Pathology Informatics 2010 – Sept 19-22, Boston, MA – Mark your Calendars

It goes without saying that this is THE pathology informatics meeting of the year and brings together two historically strong meetings - APIII and Lab InfoTech Summit (AIMCL prior to that). 

Outstanding faculty at a great venue.  Travel awards and CME availalble.

Whether you are a rookie or a seasoned veteran between the 3 tracks (see below) listed below from the conference website, this meeting will offer something to everyone. 

Another added deliverable of combining forces to have this meeting is the breadth and depth of exhibitors who will attend outnumbering either meeting on its own.

Pathology Informatics 2010

Click here to download conference brochure (PDF)

Pathology Informatics 2010 (PI-2010) is the product of more than 40 cumulative years of experience in providing continuing medical education in the area of pathology informatics. Its predecessor conferences were: (1) AIMCL, held in Ann Arbor from 1983 to 2003; (2) APIII held in Pittsburgh from 1996 to 2009; and (3) Lab InfoTech Summit from 2004 to 2009. A decision was made last year to merge these events into a single mega-event, bringing together their directors and staffs under the sponsorship of the Department of Biomedical Informatics, University of Pittsburgh, and the Association for Pathology Informatics, API.

Pathology Informatics, a subdiscipline of pathology and clinical laboratory medicine, is growing rapidly. In recognition of this fact, we offer registrants to PI-2010 three workshops on the first day of and three tracks on the subsequent two and one-half days. The three tracks are the following: (1) Applied Informatics; (2) Advanced and Experimental Informatics; and (3) Pathology Imaging Informatics. These three tracks are punctuated by plenary lectures to the whole group by noted pathologists and scientists. The first of these tracks closely approximates the previous Lab InfoTech Summit held in Las Vegas and the latter two track closely to previous APIII offerings.

We view the role of the exhibitors at PI-2010 as essential to the learning mission because they serve as partners in the deployment of new information management systems. Because the training of pathology residents and fellows in pathology informatics is essential to our mission, we have also taken special efforts to award travel grants to them in programs across the country and encourage pathology program directors to view the PI-2010 experience as an “away rotation” for such trainees. Special discounts on the registration fees are offered to them as well as to API and HIMA members.

Who Should Attend?

Pathology Informatics 2010 is an annual educational conference designed for world-wide collaboration, technology and learning together to come together in one meeting place.

PI2010 offers direct interaction with physicians, researchers, residents and graduate students, Industry-related developers, engineers, imaging informatics professionals, vendor representatives and many others interested in how informatics and imaging are transforming pathology, oncology and radiology. Prior knowledge of informatics is not required and courses are offered for individuals new to this field.

Conference Highlights

  • Three pre-conference workshops and three tracks to choose from over the course of the four conference days.

  • An eminent faculty consisting of most of the national experts in the field of pathology informatics in the country and from abroad.

  • Dawn-to-dusk programming over the course of four days including a gala welcoming reception on the first night of the conference and formal lecture-demonstrations by a selection of exhibitors.

  • Elegant conference space and room accommodations at the Westin Copley Place, one of the finest hotels in Boston.

Overall Conference Objectives

  • Present practical and emerging solutions for automated information and image management in pathology and the clinical laboratories.

  • Describe how workflow in the clinical laboratories and pathology can be supported and enhanced by new software and hardware solutions.

  • Understand the various software and hardware products available in the clinical laboratory and pathology market by interacting with a large number of exhibitors.

  • Present new research in pathology informatics on the basis of submitted competitive scientific abstracts.

  • Provide a forum for basic pathology informatics instruction for house officers and fellows in pathology training programs.

Is the iPad Radiology’s Dream Device For Mobile Healthcare?

One could substitute "pathology" for "radiology" given similar workflow and resolution issues and make the same arguments...

Is the iPad radiology's dream device for mobile healthcare?
By Erik L. Ridley
AuntMinnie staff writer
June 24, 2010

It's the mobile device that's taking the consumer electronics world by storm. But does the iPad have a role in medical imaging? Early adopters say yes -- they believe the iPad could unlock the potential of mobile computing in radiology.


The iPad has only been on the market for three months, but it has already generated significant interest and enthusiasm among radiologists and referring physicians. Efforts to define the role of the iPad in radiology are still in their early stages, but a number of researchers and vendors active in developing software applications for the iPad believe it could fulfill a role in bringing access to images and advanced visualization technology to the point of care.

Widespread utilization, however, will require addressing a number of challenges, not the least of which is security.

