplastic diseases (specificity=100%), neoplastic diseases (sensitivity=100%). CONCLUSION: The VE of the (L) in combination with high-tech visualization and multimedia and the remote participation of liver surgical oncology, oncology, radiology, pathology and cytology experts composes a feasible and reliable e-Multidisciplinary Oncologic Conference for a Personalized and Optimum Decision Making and Treatment in Liver Cancer.

Telemedicine Systems in Uterine Transplant: A Feasibility and Reliability Study of the Pre-Grafting Teleradiological Evaluation of the Uterus Graft.

The pre-grafting Tele-Radiological (TRE) evaluation of the Uterus Graft (UG) on Telemedicine Systems, in Uterus Transplant (UT) is studied by diagnostic sensitivity-specificity analysis based on simulation of TRE of the UG on 10 MR sets of female pelvic digital images by two radiologists, assessing a. The vascular variations of the grafts, and b. The inflammatory and neoplastic lesions of the UG. The pre-grafting TRE of the UG showed: a. Diagnostic unreliability for vascular variations, b. A high diagnostic reliability for inflammatory and neoplastic diseases of the UG (100%), making the MRI based TRE of the UG in UT, feasible and highly reliable for the remote pre-grafting diagnosis of UG pathologic lesions, but unreliable for integrated vascular anatomic and pathologic UG remote evaluation for pre-grafting and pre-transplant decision support and planning.

The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal and Liver Grafts.

AIM: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). MATERIAL AND METHODS: Simulation of DM on TS based TPE by 2 specialists on a total of 238 human Renal Graft (RG) and 172 Liver Graft (LG) tissues digital microscopic images diagnosing inflammatory and neoplastic lesions on four different electronic spaces (ES). RESULTS: DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). CONCLUSION: Integration of DM on TS for TPE is feasible, while ergonomics of post-grafting and pre-transplant decision support and planning depend on the size of the working ES.

Integrated Tele-radiological and Tele-pathological Evaluation of Pulmonary Grafts for Reducing the Rate of Injured and Diseased Grafts, in Lung Transplant.

AIM: Feasibility and reliability assessment of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Pulmonary Graft (PG) on Telemedicine Systems, in Lung Transplant (LT). MATERIAL AND METHODS: Sensitivity-specificity by simulating TRE of PG on 15 MR thoracic images by two radiologists and TPE by 20 specialists based on a total of 100 human PG digital images. RESULTS: Integration of TRE and TPE of PG showed an accuracy of 94.1% for hematomas and 97.1% for neoplastic identification. CONCLUSION: Integrated TRE and TPE of PG is feasible and reliable for reducing the rate of injured and diseased PG in LT.

Telemedicine systems in organ transplantation: a feasibility and reliability study of the integrated teleradiological and tele-pathological evaluation of the cardiac graft.

UNLABELLED: Aim. Feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Cardiac Graft (CG) on Telemedicine Systems. MATERIAL AND METHODS: Sensitivity-specificity analysis by a simulation of TRE of CG on 15 MR thoracic images by two radiologists and of TPE by 20 specialists based on total 100 human CG digital images, assessing injuries/trauma and lesions. RESULTS: Integration of TRE and TPE of CG for remote diagnosis showed an accuracy for: injuries/trauma/hematoma=90.9-100%, and non-neoplastic lesions=94.3%. CONCLUSION: Integration of TRE and TPE of CG is feasible and reliable for Heart Pre-Grafting and Pre-Transplant decision support and planning.

Mobile tele-medicine systems in the multidisciplinary approach of diabetes management : the remote prevention of diabetes complications.

AIM: Evaluation of feasibility and reliability of Mobile-Telemedicine Systems (M-TS) in the remote prevention of diabetes related complications. MATERIAL AND METHODS: A feasibility-reliability evaluation based on a simulating experimentation by ten specialists (N=10) who examined a diabetic patient on the electronic space of a mobile experimental telemedicine system (MU-Exp.-TS). RESULTS: I. Remote prevention of diabetic foot and other diabetes related complications is feasible (acceptability: 89-100%). II. Remote ulcer classification and diabetic foot amputation risk estimation: Accuracy=89%. CONCLUSION: The proposed MU-TS based multidisciplinary approach and prevention of diabetes related complications is feasible while that of diabetic foot is both feasible and reliable.

Tele-medicine systems in the coordination process of organ transplantation.

AIM: To search feasibility and reliability of Telemedicine Systems (TS) in the Coordination Process (CP) of Organ Transplantation (OT). MATERIAL & METHODS: Forty participants (n=40) were divided in two groups, the specialists and the non specialists and comparatively simulated the telephone/fax and the TS based CP of a renal transplant scenario. RESULTS: There was no statistically significant difference between the two groups regarding feasibility and reliability of TS in CP. Specialists found TS significantly more reliable in the fulfillment of all medicolegal requirements of OT (p<.001). CONCLUSION: Coordinators found TS in the CP of OT feasible and reliable.

