Neat marketing and easy to use instructions and portal for e-consults from UPMC. Expert opionions are now just a mouse click away.
http://www.upmc.com/HealthcareProfessionals/Physicians/Pages/digital-pathology-portal.aspx

Your first choice for a second opinion.

The UPMC Digital Pathology Consultation Portal is a convenient solution for pathologists seeking a second set of expert eyes and subspecialty expertise.

Simply upload digital images of your glass slides and the Portal connects you rapidly to our pathology experts, who are physicians of UPMC and faculty at the University of Pittsburgh.

As an established leader in informatics, telepathology, and clinical use of digital pathology, UPMC created the Portal as an instant bridge to our experts — helping to speed diagnosis and treatment.

Our team becomes your team with just a few clicks.
Through the Portal, you'll get immediate consultation from our team of internationally recognized leaders in pathology. Our Subspecialty Center of Excellence model houses experts in all subspecialty fields, no matter what your unique case presents.

Connect with your second set of eyes through the Portal today. 

 UPMC DIGITAL PATHOLOGY CONSULTATION SERVICES

 © 2011 UPMC  |  UPMC.com   

SAN FRANCISCO, Nov. 17, 2011 /PRNewswire/ -- Caliper® Life Sciences, a Perkin-Elmer Company, launched their new Vectra™ 2 with AQUA technology, an integrated solution for quantification of protein biomarkers in tissue, at the Molecular Targets & Cancer Therapeutics meeting here this week.  Caliper and HistoRx® collaborated on this new immunofluorescent imaging and analysis solution that will deliver objective, quantitative, and reproducible results: an improvement on traditional immunohistochemistry. The new product enables users to leverage the combined imaging and analysis power of Caliper's Vectra 2, an automated multiplexed and multispectral tissue imaging platform, and AQUA® technology, HistoRx's proprietary image analysis system, to provide an integrated solution to advance the identification and validation of new drug targets and improve assessment of drug response.  

"The Vectra 2 with AQUA technology represents a significant move forward for those interested in digital pathology with both brightfield and fluorescent capabilities," said Mark Gustavson, Ph.D., Director of Operations at HistoRx.  "By matching AQUA technology's fluorescence-based quantitative measurement with Caliper's market-leading multispectral imaging capabilities, users will be afforded a level of quality, performance and reproducibility that is unparalleled.  Caliper has outdone itself with enhancements to its earlier product, while HistoRx has ensured that customer needs for high-volume digital fluorescence analysis are addressed through AQUAServe™."

AQUAServe is a new server-based queuing software designed to enable 'walk-away' operation for multiple specimens while retaining the full functionality of HistoRx's flagship AQUAnalysis™ software.  AQUAServe will enable high-volume customers to take full advantage of Vectra's 200-slide loader.  Caliper will distribute the integrated product in the research market; the companies are also exploring collaborations in clinical research and diagnostics. Caliper and Vectra are trademarks of Caliper Life Sciences.

About HistoRx, Inc.

HistoRx, Inc. is a leading developer of tissue-based diagnostic solutions to advance individualized patient care.  The company's products and services are based on proprietary analysis of tissue biomarkers using AQUA technology.  AQUA technology is the only platform capable of precisely measuring protein biomarker concentration with sub-cellular resolution in tissue sections, enabling fully objective, reproducible, and automated analysis to guide drug development and therapeutic decision-making.  HistoRx is commercializing proprietary diagnostic products targeting improved treatment decision-making and patient outcomes in cancer care.  AQUA is a registered trademark of HistoRx, Inc.  For more information, please visit http://www.historx.com.

SOURCE: HistoRx, Inc.

Nice piece by Jeannie Crofts from Northwestern University Medill Reports Chicago and Liron Pantanowitz at UPMC on recent work at Stanford University using advanced technologies for tumor analysis in breast cancer.
Nov 16, 2011

Despite advances in treatment, breast cancer remains the most common cancer for women in the country, claiming 40,000 lives last year alone. A team of Stanford University engineers and doctors is hoping advanced technology will better evaluate breast cancer and potentially save lives. The study in the Nov. 9 journal of Science Translational Medicine showed how researchers trained computers to analyze tumors, which they say is more accurate than human analysis. Click here to read the full story.

Medill News Service asked a top anatomical pathologist to explain the challenges of evaluating breast cancer, what he thinks of the study and where medicine and technology go from here. Dr. Liron Pantanowitz is also an associate professor of pathology and biomedical informatics at the University of Pittsburgh Medical Center and a fellow of the College of American Pathologists.