Packing a punch

The iPad owes its potential in radiology to its mix of size, portability, battery life, and relatively high spatial and contrast resolution, said Mark McEntee, PhD, a lecturer of diagnostic imaging at the University College Dublin School of Medicine and Medical Science in Dublin, Ireland.

The iPad's vital statistics also compare favorably to the previous mobile platform of choice, the iPhone. The iPad's 9.7-inch display provides 1024 x 768-pixel resolution at 132 pixels per inch (PPI), while the iPhone 4 has a 3.5-inch (diagonal) display with a resolution of 640 x 960, although the iPhone sports 326 PPI. The iPad weighs just 1.5 lb, much less than most conventional laptops.

The larger display allows images to be displayed at or closer to their native resolution than they would on smaller portable devices, McEntee said. The battery life of the iPad is also an advantage over the iPhone; McEntee reported using the iPad for two busy days of eight-hour use without having to recharge.

"The sleep mode is fast and responsive and uses tiny amounts of energy," McEntee said. "This is a huge advantage [over] the iPhone, whose battery finds it hard to keep up with the demands of the power-hungry display."

Clinical benefit

The iPad will likely have significantly more value within a clinical environment than the iPhone, said Mark Cain, chief technology officer of advanced visualization firm MIMvista of Cleveland.

"When you consider sitting with a patient and explaining the results of a scan, there is nothing more personal than being side-by-side, images in hand," he said. "The iPhone is the more portable choice and will be better suited for those who need access at any time, not just in the hospital."

The additional resolution on the iPad is like gold for a radiologist, Cain said.

"The amount of panning required to see a large image is significantly reduced, and that saves time," he said.

The most obvious uses for the iPad in radiology include reviewing images, reading reports, and accessing medical records, said Janice Honeyman-Buck, PhD, editor in chief of the Society for Imaging Informatics in Medicine's Journal of Digital Imaging.

In addition to the larger, high-quality screen, physicians will appreciate the speed of the iPad, Honeyman-Buck said in an e-mail to AuntMinnie.com.

"It turns on quickly, seems to open and display websites and documents faster than most laptops, and it is easy and intuitive to use," she said.

The ability to provide mobile and secure access to scheduling, patient information, historical images, and other key information without being tied down to a PC offers an opportunity for efficiency gains, said Paul Merrild, senior vice president of marketing and business development at advanced visualization and healthcare IT developer Merge Healthcare of Milwaukee.

"iPads can theoretically contain the entire electronic record of the patient's imaging experience, and can be handed along the workflow as needed," Merrild said. "At the end, the iPad has potential to provide a nice teaching and communication tool between the radiologist, referring physician, and the patient."

Radiologists could review a worklist, see overall activity within the imaging practice, view preliminary images from a technologist, or sign reports using the iPad, Merrild said. The iPad could also provide access to the Web for reference information and offer instant viewing of an electronic health record (EHR).

"This device can facilitate movement of studies as needed, communication among anyone involved in a study, and sharing of images with patients," Merrild said. "In a hospital setting, images could be given to all clinical team members at the patient's bedside. The iPad could, in essence, become a portable film jacket, but one with so much more information included."

MIMvista's Cain said that every imaging application would be compelling on the iPad.

"When you consider that the iPhone screen already makes some PACS viewers from the past look dull, the iPad is just brilliant," Cain said. "Furthermore, we think every current HIS/EMR/PACS system could have an iPad interface. It seems like it would be much more economical for hospitals to have personnel carrying iPads than hundreds of PCs taking up space in every room."

The iPad also shows promise for viewing images from PACS and viewing live procedure video, according to Tony Molinari, vice president of sales and marketing at PACS developer Foresight Imaging of Lowell, MA.

3D content

Thanks to its larger size and improved resolution, the iPad offers more potential than the iPhone for using thin-client advanced visualization software, said Vikram Simha, chief technology officer at advanced visualization firm Vital Images of Minnetonka, MN. The company has seen interest from a number of its customers in using the iPad with its 3D software.

"We see a good opportunity for bringing image/result review to the bedside with an iPad to improve communication between radiology and the referring physician," Simha told AuntMinnie.com. "It has the right form factor and resolution to bring advanced visualization to the referring physician, closer to patient care."

The iPad also offers the potential for delivering interactive, rich 3D content directly into the hands of a surgeon or other referring physicians, according to Robert Taylor, PhD, president and CEO of advanced visualization vendor TeraRecon of San Mateo, CA. The iPad's design as primarily a content viewer rather than a content production device even fits radiology's traditional workflow model.

