Digital Pathology Blog

Scientific Conference being hailed as " A milestone in virtual pathology"

More than 800 pathologists experienced a unique, large-scale virtual microscopy slide seminar on the internet during the 21st European Congress of Pathology, held in Istanbul between 8-13 September. It was the first time that a microscopy slide set from a major pathology conference was made viewable on the web. The seminar was arranged by the Biomedical Informatics Research Group from the University of Helsinki.

Webmicroscope

The 17 slide seminars included breast pathology, dermatopathology, gastrointestinal pathology, hematopathology, neuropathology and uropathology. The originals of the slides were on ordinary microscopy glass. A ‘virtual slide’ digitised at a thousand-fold magnification can hold more than 60 gigabytes of data. More than 160 specimens were digitised in this way for use at the conference. Handling such large amounts of data was made possible because of efficient compression techniques and a viewing system adopted from the satellite imaging industry. “Viewing of the samples very much resembles the use of Google Earth and puts only modest requirements on the pathologist’s computer,” said Dr Mikael Lundin, who was responsible for the project’s technical development - WebMicroscope.

“To our knowledge, this is the first time that the complete microscopy slide set of a major international pathology conference has been digitised and made available on the web for the participants, and as such is a milestone in virtual miscoscopy and pathology,” said Dr Lundin.

All the virtual slides were copied to five mirror servers in Europe, which allowed pathologists to view the samples from the server that has the best connection speed. “The network of servers also marks the foundation of a novel European Virtual Microscopy Network,” said Dr Lundin. “By joining the network, a department can ensure an excellent connection speed and access to common educational material within the pathology community of Europe.”

Some of the microscopy samples were extremely rare and were collected into a special section and called ‘Once in a Pathologist’s Lifetime’. Diagnoses of the cases discussed at the conference are to be published on the internet. The seminar slides will also be available to the public to be used as an educational tool.

The new technology used at the conference is the result of a joint research and development project between the Biomedical Informatics Research Group, headed by Johan Lundin at the University of Helsinki, and Professor Jorma Isola, one of the pioneers of virtual microscopy, who is from the Institute of Medical Technology at the University of Tampere in Finland.

The conference programme included keynote lectures, symposia, slide seminars, short courses and pre-congress scientific activities. There were reviews of state- of-the-art practices and a look into the future of the discipline. Pathology is a fast moving science and the conference responded to this by covering many new and challenging aspects of clinical and research pathology.

Webmicroscope

caTissue: Streamlining Biospecimen Management

Researchers who have easy access to relevant tools, biospecimens, and patient information can focus their work on finding cures for cancer and other diseases instead of being bogged down by the logistics of finding appropriate numbers and types of research specimens.

Unfortunately, many researchers may be limited by an inadequate availability of biospecimens relevant to their research and the arduous process of collecting enough samples outside of their own lab.
Read more

A new caBIG™ software tool called caTissue (developed by the Biomedical Informatics Facility at Washington University in St. Louis, MO) promises to greatly improve the way that biospecimens are catalogued, managed, and accessed—making it easier for researchers across the country to obtain a statistically significant number of specimens for use in experiments.

Traditionally, a researcher, or group of researchers at a specific institution, maintains their own dedicated biospecimen banks, using them for their projects as needed. But the challenge for researchers is that biospecimen repositories maintained by their institutions or partners may not encompass sufficient numbers of the appropriate high quality, clinically annotated biospecimens to achieve the most expeditious and rigorous results.

To facilitate the sharing of specimens among researchers nationwide, the Tissue Banks and Pathology Workspace of caBIG™ has spearheaded an effort to provide the open access caTissue tool to manage a centralized repository describing the location and types of biospecimens across multiple institutions.

The Biomedical Informatics Facility at Washington University in St. Louis led the development of this software and was instrumental in assuring its utility for researchers.

Read more on Why caTissue is important

3-D avatar may help doctors improve care

ZURICH, Switzerland, Sept. 26 (UPI) -- IBM scientists have created software that allows physicians to use an avatar to obtain medical data in the same manner in which they interact with patients.

The prototype technology, created at IBM's Zurich, Switzerland, research center, uses an avatar -- a 3-D representation of the human body -- to allow physicians to visualize patient medical records in an entirely new way.

