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Table 2 A survey of medical standards (level 2 and level 3) suggested or already implemented in tissue-based diagnosis

From: Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology)

Medical Standard (level 2) Criteria (level 3) International/national Action
Disease order [41] Hierarchic, 1 – 10 Proposed
Formal disease classification ICD-O, SNO-MED Accepted
Disease/human classification Board discussion Accepted for tumours (WHO classification)
Disease frequency Not evaluated, probably >2 per month Open
Mandatory expert consultation Rare cancer, lymphoma Proposed
Mandatory quality assurance Breast cancer, Hodgkin's disease Accepted
Image handling, exchange by DICOM 3, HL 7 General & individual regulations Proposed
HIS, RIS communication by DICOM 3, HL 7 General & individual regulations Proposed
Expert communication guidelines 4 – 8 images/case, <2 different magnifications/case, Proposed
Virtual microscopy:   
Diagnosis/image properties >50 pixels/object, >40 objects/image, >256 × 256 image size Proposed
Disease/image features Disease – associated texture, object, structure parameters Open
Image quality measure Gray value deviation, image standardization (shading, gray value range, gradient) Open
Screening/image size Texture features: crude screening Object/structure features: classical diagnosis (H&E) Open
Diagnosis/colour space RGB space – classical diagnosis. HSI space – prognosis associated diagnosis, cancer scores (hormone receptor, Gleason, etc.) Open