"This 'consumption' of content created by radiology, without much ability to 'create' content directly, seems to be a great fit for the respective roles and goals of radiology and its physician customers," Taylor said.

Primary diagnosis?

But don't expect radiologists to ditch their PACS workstations and start interpreting images on iPads any time soon. The iPad would not be suitable for primary diagnosis due to its contrast ratio (maximum luminance/minimum luminance) and calibration issues, McEntee said.

For example, the iPad has a maximum luminance of 270 cd/m2, which, while higher than the average of 150-200 cd/m2 seen in off-the-shelf displays, is much lower than your average primary interpretation display, which has an average maximum luminance of 500-600 cd/m2. The iPad's minimum luminance is 0.3 cd/m2, which yields a still impressive contrast ratio of 900:1 for a portable device; the iPhone and Dell Axim v51 both have a contrast ratio of 100:1, McEntee said.

Display calibration is also an issue, McEntee said. "The iPad cannot currently be calibrated as software [and] cannot be installed in the normal way; presumably, we would 'need an app for that,' " he told AuntMinnie.com.

In addition to commercial offerings, the popular open-source OsiriX DICOM image viewer will undoubtedly make its way to the iPad, although an iPad-specific version is not yet available.

The current OsiriX version for the iPhone can be viewed on the iPad's full screen using the iPad's 2x button. However, this magnification can accentuate the resolution differences between the iPad and iPhone, leading to grainy text. "Presumably, later releases will solve this," McEntee said.

An OsiriX version for the iPad is listed as "soon available," according to a January 29, 2010, post on the OsiriX website.

Ed Heere, president and CEO of CoActiv Medical Business Solutions of Ridgefield, CT, said the company's OsiriX-integrated iPhone application can work well on the iPad as a temporary solution, providing four times the viewing size as measured in square inches as the iPhone when using the viewer's 2x button.

"The high-resolution iPad screen provides a bright, crisp image even at the enlarged size," Heere said. "Future iPad-specific apps will allow simultaneous viewing of current and prior studies as well as multiple series/image windows and much greater add-in functionality."

Other educational apps will also likely find use on the iPad, McEntee said.

Limitations

For all of its advantages, the iPad does come with some limitations to its use in radiology applications. One of the main concerns with clinical use of the iPad is the security of patient information and loss or theft of the device, McEntee said.

"To comply with HIPAA, the iPad would have to be locked with a pass key and the access to imaging should be via a Web server," McEntee said. "This should be password-authenticated and encrypted."

Also, no images should be stored on the device itself, he said.

"The locked-down nature of the hardware for the iPad means that it is very difficult to operate as a replacement for a laptop," McEntee said. "You cannot save files to the iPad; although certain apps allow a similar functionality, this seeming disadvantage makes it more secure from an imaging perspective. If lost, you can be assured that -- provided the previous user logged out -- there are no patient data on the iPad."

Hospital IT departments will have to work on the logistics of ensuring secure access to data, according to Honeyman-Buck. "These devices cannot be left lying around where another person could access protected patient information," she said.

The tablet PC's larger size can also be a detriment. Because it won't fit in a pocket, it will need some sort of shoulder-strap cover that doesn't impede the physician's easy access to the screen, Honeyman-Buck said.

In contrast to the more mobile form factor provided by the iPhone, the iPad would probably take the place of a patient chart -- kept in a slot on a bed or a wall, and picked up by various different users when access to enterprise data is needed, TeraRecon's Taylor said.

"So, the iPad will need some software changes to find a niche in healthcare, because it will need to be a locked-down, tightly controlled IT asset accessible safely by multiple users -- in that regard, it's not there yet," Taylor said.

The weight of the iPad can make it difficult to carry around and use, Foresight's Molinari said. In addition, it suffers from connectivity issues (such as no USB support).

And institutions need to be aware of more than just the physical security of the iPad. A virtual private network (VPN) will be required to use the iPad for secure, HIPAA-compliant remote viewing of images, CoActiv's Heere said.

"Perhaps future Apple [operating system] versions and future apps will allow the use of SSL connectivity like on our PC platforms, eliminating the need for VPN tunnels," Heere said.

FDA impact

Also yet to be determined is the impact on the iPad of the U.S. Food and Drug Administration's (FDA) decision earlier this year to classify MIMvista's Mobile MIM iPhone image viewing software as a class III device requiring premarket approval (PMA). If the FDA's decision stands, it could hamstring the development of commercial image review apps by requiring software developers to go through the time-consuming PMA process.

