Digital Pathology Blog

Research Institute Speeds Cancer Research with High-Performance Computing System

From Microsoft:

"Using Windows HPC Server 2008 for research enhances cancer detection and optimizes the pathology review process. We can now tackle research areas that we’ve never dreamed of tackling before.” - Dave Billiter, Director, Research Informatics Core Nationwide Children's Hospital

Watch a video.

BioImagene Develops Companion Algorithms (TM) to Further Enable Personalized Medicine

This morning BioImagene annouced the use of companion algorithms.  What I think we are seeing in digital pathology is less talk and interest in hardware and more interest with software whether it be image analysis, algorithms for detection/diagnosis or software to help meet the demands of personalized medicine. 

While the actual scanning is not trivial and much effort has been put in to this to provide adequate solutions for clinical use, the value of the whole slide rests not only with being able to view this locally or remotely but use the digital data set to enhance what may not be possible or feasible with the "raw" glass alone.  I gather we will see more applications like this in the near future. 

Full press release below.

SUNNYVALE, Calif.--June 29, 2009  -- (BUSINESS WIRE)--BioImagene, the leading provider of innovative digital pathology solutions, announced today that the company is advancing its goal of bridging personalized medicine and the clinical practice of pathology by providing Companion Algorithms (TM). These specialized algorithms, which BioImagene develops for use with its Virtuoso (TM) suite of web-based software, aid pathologists in the quantitative assessment of specialized diagnostic tests used to determine patient suitability for specific cancer therapies. As pharmaceutical companies work to develop companion diagnostics to individualize therapy for cancer patients, Companion Algorithms further enable pathologists to correctly identify and accurately measure specific biomarkers used to determine appropriate treatment options for patients.

“Companion diagnostics will play an increasing role in cancer care as physicians strive to provide the therapies that are most likely to be advantageous to individual patients,” said Keith J. Kaplan, M.D., Mayo Clinic. “Companion Algorithms bring personalized medicine one step closer to reality and can help the pathologist provide the most actionable information to the oncologist.”

Ajit Singh, Ph.D., chief executive officer of BioImagene, commented: “The Human Genome Project opened the doors to research in the field of biomarkers and cancer diagnostics; however, challenges still exist in using biomarkers to identify subpopulations of patients that are likely to respond favorably to targeted treatments. Providing pathologists with Companion Algorithms will ultimately move our industry closer to the goal of personalized medicine.”

BioImagene’s Companion Algorithms can be used by pathologists to aid in the interpretation of digitized images of cancer diagnostic tests including immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). Digitized images can be generated by one of BioImagene’s iScan slide scanning systems, such as Coreo, Concerto, or Solo. In February 2009, BioImagene received clearance from the U.S. Food and Drug Administration (FDA) for use of one of its Companion Algorithms in the company’s PATHIAM™ IVD Imaging Software for HER2/neuimmunohistochemistry tests. The iScan Coreo and associated software are used to detect and provide a quantitative measurement of HER2/neu, a protein measured in breast cancer patients to determine their candidacy for treatment with the Genentech drug Herceptin (TM).

“The Herceptest, the first FDA-approved companion diagnostic, is used to identify the subset of breast cancer patients who over-express the HER2/neu protein and will therefore have a high probability of responding to Herceptin,” said Robert Monroe, M.D., Ph.D., chief medical officer of BioImagene. “BioImagene’s FDA-cleared HER2/neu Companion Algorithm improves the accuracy and reproducibility of Herceptest interpretation. BioImagene offers additional Companion Algorithms for breast cancer and is committed to developing new Companion Algorithms for other companion diagnostic tests used in prostate, colon, lung and other cancers.”

 

July 9-10 GTCBio Rediscovering Biomarkers, San Diego

Courtesy of Definiens:
Definiens Cordially Invites You to:
GTCBio's Third Annual Rediscovering Biomarkers
July 9-10, San Diego
Definiens will be demonstrating the Definiens XD image analysis platform for image analysis of cells, tissues, and non-invasive images.
Additionally, Peter Duncan, Director of Marketing and Business Development, Definiens, will be presenting:
Standardizing Image Analysis of Biomarkers Across the Biomedical Continuum
The talk will highlight a “game changing” image analysis software platform, Definiens XD. Definiens XD facilitates image analysis of complex images, from any source, in any dimension; allowing for the first time, a standardized platform for image analysis of biomarkers across the biomedical continuum.
Topics covered include:
• Image analysis of cell-based assays • Image analysis of biomarkers in heterogeneous tumor tissue • Image analysis in non-invasive imaging
If you are interested in attending, please contact us and we will provide a $500 voucher towards the conference registration.
See you at the conference!