Q. What are the challenges when it comes to diagnosing or evaluating breast cancer?
A. When pathologists evaluate breast cancer with the use of their microscope, they essentially have to perform two tasks - both with inherent difficulties. The first is to make an accurate diagnosis based mainly on the structure or form of the cells.  Once they have made a diagnosis of cancer, their next task is to provide some predictive information about the tumor’s behavior and prognosis, as well as information about that tumor’s likelihood of responding to specific targeted therapy. If this latter task is performed with the light microscope and human eye, then such scores may vary. However, if this scoring is performed using image analysis by examining a digital image, then it is likely that the results will be more reproducible. In other words, if every pathologist is given the same yardstick to perform these measurements, the results will be more accurate.

Q.  What do you think of this Stanford University study?
A. I think the study is a really well conducted one and is important for two reasons. First, there are likely many factors about cancers that may be important for prognosis. This study uncovered one such prognostic factor [A characteristic that can be used to estimate the chance of recovery from a disease or the chance of recurrence]. Secondly, it showcases very nicely the added value (what I call 'magic' or potential) of a digital pathology image. The data in the digital images of this study helped uncover the important prognostic feature of breast cancer. It is feasible that in the future pathologists may use this C-Path system (computer tool) to measure and report out this important factor in breast cancers to better manage patients.

Q. Do you think there is some promise with a computerized way of analyzing breast cancer?
A. Yes, definitely. As I mentioned above, computer-aided tools allow pathologists to provide more reproducible and accurate diagnoses. In fact, similar tools have been used for several years now by pathologists for breast cancer, some of which are FDA approved for this purpose. However, we still need to see some long-term studies to determine the real value of these tools.

Q. Where do you see medicine and technology going from here?
A. While tools like this are definitely helping us move towards practicing better personalized medicine, I do not believe that they will replace the pathologist. Rather, in this new era of digital pathology, pathologists will be able to use more and hopefully better tools. In radiology, for example, even though their images have been converted to digital format for many years now, radiologists are still required to interpret these images, called upon to apply appropriate computerized tools, and are in the best position to interpret the results from these analyses. I think the future of digital pathology is bright and with studies like this I am pleased to see that we are headed in the right direction.

In the wake of the FDA panel at Pathology Visions 2011 many questions have come to mind. 

As a dues paying, card carrying member of the College of American Pathologists, I have benefited in many ways professionally being associated with the professional organization.  From the time I was a junior member I have served on a number of committees, working groups and ad hoc task forces.  As a member of the Informatics Committee many years ago was involved with writing the checklist questions for telepathology that are now part of the laboratory accreditation program.  We also put together a course on digital pathology, whole slide imaging and telepathology that remains current today.  Through the foundation I have helped plan the CAP Futurescape Conference and review grant submissions for resident travel awards.  The foundation serves many other purposes including humanitarian aid, patient education and research support that have helped many.  

Every lab I have worked in has been has been CAP accredited and I have been fortunate to inspect many. The process is professional, collegial and always informative.  The College does a fantastic job of doing its part to ensure labs are providing accurate results while being safe and orderly workplaces.  

Truth be told, I get a majority of my CME from the College's Performance Improvement Program (PIP) surgical pathology slide program.  Dollar for dollar and hour for hour, a very effective way to stay current, see great cases and learn effectively without the hassle of travel or meeting registrations although I do enjoy the annual CAP meeting and have supported this for many years.

There are dozens of other committees, education programs, meetings, courses, philanthropic activities, etc... that the College offers on behalf of its members and laboratories.

With all that being said, I wonder if the College did not do enough to keep the FDA from regulating whole slide imaging hardware and software.  

Did the College discuss with the FDA, pathologists innately conservative nature and need and necessity to self-validated any device, test or application within their laboratories?  Did the College mention the degree of scrutiny we as a specialty self-validate, inspect, re-inspect, check and re-check our product, whether a CBC report or an anatomic pathology report?  Pathologists have procedures to read the actual procedures for the specific test, instrument or procedure.  Sit in a committee meeting that is discussing linearity surveys and you can begin to get a sense of what I mean.  If you know the joke about the internist, pediatrician, pathologist and surgeon who go duck hunting you also understand how physicians in general and pathologists in particular know their limits and pick and choose the tools they use to do their jobs (even surgeons).  

Did the College mention to the FDA that like the microscope, even the oldest, crappiest, dirtiest microscope in the department, in the right hands has been used effectively for decades to help save lives and take care of people?  

And where is the FDA when it comes to the microscope?