Indeed, MIMvista's Cain believes that the FDA's logic in regulating iPhone software would also apply to the iPad.

"The iPad makes portable image viewing significantly more usable and practical, which seems to challenge the claim that it is not a medical device," he said.

Merge's Merrild said that his company believes there will not be issues with the FDA regarding radiology workflow tasks such as scheduling, insurance verification, billing, and report viewing.

"Even with very limited image viewing capabilities -- without the presence of measurement tools or advanced features such as [multiplanar reformatting] or angle measurements -- this will likely be acceptable to regulators and users," Merrild said.

In the meantime, innovation in terms of mobile image review will definitely be limited until the FDA or other authorities in other jurisdictions provide a clear ruling on the use of these devices as part of a diagnostic toolset, Merrild said.

"We have confidence that these regulatory issues will eventually be resolved," Merrild said. "We believe the larger issue facing patient safety in radiology currently is the use of open-source [non-FDA approved] software on workstations."

CoActiv's Heere believes the initial and somewhat undefined position of the FDA on the use of mobile devices in radiology will ultimately be resolved in favor of a "patient care" approach.

"A strict interpretation of some of the current information would suggest that even the use of laptop or notebook computers would require a PMA for use in radiology," Heere said. "This would create a real problem for the hundreds of thousands of current users of these existing mobile devices. Until a formal published position is released by the FDA, we stand by our original position that the iPhone and iPad use of any of our products is strictly for review purposes and not for any diagnostic or interpretive use."

By Erik L. Ridley
AuntMinnie.com staff writer
June 24, 2010


Scientists Create 3D Models of Whole Mouse Organs

Yale University engineers have for the first time created 3D models of whole intact mouse organs, a feat they accomplished using fluorescence microscopy. The team reports its findings in the May/June issue of the Journal of Biomedical Optics, in a study published online this week.

Combining an imaging technique called multiphoton microscopy with “optical clearing,” which uses a solution that renders tissue transparent, the researchers were able to scan mouse organs and create high-resolution images of the brain, small intestine, large intestine, kidney, lung and testicles. They then created 3D models of the complete organs—a feat that, until now, was only possible by slicing the organs into thin sections or destroying them in the process, a disadvantage if more information about the sample is needed after the fact.

With traditional microscopy, researchers are only able to image tissues up to depths on the order of 300 microns, or about three times the thickness of a human hair. In that process, tissue samples are cut into thin slices, stained with dyes to highlight different structures and cell types, individually imaged, then stacked back together to create 3D models. The Yale team, by contrast, was able to avoid slicing or staining the organs by relying on natural fluorescence generated from the tissue itself.

When combined with optical clearing, multiphoton microscopy—so called because it uses photons to excite naturally fluorescent cells within the tissue—can image a larger field-of-view at much greater depths and is limited only by the size of the lens used. Once the tissue is cleared using a standard solution that makes it virtually transparent to optical light, the researchers shine different wavelengths of light on it to excite the inherently fluorescent tissue. The fluorescence is displayed as different colors that highlight the different structures and tissue types (in the lung, for example, collagen is depicted as green while elastin shows up as red).

“The intrinsic fluorescence is just as effective as conventional staining techniques,” said Michael Levene, associate professor at the Yale School of Engineering & Applied Science and the team leader. “It’s like creating a virtual 3D biopsy that can be manipulated at will. And you have the added benefit that the tissue remains intact even after it’s been imaged.”

The Yale team was able to reach depths in excess of two millimeters—deep enough to image complete mouse organs. Typical tissue samples taken during patient biopsies are about this size as well, meaning the new technique could be used to create 3D models of biopsies, Levene said. This could be especially useful in tissues where the direction of a cancerous growth may make it difficult to know how to slice tissue sample, he noted.

In addition, the technology could eventually be used to trace fluorescent proteins in the mouse brain and see where different genes are expressed, or to trace where drugs travel in the body using fluorescent tagging, for example.

“Fluorescence microscopy plays such a key role throughout biology and medicine,” Leven said. “The range of applications of this technique is immense, including everything from improved evaluation of patient tissue biopsies to fundamental studies of how the brain is wired.”

Other authors of the paper include Sonia Parra, Thomas Chia and Joseph Zinter, all of Yale University.