Mayo model praised, but can it last?

By Jeff Kiger Post-Bulletin, Rochester MN 

Recent weeks have cemented the Mayo Clinic's reputation as a health care superstar but raised the ominous question of how long that can continue under the present U.S. health care system.

	Time Magazine excerpt: "The Mayo clinic attracts Kings and Presidents, injured athletes and ailing billionaires. ... But Rochester's costs are well below the national average because Mayo also provides tremendous value for ordinary care ..."

With the health reform debate heating up, Mayo Clinic has been praised on the national stage as a model for offering quality health care at a low price. Those patting Mayo on the back include President Obama, Time magazine and The New Yorker magazine.

But the question has been raised: Can even Mayo continue to use the Mayo model?

Dr. Atul Gawande's article in The New Yorker magazine June 1 showed that Mayo's per-person Medicare costs in Rochester were low even though it provided a high level of care. He contrasted that with McAllen, Texas, which has some of the high costs but poor quality.

The system of paying for medicine doesn't reward Mayo's quality, and instead drives up costs by encouraging doctors to order pricey scans and surgeries, as they do in McAllen, Gawande concluded,

In his article, "The Cost Conundrum," Gawande wrote, "In the war over the culture of medicine the war over whether our country's anchor model will be Mayo or McAllen the Mayo model is losing."

That was echoed in a June 29 Time magazine article on the Mayo model, which details Mayo's "institutional obsession with evidence-based medicine" it keeps track of what works and does it. Also, Mayo pays doctors fixed salaries so they don't make more if they do more to patients and they don't make less if they take more time to talk to them, the article said.

Mayo Dr. Dawn Milliner was quoted as saying, "We've been able to buffer our staff from the harsh realities of the system, so they can concentrate on patient needs, But it's not clear how long we can keep doing that."

Gawande explained his conclusion this week.

"Their (Mayo's) practice model is closer to the quality and cost we want, though we have a financing system that doesn't make it sustainable," wrote Gawande in an e-mail. "My conclusion is that it's the financing system that has to change, not the medical system."

Mayo Clinic, which lost $840 million on $1.7 billion in Medicare treatment last year, agrees.

"That's the underlying reason we are involved in health care reform," says Josh Derr of the Mayo Clinic Health Policy Center. "The Medicare system is a fee for care system. We want to that shifted to value."

Derr says the short-term fix would factor value into Medicare reimbursement. The longterm fix tosses out the pay-per-service plan, to be replaced with something like a bundled care method. That means a heart attack would be covered with one fee for all related treatment and that encourages a hospital "to do things right the first time," he said.

Of course, change may take a long time, even if Obama admires Mayo's methods.

"Mayo will still find way to stick with its model of care going forward," Derr says. "We'll just have to find different ways to do that."

Dr. In S. Pole Rescue Loses Cancer Battle

Dr. Jerri Nielsen FitzGerald was the center of a dramatic 1999 rescue.

(CBS/AP)  Dr. Jerri Nielsen FitzGerald, whose struggle against breast cancer during a winter at the South Pole captivated the world, has died. She was 57.

Her husband, Thomas FitzGerald, says she died Tuesday at their home in Southwick, Mass. The cause was cancer.

Nielsen was the only doctor at the Amundsen-Scott South Pole Station when she found a lump in her breast in June 1999, raising fears of cancer. Weather conditions didn't permit a rescue, so she performed a biopsy on herself with the help of staff.

She began treating herself using drugs dropped by parachute in the dark polar winter in July, in a mission documented by CBS News.

Despite her illness Nielsen kept busy with her duties up until she left the South Pole, her sister-in-law, Diana Cahill, told CBS News in 1999.

"She didn't have time to focus on her condition at all. She's a very giving person," Cahill said.

Following the dramatic airlift, she told The Vindictor newspaper she wanted to return to the Antarctic.

"It was such a wonderful place. I still love it. I would do it again. Even knowing what happened to me, it was the best year of my life," Nielsen told the newspaper.

Her cancer went into remission until 2005.