Telepathology as a method to optimize quality in organ transplantation: a feasibility and reliability study of the virtual benching of renal graft.

AIM: To search feasibility and reliability of Telemedicine Systems (TS) in the procurement of Renal Transplantation. MATERIAL AND METHODS: By an experimental TS, twenty six (n=26) specialists based on a hundred and thirty (N=130) simulated remote image examinations, assessed sensitivity-specificity of the remote examination of Renal Graft (RG) about diseases and damages (Virtual Benching=VB). RESULTS: Analysis showed: injuries (sensitivity=100%), injuries of the capsula (sensitivity=100%), hematomas (sensitivity=96.2%), non neoplasmatic diseases (specificity=100%), tumors (sensitivity=100%). CONCLUSION: The VB of RG after retrieval is feasible and reliable for prevention of damaged renal RG from being sent to the recipient hospital and for transplant planning.

Telepathology as a method to optimize quality in organ transplantation: a feasibility and reliability study of the virtual benching of pancreas graft.

AIM: To search feasibility and reliability of Telemedicine Systems (TS) in the procurement of Pancreas Transplantation. MATERIAL AND METHODS: By an experimental TS, twenty six (n=26) specialists based on a hundred and thirty (N=130) simulated remote image examinations, assessed sensitivity-specificity of the remote examination of Pancreas Graft (PG) about diseases and damages (Virtual Benching=VB). RESULTS: Analysis showed: Injuries (sensitivity=100%), injuries of the capsula (sensitivity=84.6%), hematomas (sensitivity=92.3%), non neoplasmatic diseases (specificity=92.3%), tumors (sensitivity=72%). CONCLUSION: The VB of PG after retrieval is feasible and reliable for prevention of damaged PG from being sent to the recipient hospital and for transplant planning.

Telepathology as a method to optimize quality in organ transplantation: a feasibility and reliability study of the virtual benching of liver graft.

AIM: To search feasibility and reliability of Telemedicine Systems (TS) in the procurement of Liver Transplantation. MATERIAL AND METHODS: By an experimental TS, twenty six (n=26) specialists based on a hundred and thirty (N=130) simulated remote image examinations, assessed sensitivity-specificity of the remote examination of Liver Graft (LG) about diseases and damages (Virtual Benching=VB). RESULTS: Analysis showed: injuries (sensitivity=96%), injuries of the capsula (sensitivity=91.7%), hematomas (sensitivity=91,7%), non neplasmatic diseases (specificity=100%), tumors (sensitivity=100%). CONCLUSION: The VB of LG after retrieval is feasible and reliable for prevention of damaged liver grafts from being sent to the recipient hospital and for transplant planning.

Telemedicine systems in organ transplantation: a feasibility and reliability study of the integrated teleradiological and tele-pathological evaluation of renal graft.

AIM: To determine feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Renal Graft (RG) on Telemedicine Systems (TS). MATERIAL AND METHODS: A sensitivity-specificity analysis by a simulation of the TRE of RG on 15 MR abdominal images by a radiologist and of the TPE of RG by 26 specialists based on 130 human RG images assessing damages and lesions. RESULTS: The integrated analysis of TRE and TPE of RG showed: Sensitivity=96.7%, Specificity=100% and Accuracy=97.6%. CONCLUSION: The TRE integrated with the TPE of RG is feasible and reliable for RG transplant decision support and planning.

Telemedicine systems in organ transplantation: a feasibility and reliability study of the integrated teleradiological and tele-pathological evaluation of pancreas graft.

AIM: To determine feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Pancreas Graft (PG) on Telemedicine Systems (TS). MATERIAL AND METHODS: A sensitivity-specificity analysis by a simulation of the TRE of PG on 15 MR abdominal images by a radiologist and of the TPE of PG by 26 specialists based on 130 human PG images assessing damages and lesions. RESULTS: The integrated analysis of TRE and TPE of PG showed: Sensitivity=93.3%, Specificity=100% and Accuracy=95.1%. CONCLUSION: The TRE integrated with the TPE of PG is feasible and reliable for PG transplant decision support and planning.

Telemedicine systems in organ transplantation: a feasibility and reliability study of the integrated teleradiological and tele-pathological evaluation of liver graft.

AIM: To determine feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Liver Graft (LG) on Telemedicine Systems (TS). MATERIAL AND METHODS: A sensitivity-specificity analysis by a simulation of the TRE of LG on 15 MR abdominal images by a radiologist and of the TPE of LG by 26 specialists based on 130 human LG images assessing damages and lesions. RESULTS: The integrated analysis of TRE and TPE of LG showed: Sensitivity=96.6%, Specificity=100% and Accuracy=97.5%. CONCLUSION: The TRE integrated with the TPE of LG is feasible and reliable for LG transplant decision support and planning.