Citation: Journal of Biomedical Optics 15(3), 036017 (May/June 2010)

Precision breast panel analysis with the Ventana VIAS Image System

Ventana
Medical Systems, Inc., the leading provider of automated image analysis tools
for breast panel interpretation, recently announced that the CAP HQIP-B 2009
Survey for laboratory proficiency testing of HER2/neu showed the Ventana VIAS
image analysis system as the first choice of labs around the country. In the
recent CAP survey the VIAS was used for automated image analysis of HER2/neu by
46% of laboratory sites using automated analysis.

As
pathologists become more involved in generating information that directly
impacts treatment decisions as part of the personalized medicine model, there
is an increasing need for advanced laboratory tools that go beyond traditional
methods and diagnostics. The VIAS system is an automated system that can assist
the pathologist in the assessment of breast cancer protein markers such as HER-
2/neu, ER, PR, p-53, and Ki67. After the primary diagnosis is made, the
pathologist can choose to utilize the VIAS system to quantify the level of
estrogen receptor, progesterone receptor or HER2 protein objectively via
computerized algorithms rather than relying solely on subjective assessment,
which can vary between observers of different skill levels.

Ventana
Medical Systems is committed to providing innovative solutions for digital
pathology and image analysis as part of their product offering for hospitals
and laboratories throughout the country. The Sierra Medical Center in El Paso,
Texas started utilizing the image analysis system in 2008, and has seen its
tremendous value for the past couple of years in allowing pathologists to
detect and classify cancerous cells more quickly. “The VIAS image analysis
system improves the accuracy of immunohistochemistry testing and provides
reproducible results when interrupting breast cancer cases,” says pathologist
Dr. Judith Pester, Pathologist at Sierra Medical Center. “VIAS has been
instrumental in providing us with more accurate test results and ensuring that
patients receive appropriate treatment of their breast carcinoma.”

 

About
CAP Proficiency Testing

The
College of American Pathologists (CAP) Surveys program is the largest external
quality assessment program in the world. As such, it provides an unparalleled
selection of challenges and offers the largest database in existence for
interlaboratory comparison. The CAP has accumulated significant experience in
managing this type of program and is knowledgeable in its uses and limitations.
http://www.cap.org

About
Ventana Medical Systems, Inc.

Ventana
develops, manufactures, and markets instrument/reagent systems that automate
tissue preparation and slide staining in clinical histology and drug discovery
laboratories worldwide. The Company's clinical systems are important tools used
in the diagnosis and treatment of cancer and infectious diseases. Ventana drug
discovery systems are used to accelerate the discovery of new drug targets and
evaluate the safety of new drug compounds. In addition, the Company offers
premier workflow solutions designed to improve laboratory efficiency, providing
safeguards to enhance the quality of healthcare. Ventana is a wholly owned
member of the Roche Group. For more information on Ventana Medical Systems,
Inc. visit
http://www.ventanamed.com.

Contact: Alana Bolton, Phone:
520.229.4164 / e-mail:
alana.bolton@ventana.roche.com

Dako and Omnyx Sign Agreement within Digital Pathology

GLOSTRUP, Denmark & PITTSBURGH, Jun 21, 2010 (BUSINESS WIRE) -- Dako, a Danish-based world leader in tissue-based cancer diagnostics, and Omnyx, a leader in digital pathology solutions, announced today that they have entered into a three-year agreement to develop clinical algorithms for digital pathology. The aim is to support pathologists in generating even more accurate, objective and reproducible diagnostic results.

Under the agreement, Dako will utilize its expertise in staining and image analysis to develop image analysis algorithms that will be incorporated into the Omnyx digital pathology platform as part of Omnyx's overall strategy of providing pathologists with a comprehensive digital work environment. The algorithms developed under the agreement will be specifically optimized for Dako's breast cancer panel of immunohistochemical and in-situ hybridization tests.

"Digital pathology offers significant potential to improve the quality of cancer diagnosis by improving the consistency of test interpretation. The Omnyx/Dako partnership will help standardize the reagent-to-result process and enhance the ability of pathologists to interpret breast cancer tests," says Mike Becich, vice chair of Pathology Informatics at the University of Pittsburgh Medical Center in Pittsburgh.

Immunohistochemical and in-situ hybridization tests are widely used by pathologists worldwide to help determine the diagnosis and prognosis and predict patients' response to specific therapies for a large number of cancers, including breast cancer. Digital pathology is enabled by imaging systems and computer technology that allow for the digitization of glass slides and efficient management of the resulting image data. It enables pathologists to improve productivity by reviewing tissue sections without handling traditional glass slides and to interpret tissue-based test results more objectively with the help of image analysis algorithms. Digital pathology also holds tremendous potential for standardizing test interpretation and for improving accuracy in cancer diagnostics.