Mayo Clinic going to Mall of America

My institution recently announced that it plans an outpost amid the roller coasters, restaurants and retailers as the Mall of America expands into a second phase.  At first glance I thought this would be a "retail clinic" within the large shopping center outside of Minneapolis but organizers have some different ideas that may be more beneficial overall to patients and providers.

I recently had an experience at a retail clinic I will write about in the future but think the exposure is positive for the clinic as another entry point for care that may could provide cost-effective health care, counseling, education or accomodate necessary referrals. 

Come to Minnesota for tax-free clothes and stay for your health care needs.  Will see what this will look likes as plans solidify and how health care providers closer to Minneapolis will respond.

Mayo officials said they haven't decided what services the site will offer, but said they could include diagnostic screenings, wellness counseling and other services that might direct patients to the home campus in Rochester.

"The Mall of America provides a tremendous opportunity to provide a gateway to services we provide and a platform for innovation," said Dr. Glenn Forbes, CEO of Mayo Clinic Rochester, adding: "It's not our intention to replicate what we're doing in Rochester."

The new facility might, for example, offer telemedicine consultations and organize logistics for international patients. But it will not offer routine primary care such as treating sore throats and broken bones.

At a news conference last Wednesday attended by Mall officials and Gov. Tim Pawlenty, Mayo executives said they plan to spend the next 12 months deciding the nature of the facility and the size of their investment. There is no opening date as yet.

Twin Cities hospital and clinic chains such as Allina, Fairview and Park Nicollet compete vigorously for patients in specialty care. Should they be worried?

"I would say a little bit," said Allan Baumgarten, an independent Twin Cities health care analyst. "Although most people have longstanding relationships with their doctors, we are going into a time when people are paying more and more out of their own pocket either because they have lost coverage or have high deductibles.

"This gives someone with a brand name like Mayo an opportunity to say 'Don't think of Mayo being 90 miles away. Think of Mayo as being at the Mall of America.' There's a portal there that could lead to the renowned Mayo Clinic."

Blog content now syndicated on Newstex

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New technology with host of photonic applications

A research team led by a chemist at the University of California, Riverside has fabricated microscopic polymer beads that change color instantly and reversibly when external magnetic fields acting upon the microspheres change orientation.

Applications of the new material include display type units such as rewritable or reusable signage, posters, papers and labels, and other magnetically activated security features, as well as environmentally friendly pigments for paints and cosmetics, and ink materials for color printing.

More information at:

http://www.eurekalert.org/pub_releases/2009-06/uoc--nfm061609.php

http://newsroom.ucr.edu/news_item.html?action=page&id=2124

Digital Microscopy for under 100 bucks? Check out the zPix™ - MM-740

Became aware of this through a pathology listserv as a low cost digital camera (under $100).

"The zPix™ 200 from Carson Optical is a powerful Zoom Digital Microscope that displays the Magnified image right on your computer screen. The impressive 26x-130x Zoom Magnification allows you to see details of ordinary objects you never knew existed! Capture an image to keep using the built-in 1.3 megapixel resolution Digital Camera. You can even capture close-focus video! The MM-740 Zoom Digital Microscope is compatible with the following: Mac OSX 10.4 or later, Windows 98 SE, Windows 2000, Windows ME, Windows XP, Windows Vista. A USB 2.0 port is required.

Also available with a 640 x 480 resolution Digital Camera- zPix™

View some images we took with the zPix"

Open letter to patients regarding health care coverage

Dr. Wes has an open letter to patients regarding health care coverage:

Dear Mr. and Ms. Patient,

It has come to my attention that in order for you to enjoy success as patients in the new era of health care reform, you must start working now to prevent illnesses that might befall you. Do not, under any circumstances, eat or drink too much. Fast food might as well be considered illegal. Exercise three, four, five times a day, even if it means take time off from work. It goes without saying that you should not smoke. The government has data that demonstrates how you have become fat, lazy, and a huge burden on our health care system. Your non-compliance threatens the very fiber of our economy. Even employers realize this, and are using calculators to figure your financial burden to them.

Now, in the unfortunate circumstance where you might become sick, you will need to develop symptoms that follow a few simple rules. Do not, under any circumstances, develop symptoms that fall outside federal protocols developed based on comparative effectiveness research data. If you do, your doctors will face pay cuts, litigation, limited resources due to lack of funding for cost-ineffective technologies, and the scourge of discharge planners. Does the term "leper colony" mean anything to you?

Read the rest here.