Called the Anatomic and Symbolic Mapper Engine, ASME allows a doctor to click with a computer mouse on a particular part of the avatar's body to trigger a search of medical records to retrieve relevant information.

"Its like Google Earth for the body," said IBM Researcher Andre Elisseeff, who led the project. "In hopes of speeding the move toward electronic healthcare records, weve tried to make information easily accessible for healthcare providers by combining medical data with visual representation, making it as simple as possible to interact with data that can improve patient care."

IBM said its researchers are now exploring integrating speech technology into ASME.
http://www.upi.com/NewsTrack/Science/2007/09/26/3d_avatar_may_help_doctors_improve_care/3808/

Audio Chip Listens For Cancer

Cancer-sensing devices built as cheaply and efficiently as wristwatches – using many of the same operating principles – could change the way clinicians detect, treat and monitor cancer in patients. Researchers from the Georgia Institute of Technology have created an acoustic sensor that can report the presence of small amounts of mesothelin, a molecule associated with a number of cancers including mesothelioma, as they attach to the sensor’s surface.

According to the researchers, the study is a proof of principle, demonstrating a technique that might work for the detection of nearly any biomarker – a collective term for a molecular signal that denotes the presence of disease. They presented their findings at the American Association for Cancer Research’s second International Conference on Molecular Diagnostics in Cancer Therapeutic Development.

“It is one thing to be able to identify biomarkers for a disease, but it is another to be able to find them in blood quickly and easily at very low concentrations,” said Anthony Dickherber, a graduate student in the School of Electrical and Computer Engineering at Georgia Tech. “We envision that, one day, doctors can use an array of our sensors as a sort of laboratory in their office, where they could use a quick blood sample to detect or monitor the signs of cancer.”

According to Christopher Corso, the other graduate student engaged in the project and an M.D., Ph.D. student, such a device would be a boon to healthcare practice, allowing physicians to screen patients for signs of disease before opting for more expensive or invasive diagnostic techniques. Responding to the growing need for such sensors in both research and clinical practice, Dickherber, Corso and research adviser William D. Hunt, Ph.D., conceived of and developed the ACuRay chip, standing for ACoustic micro-arRay – a device that shares more in common with an inexpensive wristwatch than the sort of cutting edge molecule-sorting apparatuses currently used by researchers and clinical laboratory technicians.

The array consists of a series of electrodes deposited on the surface of a thin film of zinc oxide, which allows the device to resonate, or vibrate, at a specific frequency when a current is applied, much like the quartz timing devices used in many clocks and watches.

“The sensor itself is built on a base of silicon, like a computer chip, and could be mass-produced using very well known and inexpensive microelectronic fabrication techniques,” Dickherber said.

To turn this array into a sensor, the Georgia Tech researchers coated the zinc oxide surface with mesothelin-specific antibodies generated in the lab of Ira Pastan, M.D., at the National Cancer Institute. These molecules are engineered versions of the antibodies the immune system creates to identify foreign intruders, such as microbial parasites. In this study, the researchers coated the sensor with antibodies for mesothelin, a cell-surface protein that is highly expressed in mesothelioma, ovarian cancer, pancreatic cancer and other malignancies.

When the mesothelin binds to an antibody, the added mass changes the frequency at which the acoustic wave passes between the electrodes on the surface of the device. The device is able to “hear” the pitch change due to nanomolar concentrations of mesothelin (just a few molecules amid billions) binding to antibodies on the chip. The technology has the potential of detecting biomarkers in even lower concentrations than those tested, Dickherber said.

“It is really an elegant engineering solution to a very complicated problem,” said Hunt, a professor of electrical and computer at Georgia Tech and lead researcher on the project. “We could, for example, detect a number of different markers for a single disease on a single chip no bigger than the tip of a fountain pen. With refinement, this technology could readily lead to an inexpensive, ubiquitous technology for researchers, physicians and the clinical laboratory.”

BioImagene Announces Two New Executive Management Appointments

BioImagene, a leading provider of total digital pathology solutions, today announced the appointment of Bikash Sabata as the Chief Technology Officer (CTO) and Mike Cusack as Vice President Marketing. Bikash will be responsible for the technological vision and development of innovative imaging products. Mike will be responsible for worldwide marketing strategy and product development. Bikash and Mike will report to CEO Mohan Uttarwar.