Oh yeah, they do not regulate those. Something about one being older than the other. Most of us probably don't know if it is a xenon, halogen, incandescent or some other gas or filament producing the white light turned blue by filters, shown through a paper thin tissue section, through a lens, off some mirrors (not cleaned for a long time) and through some more glass to the back of our retinas is "calibrated", "validated" or "Kohler illuminated".  

What we do now is if the tissue section stinks or the microscope image being presented to our neurons stinks, we go back, check the fixation, cutting, staining, light source, lens, condensors, etc... to make it right and offer the best quality product for the most accurate diagnosis. 

Shoot, I took my pathology boards, the test used to say that one is "board certified" by reading digital slides and images.  There were some glass slides as well with rudimentary microscopes.  The monitors were low resolution CRT monitors but perhaps this was the test -- if you can diagnose these images and slides with this lousy technology, you can probably do it with better equipment where you are actually going to practice.  I didn't know you could zoom in on the images to a higher magnification and still passed.  I don't know whats worse - not knowing I could do this when I should have or passing the exam without having to...Before this the boards would show kodachromes.  Folks in the back of large rooms claimed needing binoculars to see the images across the room.  And they passed too.

The same would be true for a slide scanner and viewer, we may all not know if it is "line" or "tile" or took 2 minutes or 4 but we would use it as any other tool and expect it to present a diagnostic quality image to diagnose.  We would know enough to know a bad image or bad scan much like we know enough to know when a microscope lens that is not suppose to has oil on it, needs a bulb changed or has the wrong oculars on it because a resident or colleague swapped yours out for another.

In their letters to the FDA in October of 2009, Drs. Visscher and Schwartz (at the time a past president of the College and not yet named CMO at Aperio) eloquently make these points in the day to day surigcal practice of pathology with many decades of combined experience in large laboratories with many responsibilities in those laboratories.  In addition to the microscope, they mention other information that is used in making a diagnosis and the value adds for digital pathology in their environments.

Additionally, Dr. Juan Rosai in his letter to the FDA prior to that meeting, one of the world's foremost pathologists maintains that if he can use the technology for the most difficult consults from all over the world, "routine" cases, since they are "routine" could be diagnosed with digital pathology accurately, closing his letter with "I would simply conclude by saying than from a technical and scientific standpoint I am thoroughly convinced that a diagnosis made on the basis of a well-prepared digital image of a representative whole section is just as informative and accurate as that performed by using the time-honored examination of a glass slide under the binocular microscope."

Did the College stand up for pathologists and make this statement based on its many members, peer-reviewed works from the pathology community and the College's own internal efforts to help ensure this technology was implemented and used appropriately?

I of course do not know.  If since and before October 2009 these discussions took place, I do not think the CAP has shared its efforts widely with its members or did not have these discussions.  

In a subsequent post on this issue, I will offer a way in which the College of American Pathologists can help ensure this technology is marketed and used as it is intended in a safe and effective manner.

High-tech Market Leader Is Set to Boost Growth with a Local Presence in India

Wetzlar, Germany / Delhi, India. Leica Microsystems, a world leading provider of microscopy systems and total histology solutions, today announced that it has acquired the microscopy and histopathology business of Labindia Instruments Pvt. Ltd., a leading solutions and service provider in India. This transition comes after more than 20 years during which Labindia has successfully distributed Leica’s products in India. Over 130 associates from Labindia have transferred to Leica Microsystems to sustain continuity for existing customers who will continue to benefit from Labindia’s wide experience of their needs and applications. In effect the acquisition is a natural culmination of a long and fruitful partnership and supports Leica Microsystems’ strategy to expand its operations in India.

“Leica Microsystems’ expansion of its commercial operations in India creates extended opportunities for interaction, collaboration and innovation to benefit all of our customers in the life sciences, industrial laboratories and hospitals for both diagnostics and surgery,” explains Arnd Kaldowski, President Leica Microsystems. “This acquisition will enable closer contact with our customers so that we can better support them in their day-to-day work.”

Labindia’s and Leica Microsystems’ shared history dates back to the end of the 1980s when the Indian company started serving Indian customers of Reichert Jung, which shortly afterwards became part of Leica. Vijay Bibikar, Director Labindia, comments: “We are convinced that at this point in time this agreement is a logical further step in the long history of close cooperation between Labindia and Leica Microsystems and that it will be beneficial to all our customers.” Says Kaldowski: “We highly appreciate the work that our partner Labindia has done driving our business in India to its present high level. We are excited about the future potential of the Indian market and the potential to help our customers to meet with their professional challenges.”