"Dako is committed to improving patient care by finding ways to further enhance the standards and accuracy in cancer diagnostics," said Lars Holmkvist, CEO of Dako. "This agreement with Omnyx is another important step in the implementation of our strategy by joining forces with strong digital pathology partners. Digital pathology is important as it offers great potential to improve the quality of cancer diagnosis and care by helping standardize test interpretation to the benefit of pathologists and their patients."

"Omnyx sees a future where algorithms help pathologists make better clinical decisions," said Gene Cartwright, CEO of Omnyx. "Our partnership with Dako will allow us to provide reliable, high-performance IHC algorithms to clinicians who use Dako tests. Enabling algorithms within the context of a complete digital workflow environment provides pathologists with a powerful set of tools to improve both confidence and efficiency."

About Immunohistochemistry

Immunohistochemistry refers to the process of localizing antigens (e.g. proteins) in cells of a tissue section exploiting the principle of antibodies binding specifically to antigens in biological tissues. Immunohistochemical staining is widely used in the diagnosis of abnormal cells such as those found in cancerous tumors.

About Dako

Dako, based in Denmark, is a global leader in tissue-based cancer diagnostics. Hospital and research laboratories worldwide use Dako's know-how, reagents, instruments and software to make precise diagnoses and determine the most effective treatment for patients suffering from cancer. Employing more than 1000 persons and operating in more than 70 countries, Dako covers essentially all of the global anatomic pathology markets.

About Omnyx

Omnyx, LLC is a joint venture of GE Healthcare and The University of Pittsburgh Medical Center with locations in Pittsburgh and Piscataway, NJ. The company is developing an enterprise platform to transform the scope of pathology to an all-digital workflow. The company will sell their digital pathology platform to clinical labs and offer an enterprise software platform for image management, workflow automation, image analysis algorithms and system integration along with its high speed whole-slide scanners. Close collaboration with pathologists at UPMC and other institutions along with their relationship with GE Healthcare allows Omnyx to focus its innovation on the needs of anatomic pathologists worldwide. Omnyx digital pathology products are currently in development and have not yet been cleared by the FDA.

SOURCE: Omnyx, LLC

Compelling Results from SOX2 Expression Analysis Study in NSCLC using Definiens Tissue Studio

On June 10th at the Definiens Digital Pathology Webinar Series, Sven Perner and Theresia Wilbertz from University of Tuebingen presented a compelling study regarding SOX2 expression analysis in NSCLC, comparing two independent NSCLC cohorts. Their findings indicated that:

1. Elevated SOX2 expression is found in patients with squamous NSCLC, and correlated with better prognosis
2. Elevated SOX2 expression in these cohorts correlated with elevated SOX2 copy numbers as observed by FISH

Please note that the webinar is available for watching in HD – just click one of the HD options in the lower right. You can then click the “full screen” button and watch the webinar clearly.

 

 

 

 

CAP Pathologist Service Spotlight Award Announced

Congratulations to Drs. McMonigal, Neal and Eisen.

CAP Pathologist Service Spotlight Awards Announced

As director of Clinical Laboratories at NASA, Kathleen A. McMonigal, MD, FCAP, attends each landing of the space shuttle and ensures the integrity and safe keeping of the astronauts’ medical specimens. Dr. McMonigal inventories and organizes a retrieval system for all astronaut specimens held by NASA since the 1960s. She developed a protocol for astronauts to obtain their own specimens. The College proudly recognizes Dr. McMonigal with the Pathologist Service Spotlight Award for her work in setting medical standards for astronaut selection prior to review by the Aerospace Medicine Board. The College also honors Margaret H. Neal, MD, FCAP, and recognizes her leadership in the development of the CAP Mentor Program. As a seasoned pathologist, Dr. Neal gives guidance to pathologists new to the specialty and contributes to the program’s success. Richard N. Eisen, MD, FCAP, is the newest recipient of the Spotlight Service Award for his work to advance cancer research and the specialty.
Learn more.


Image Analysis as a Tool for Prognostic and Predictive Biomarkers in Breast Cancer – How Reliable Is It?

Definiens Digital Pathology Webinar Series:

Image Analysis as a Tool for Prognostic and Predictive Biomarkers in Breast Cancer – How Reliable Is It?

June 30th, 11am EDT (4pm GMT)

Register: https://www2.gotomeeting.com/register/434138978

In this talk, Dr. Marilyn Bui and Mark Lloyd of the Moffitt Cancer Center will discuss their assessment of Definiens Tissue Studio for analysis of prognostic and predictive biomarkers in breast cancer.