"We are delighted with the appointment of Bikash Sabata as CTO," said Mohan Uttarwar, President and CEO of BioImagene. "He brings a strong combination of technology research in academic settings and product development in startups. We look forward to leveraging his industry experience in imaging to advance and enhance our product offerings."

Mr. Uttarwar continued, "We are very pleased that Mike Cusack has joined BioImagene's Management Team as our new VP Marketing. Throughout his career, Mike has successfully launched new products. His proven track record in successful expansion of start ups will be great assets for commercialization for our products, especially TissueMine(TM) and PATHIAM(TM)."

Mr. Sabata comes to BioImagene with over 15 years of experience in developing imaging and computer vision architecture and algorithms. His works on distributed and autonomous systems, computer vision and parallel computing, have been widely published. He most recently held the position of Co Founder and CTO at Aginova Inc, where he successfully developed corporate vision. He was also responsible for the formation of the executive team, product architecture and development, and revenue generation.

Mr. Cusack has over 25 years of management experience in marketing and sales in high growth and start-up companies. His most recent position was that of Vice President Sales and Marketing at High Throughput Genomics, where he was responsible for marketing strategy and product positioning. Mike's prior experience includes Vice-President International at Ventana, and Vice-President of Marketing and General Manager Europe in Ventana Medical Systems SA.

About BioImagene

BioImagene, Inc., based in Cupertino, California, is a leading provider of image informatics solutions for digital pathology, covering a wide range of products from Discovery to Diagnostics. All products are for research use only except Pathiam(TM) Imaging Software for HER2/neu. www.bioimagene.com. Media contact: Suchitra Parthasarathy at 408 207 4285.

Massachusetts will provide online access to information on insurers' payments to hospitals

The Boston Globe (9/22, Kowalcyzk) reported that Massachusetts residents will soon be able to access information on the "prices individual hospitals are paid by insurers for performing specific procedures -- data state officials hope will encourage comparison shopping and reduce medical costs." The announcement "by the state's new Health TheCare Quality and Cost Council makes Massachusetts one of the first states to make this normally secret information public." The new information will also allow people to see "whether hospitals adhere to best practices and achieve good outcomes for patients...for the procedures for which" payment is disclosed. This could lead consumers to decide, "for example, [that] if a hospital charges far more than other institutions for treating heart attack or pneumonia patients, but has lower quality scores, the extra cost is not justified."

Apollo and IBM To Host Upcoming Digital Pathology Seminar

Falls Church, VA,  September 18, 2007   -   Apollo and IBM Healthcare & Life Sciences have joined together to host a complimentary one-day symposium and workshop to demonstrate how digital pathology is transforming the practice of pathology. In just one day, attendees will learn about the latest developments in Pathology digital imaging, Pathology PACS, telepathology, and whole slide scanning, including hands-on demonstrations with PathPACS(R). Renowned speakers in the field will share their experiences and there will be plenty of opportunity to network with peers in pathology.  This one-day event is designed to be the most valuable, enlightening, and educational event of the year. Apollo, a Virginia-based company established in 1993, was founded with the dream of developing the most advanced medical imaging interface technologies for healthcare and life sciences laboratory professionals — to provide superior medical care for patients around the globe. Apollo is working with IBM Healthcare & Life Sciences to provide innovative management strategies in response to the growing demand for digital pathology solutions. IBM Healthcare & Life Sciences is dedicated to setting new standards of care in technologies, services, and insight. Apollo and IBM Healthcare & Life Sciences hosting complimentary one-day seminar (including breakfast and lunch) to discuss latest trends in pathology digital imaging. Full announcement and list of speakers here (http://www.apollopacs.com/presscenter/Seminar%2011-15-2007/press_release_view)

Animal studies raise microchip suspicions

www.chicagotribune.com/features/lifestyle/health/chi-0916_health2_r_n_dsep16,1,3129849.story

chicagotribune.com

QUALITIES OF LIFE: HEALTH

Animal studies raise microchip suspicions

By Todd Lewan

Associated Press

September 16, 2007

When the U.S. Food and Drug Administration approved implanting microchips in humans, the manufacturer said it would save lives, letting doctors scan the tiny transponders to access patients' medical records almost instantly. The FDA found "reasonable assurance" the device was safe, and a subagency even called it one of 2005's top "innovative technologies."