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Leica Microsystems is a world leader in microscopes and scientific instruments. Founded as a family business in the nineteenth century, the company’s history was marked by unparalleled innovation on its way to becoming a global enterprise.

Its historically close cooperation with the scientific community is the key to Leica Microsystems’ tradition of innovation, which draws on users’ ideas and creates solutions tailored to their requirements. At the global level, Leica Microsystems is organized in four divisions, all of which are among the leaders in their respective fields: the Life Science Division, Industry Division, Biosystems Division and Medical Division.

Leica Microsystems’ Biosystems Division, also known as Leica Biosystems, offers histopathology laboratories the most extensive product range with appropriate products for each work step in histology and for a high level of productivity in the working processes of the entire laboratory.

The company is represented in over 100 countries with 12 manufacturing facilities in 7 countries, sales and service organizations in 19 countries and an international network of dealers. The company is headquartered in Wetzlar, Germany.

“Flexibility, speed and objectivity” are the key benefits that PathXL’s Integrated Digital Pathology Solution is providing to the Oxford Biomedical Research Centre. 

PathXL, a leading provider of Digital Pathology Workflow Solutions, today announced the completion of a contract with the Oxford Biomedical Research Centre to provide the centre with an integrated digital pathology solution.

Drug discovery studies within the research centre will be greatly accelerated and enhanced due to the ability of PathXL’s solution to enable timely and accurate image analysis, a pivotal part of the translational medicine pathway. 

The solution brings together:

• PathXL's own PathXL Manager Virtual Slide Management and Hosting software
• Image Analysis from Visiopharm
• A comprehensive ISO 27001 hosting service from PathXL to enable Oxford BRC’s virtual slide sets to be stored and managed securely on the latest SAN storage technology.

PathXL's software works seamlessly with almost every available scanner, including the Hamamatsu NanoZoomer recently selected by Oxford BRC.

PathXL’s management software and suite of specific applications enable users to upload, archive, search, share, collaborate and report on huge volumes of pathology data without worrying about performance, security or ease of use and without getting locked into expensive proprietary standards and systems. PathXL can either be provided fully deployed on the customer’s site or as a hosted service over the web. This hosted option allows users to realise the full benefits of digital pathology, without major capital investment and without the need to support the solution in-house. Sharing slides with partners, pathologists and pharmas is at the heart of Oxford BRC’s day to day requirements so an important benefit of using PathXL is that pathologists can review cases with full clinical information instantly from any remote location.

Visiopharm’s software provides efficient tools for extracting morphometric data from Whole Slide Images. It is designed specifically for Pathologists, providing simple controls for identification, classification, and quantification of nuclei, membrane, cytoplasm and other structures of relevance.   It allows Pathologists to work in true stain space (through colour de-convolution).  The technology is based on some of the most recent breakthrough research in image analysis and pattern recognition; and the software has been designed to reduce both the cost of learning and the cost of computing.  

Oxford Biomedical Research Centre is a partnership between the University of Oxford and Oxford University Hospitals, funded by the National Institute for Health Research. Oxford BRC undertakes translational research, meaning first time studies of medical innovations in patients, to improve healthcare delivery for all. 

The organisation funds or part funds 185 research projects across 10 therapeutic themes with a specific clinical focus, and 4 cross-cutting themes providing technology and innovation infrastructure for the clinical themes.

Oxford BRC chose PathXL because it uniquely provides:

• A robust and open digital pathology platform to support their national and international research collaborations,
• Pre-integration with Visiopharm’s best of breed Image Analysis framework,
• Flexible and reliable hosting options for any elements Oxford BRC chooses not to support in house,
• A wealth of other applications available on the same PathXL platform – such as biobanking, research and clinical workflow solutions.

Professor Runjan Chetty, Director of Translational Pathology and Consultant GI/Pancreatic Pathologist says: “By adding PathXL’s Digital Pathology services to what we have to offer gives us the flexibility, speed and objectivity needed for biomarker assessment in particular.  TMA’s stained with novel biomarkers are a pivotal part of the translational medicine pathway and the timely, accurate scoring that image analysis provides will lead to the more interesting, relevant molecules lending themselves to target and drug discovery studies.  We foresee several other research and educational applications using PathXL for the wider remit of Digital Pathology.”