The agenda for the webinar will be:

? Current standards in IHC and pathology
? Advantages of automated image analysis
? How Definiens Tissue Studio is used for digital pathology image analysis
? Case study comparing Definiens Tissue Studio analysis results with “gold standard” immunohistochemistry Her2 and ER best practices.
? Results

Speakers:

Dr. Marilyn Bui – Scientific Director, Analytic Microscopy Core, Moffitt Cancer Center, Tampa, Florida

Mark Lloyd – Staff Scientist, Analytic Microscopy Core, Moffitt Cancer Center, Tampa, Florida

Eye-Candy: Detection of Crypt Volume and Ki67 nuclear biomarkers using Definiens XD

This is just amazing stuff. Watch Definiens XD in action first locate the nuclei; determine positive and negative Ki67 nuclei; locate the small intestine crypt; fill the crypt and “cut” the top to establish the area that can be measured.

This was a pre-clinical study done by Novartis to use both Ki67 positive nuclei as well as the area of the small intestinal crypts in a rodent model as part of their FDA submission packet. Imagine doing this manually across thousands of animal tissue samples? Ouch!

This is just a testament to how powerful Definiens is – you really can measure anything in an image.

Watch the video:

 

Webinar from CRi on Quantitating Multiple Protein Expression in Intact Tissue

Event-june_2010_webinar_banner_jpg-632010 Multispectral imaging bridges the gap between ‘omics’ multiplexed array-based techniques and conventional tissue imaging. This webinar provides an overview of how leading scientists are using multi-label imaging in combination with pattern-recognition image analysis software to analyze biomarkers specific to important disease-related cellular states, such as signaling configuration, stem cell pluripotency, and receptor expression.  Call +1-781-935-9099 ext 158 or e-mail us NOW at toleary@cri-inc.com to sign up for this FREE webinar.

Featured Speaker: James Mansfield
Director, Multispectral Imaging Systems
Cambridge Research & Instrumentation, Inc.
Title: Quantitating multiple protein expressions in intact tissue.
Date: Thursday, June 17, 2010
Time: 1:00 PM - 2:00 PM EDT
After registering you will receive a confirmation email containing information about joining the Webinar.

REGISTER HERE

CRi technology helps to bridge the gap between advances made in the ‘omics’ multiplexed array-based techniques and conventional tissue imaging. This webinar provides an overview of how leading scientists are using multi-label imaging in intact tissue, in combination with pattern-recognition image analysis software to analyze biomarkers specific to important disease-related cellular states, such as signaling configuration, stem cell pluripotency, and receptor expression.  

Improved specificity in determining disease subclasses through protein expression profiles is a goal of many studies. Obtaining this specific information requires the analysis of multiple proteins on a per-cell basis in intact tissues, from specific architectural contexts.

In pharmaceutical drug development, revealing correlations between protein activity and clinical outcome supports target validation, trial design, patient selection, response assessment, and, if trials are successful, the diagnostic component of theranostics. However, the ability of tools to support these activities depends strongly on their precision and accuracy for quantitating protein labels. Multispectral imaging coupled with automated learn-by-example analysis software offer a powerful combination to generate reproducible data of per-cell phenotypes in tumor regions or other regions of interest. Many techniques deployed today, such as those based on microarray detection, or analysis of sample lysates, provide data that are, in fact, averages from volumes of tissue, including many cells not of interest. These methods blur-out key proteomic information that resides at the cellular level and that relates to the signaling states of individual cells.

System Requirements
PC-based attendees
Required: Windows® 7, Vista, XP, 2003 Server or 2000
Macintosh®-based attendees
Required: Mac OS® X 10.4.11 (Tiger®) or newer

Space is limited.
Reserve your Webinar seat now at:
https://www1.gotomeeting.com/register/833013281

Thoughts on How Digital Pathology Will Usher in New Era of Personalized Medicine

Dr. Joseph Krueger over at his Instablog has some interesting comments concerning digital pathology and personalized medicine. 