But neither the company nor the regulators publicly mentioned this: A series of veterinary and toxicology studies, dating to the mid-1990s, stated that chip implants had "induced" malignant tumors in some lab mice and rats.

"The transponders were the cause of the tumors," said Keith Johnson, a retired toxicologic pathologist, explaining the findings of a 1996 study he led.

Leading cancer specialists reviewed the research for The Associated Press and, while cautioning that animal test results do not necessarily apply to humans, said the findings troubled them. Some said they would not allow family members to receive implants, and all urged further research before the glass-encased transponders are widely implanted in people.

2,000 implanted in humans

To date, about 2,000 radio frequency identification, or RFID, chips have been implanted in humans worldwide, according to VeriChip Corp. The company, which sees a target market of 45 million Americans for its medical monitoring chips, insists the devices are safe.

"We stand by our implantable products which have been approved by the FDA and/or other U.S. regulatory authorities," said Scott Silverman, chairman and chief executive officer of the Delray Beach, Fla., company.

Management was "not aware of any studies that have resulted in malignant tumors" in lab animals, but he added that millions of pets have been implanted with microchips, without reports of significant problems.

The FDA also stands by its approval of the technology but declined repeated requests to specify what studies it reviewed before approving the implants.

The agency is overseen by the Department of Health and Human Services, which, at the time of VeriChip's approval, was headed by Tommy Thompson. Two weeks after the device's approval was formally announced on Jan. 10, 2005, Thompson left his Cabinet post, and by July was a board member of VeriChip Corp. and its parent company, Applied Digital Solutions. He was compensated in cash and stock options.

Also making no mention of the findings on animal tumors was a June report by the ethics committee of the American Medical Association, which touted the benefits of implantable RFID devices.

Had committee members reviewed, or even been aware of, the literature on cancer in chipped animals?

No, said Dr. Steven Stack, an AMA board member.

Published in veterinary and toxicology journals between 1996 and 2006, the studies found that lab mice and rats injected with microchips sometimes developed subcutaneous "sarcomas," or malignant tumors, most of them encasing the implants.

*A 1998 study in Ridgefield, Conn., of 177 mice reported cancer incidence to be slightly higher than 10 percent, a result the researchers described as "surprising."

*A 2006 study in France detected tumors in 4.1 percent of 1,260 microchipped mice. This was one of six studies in which the scientists did not set out to find microchip-induced cancer but noticed the growths incidentally.

*In 1997, a study in Germany found cancers in 1 percent of 4,279 chipped mice. The tumors "are clearly due to the implanted microchips," the authors wrote.

Caveats accompanied the findings. "Blind leaps from the detection of tumors to the prediction of human health risk should be avoided," one study cautioned. Also, none of the studies had a control group that did not get chips, so the normal rate of tumors cannot be determined and compared to the rate with chips implanted.

Specialists see red flags

Still, specialists at some pre-eminent cancer institutions said the findings raised red flags.

Dr. Cheryl London, a veterinarian oncologist at Ohio State University, noted it's easier to cause cancer in mice than people. "So it may be that what you're seeing in mice represents an exaggerated phenomenon of what may occur in people."

Tens of thousands of dogs have been chipped, she said, and veterinary pathologists haven't reported outbreaks of related sarcomas. (Published reports detailing malignant tumors in two chipped dogs turned up in AP's four-month examination of research on chips and health. In one dog, the researchers said cancer appeared linked to the presence of the embedded chip; in the other, the cancer's cause was uncertain.)

Nonetheless, London saw a need for a 20-year study of chipped canines. Dr. Chand Khanna, a veterinary oncologist at the National Cancer Institute, also backed such a study, saying current evidence "does suggest some reason to be concerned about tumor formations."

Meanwhile, the animal study findings should be disclosed to anyone considering a chip implant, the cancer specialists agreed

BCBS to pay out more than $131 million

BCBS settling parties agree to pay out more than $131 million; Oct. 19 is key deadline

Physicians who provided covered services to any patient enrolled in or covered by Blue Cross Blue Shield (BCBS) plans at any time between May 22, 1999, and May 31, 2007, may be entitled to a payout as part of a class action lawsuit settlement agreement.