Philip Murray, Executive Vice President of PathXL, said “We are really delighted to have been selected by Oxford BRC to be their digital pathology partner.  Oxford is one of the top biomedical research organisations in the world and their choice of PathXL is pleasing affirmation of the strength of the solutions we have to offer.  It also reflects a clear trend in the adoption of Digital Pathology - the technology has been widely accepted in education for some years, but the Oxford contract bears out our own experience that research organisations now view the technology as central to their work.  We look forward to helping Oxford enhance the efficiency and outcomes of their vital research programmes.“ 

About PathXL

PathXL specialises in web-based software and workflows for Digital Pathology.  Its PathXL™ Manager product provides a robust, secure and open web-based platform to enable digital pathology users across all fields to manage, view and collaborate around virtual slides easily and efficiently.  In addition, PathXL provides a range of applications and workflows on top of PathXL™ Manager to deliver specific solutions to pathologists, scientists and students in Education, Research, Clinical and Biobanking settings.  PathXL also provides a full range of supporting services, including scanning, hosting, image analysis and consultancy.  PathXL operates in the UK, Europe and North America.

PathXL is a privately owned company, headquartered in Belfast, Northern Ireland.  For more information please visit: http://www.pathxl.com

Model under study may someday help, not replace, physicians, researchers say

November 9, 2011

In light of FDA comments on the same day these are the kind of tools and technologies that are additive to a pathologists' toolbox to appropriately diagnose and try to predict clinical behavior with morphology that digital pathology offers. In addiiton to what we can recognize -- cell morphology, nuclear morphology, mitoses, tubules, stroma, etc... but there are a lot of details we cannot see with light microscopy alone and computer algorithms can help us with.  No way a single pathologist can accurately, reproducibly and consistently assess 6,000 cellular features on dozens of slides.  Early results on a limited number of patients but this looks promising.  Stay tuned.

By Kathleen Doheny
HealthDay Reporter

WEDNESDAY, Nov. 9 (HealthDay News) -- A new computer model analyzes microscopic breast cancer images and predicts patient survival better than the pathologists who do the job now, new research suggests.

The computer program "provides information above and beyond what the physician provides, using the same data," said Daphne Koller, a professor of computer science at Stanford University and senior author of the study. The computer model is called Computational Pathologist, or C-Path.

Although the technique needs much more study, it may someday supplement analysis of breast cancer by pathologists, who use a process that has remained largely unchanged for 80 years, said Koller.

With the traditional method, pathologists examine a tumor visually under a microscope and score it according to an established scale. The scores help doctors figure out the type and diversity of the cancer. From that information, they calculate the outlook and course of treatment.

The pathologists' determination relies on three factors: what percent of the tumor is made up of tube-like cells; the diversity of the nuclei in the outer cells; and how often those cells divide.

But the system is subjective, said the study authors, whose computer model found that additional factors may influence survival. The study is published Nov. 9 in Science Translational Medicine.

Using the C-Path image analysis program, Koller's team trained the computer to analyze biopsied breast cancer tissue and to determine the cancer features that matter most and least in predicting survival.

The computer model looked at more than 6,000 cellular factors and found that characteristics of the cells surrounding the cancer -- the cancer's environment -- are also important in predicting survival.

"We found 11 [factors] ultimately that showed the most robust association with survival," said Dr. Andrew H. Beck, an assistant professor of pathology at Harvard Medical School, in Boston. He is the lead author of the study, done while he was a doctoral student at Stanford School of Medicine.

The researchers applied the C-Path system to images from two groups of patients with breast cancer. One group, from the Netherlands, included 248 people. The other, from Vancouver, Canada, had 328 patients.

The prognostic score generated by C-Path was strongly associated with survival in both groups, Koller said. The groups predicted to be high risk by C-Path were more likely to die in a given year than those predicted to be low risk, she said.

C-Path would help, not replace, pathologists. "We see it ultimately as a complementary approach," said Beck.

Neither Stanford nor the researchers has begun commercial development of the method, Koller said.

In a commentary accompanying the study, Dr. David L. Rimm, professor of pathology at Yale University School of Medicine, called the research ''landmark" work.

"C-Path potentially is the first truly objective, quantitative grading system for cancerous tissue and its surrounding stroma [connective tissue]," he writes.

However, Rimm and other experts agreed that further research is needed. "This isn't quite ready for prime time," he said.

Dr. Anil V. Parwani, a pathologist and division director of pathology informatics at the University of Pittsburgh Medical Center, said: "It (C-Path) has interesting potential and provides a novel look. The results are interesting, but the study is limited."

More information

To learn more about breast cancer, visit the College of American Pathologists.

Copyright © 2011 HealthDay. All rights reserved.

Tags: breast cancer, research, cancer, computers