The group of BCBS settling parties has agreed to distribute $131,209,507 (with accrued interest since June 30) among eligible physicians who file a claim form by Oct. 19. If you think you may be eligible and have not yet received a notice in the mail, visit related link below to download the mailed notice, claim form and claim form instructions that were mailed to physicians on July 27. Be sure to submit a completed claim form by October 19. One form can be prepared for an entire practice. However, a list of every physician as well as the number of shares to which each physician is entitled should be attached.

If you have questions about the settlement you can contact the settlement administrator via the e-mail address listed at http//:www.hmosettlements.com or by telephone at (877) 893-2643. You may also obtain information regarding this and other settlements at on the AMA Web site – see related link below

* * * * * * * * *

Two health insurers send combined $79 million to physicians This month, physicians who filed timely claim forms as part of the Health Net and Humana settlements of the class action multi-district litigation case received funds from the settlements. Health Net settlement funds totaling $39 million were disbursed on Aug. 6 among physicians who received between $59.30 and $593, depending on the number of shares of the settlement to which they were entitled.

Humana distributed about $40 million in settlement disbursement checks on August 10. Physicians received between $78.91 and $789.10 depending on the number of shares to which they were entitled.

Related links:

www.hmosettlements.com

www.ama-assn.org/go/settlements

Amirsys® Selects Aperio Slide Scanning System

STATdx®PathIQ™ ImmunoQuery® for Pathology to Revolutionize Reference Content for Anatomic Pathologist

Vista, CA – September 18, 2007 - Aperio Technologies, Inc., (Aperio) the leading provider of digital pathology systems and services to the healthcare and life sciences industry, has announced that its ScanScope slide scanning system has been selected by Amirsys, Inc. to integrate digital whole slide images into Amirsys’ STATdx®PathIQ™ ImmunoQuery® diagnostic decision support system for Pathology. The ScanScope system is integral to Amirsys’ efforts to provide pathologists with comprehensive, evidence-based pathology content. STATdx®PathIQ™ ImmunoQuery® is the first component of Amirsys’ STATdx product family designed to improve quality of care and decrease the time required by pathologists to research complex pathology cases. Its digital format ensures that pathologists have access to on-demand reference tools wherever and whenever they need it.

Dr. Elizabeth Hammond, MD, FCAP, and Amirsys Executive Editor commented, "Aperio’s unparalleled expertise in digital pathology systems enables us to develop the most comprehensive and visually detailed digital slide reference system available to pathologists today. Through this technology, we will be better able to help pathologists world-wide improve the quality of patient care as well as pathology research and analysis to improve patient outcomes."

Aperio’s award-winning and patented linear array-based ScanScope slide scanning systems create seamless, true color whole slide images at giga-pixel resolution from an entire glass slide in a matter of minutes. Aperio’s slide scanning systems are offered with Spectrum™ software to enable the secure viewing, analysis and management of digital slides and other images in a multi-user, multi-site environment.

"We’re excited about supporting Amirsys, and having the opportunity to leverage Aperio’s high-capacity digital slide scanners to help the pathology community improve their daily work activities," stated Dirk Soenksen, CEO of Aperio.

About Amirsys 

Amirsys® is a medical information systems provider that develops its own proprietary technology and content exclusively in the image-intensive areas of pathology and radiology. Amirsys (www.AMIRSYS.com) is a leading provider of medical imaging information in print and online form. Over 200 world-renown authors have come together to create the backbone of Amirsys. Combining the knowledge and expertise of these authors has enabled Amirsys to create a family of top quality digital and print reference products and is the substance behind its motto: "Names You Know. Content You Trust.®"

About Aperio Technologies 

Aperio is digitizing pathology. We provide systems and services for digital pathology, which is a digital environment for the management and interpretation of pathology information that originates with a digital slide. Aperio’s award-winning ScanScope slide scanning systems and Spectrum™ digital pathology information management software improve the efficiency and quality of pathology services for pathologists and other professionals. Applications include education, remote viewing, archival and retrieval, basic research, and image analysis. Aperio’s products are intended for research and education use only. For more information, please visit www.aperio.com.