He writes "This new technology, whole slide imaging, or digital pathology, is moving pathology closer towards an electronic science. Radiologists have worked exclusively from digital media for years, but pathology is just now moving in this direction. The entire tissue section on the glass slide is scanned in a high-throughput scanner, made by established digital pathology companies like Aperio, Bioimagene, Zeiss, and Hamamatsu, or newer entrants with even faster scanning technologies like Leica, Philips, and GE’s Omnyx subsidiary. The pathologist can now read and diagnose from a computer screen, eliminating the need to ship glass slides around during clinical trials. More importantly, the pathologist can run computer image analysis across the tissue section, generating quantitative information highly useful in the development of a companion diagnostics program. This methodology not only speeds up the pathological assessment process, reducing cost, it provides the means for a rapid and inexpensive companion diagnostic based on the “gold standard” assessment of pathology."

Who could disagree with that?  I think Dr. Krueger touches on one of the many values of digital pathology; the power of image analysis with a digital data set, a real advantage over analog review alone. 

The post provides interesting background and further discussion that is worth checking out:

Digital Pathology Will Usher in New Era of Personalized Medicine

Case of the Week 53

Welcome back to Case of the Week! It’s been a while since our last post due to the holiday, but now we’re back on schedule with a fun video for you:

The following insect was removed from the flank of a Medical Resident from Minnesota who had mistaken it for a ‘mole’ or ’skin tag’. He notes that it had been present for at least 5 days. He is concerned that he is now at risk for an arthropod borne disease; specifically he is worried about Lyme disease. What should you tell him?

Click here to view the embedded video.

Here are some accompanying images to aid in identification.

Pathology Visions Announces Keynote Speaker; Abstract Deadline Extended

Join Us for Pathology Visions 2010

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SYLVIA ASA, MD, PhD, ANNOUNCED AS KEYNOTE SPEAKER
Sylvia Asa: Pathology Vision 2020Pathology Visions is pleased to announce Sylvia Asa, MD, PhD, as the 2010 Keynote Speaker. Dr. Asa is the Pathologist-in-Chief and Medical Director of the Laboratory Medicine Program at the University Health Network. As head of the largest pathology department in Canada, Dr. Asa has made innovative changes to the practice of the discipline. To read more about Dr. Asa, click here.



PATHOLOGY VISIONS ABSTRACT DEADLINE - ONE WEEK LEFT!
The deadline to submit abstracts for oral and poster presentations is June 15! To submit your abstract, click here.

Poster presenters will be given a two-day display opportunity. Outstanding posters will be eligible to receive complimentary conference registration.

As a presenter, you can share your experiences and discuss potential uses for digital pathology in the future. Submission topics include:

  • Business Case/Reimbursements
  • Cytology
  • Diagnostic Pathology
  • Disease-Specific 
  • Drug Development
  • Education
  • Frozen Sections
  • Hematopathology
  • Image Analysis
  • Immunohistochemistry (IHC)
  • Informatics
  • IT
  • Personalized Medicine
  • Research Applications
  • Telepathology
  • Toxicologic Pathology
  • Validating Algorithms

To submit your abstract, click here


ABOUT PATHOLOGY VISIONS
Pathology Visions is the annual meeting of the Digital Pathology Association, held October 24-27, 2010, at the Sheraton San Diego Hotel and Marina on the beautiful San Diego bay. Enjoy thought-provoking discussions on digital pathology applications and enrich your conference experience through the following:

  • Exciting presentations on new applications
  • Peer-to-peer discussions on digital pathology 
  • Hands-on workshops
  • Scientific poster sessions
  • Digital pathology demonstrations
  • Networking events

Register Now!


Digital Pathology AssociationABOUT THE DIGITAL PATHOLOGY ASSOCIATION (DPA)
The mission of the DPA is to facilitate awareness of digital pathology applications in healthcare. Members are encouraged to share best practices and promote the
use of the technology among colleagues in order to demonstrate efficiencies, awareness, and its ultimate benefits to patient care. To learn more or apply for membership, visit http://www.digitalpathologyassociation.org.  
 

 

For more information, visit
http://www.pathologyvisions.com

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Opportunity at ChemImage for Histopathology Algorithm Scientist

EMPLOYMENT OPPORTUNITY

HISTOPATHOLOGY ALGORITHM SCIENTIST
REPORTS TO: BOB SCHWEITZER, LEAD ALGORITHM SCIENTIST

JOB DESCRIPTION:

  • This person will be responsible for developing and implementing image and spectral-based algorithms for detection, classification, and quantification of materials in hyperspectral images.
  • Research and develop novel data analysis algorithms for product and application development
  • Collaborate on gov’t proposals and grants in the area of algorithm development
  • Generate and author patents
  • Support on-going gov’t and commercial projects
  • Work directly with software engineers to implement algorithms into commercial software products

COMPANY:

  • ChemImage Corporation located in Pittsburgh, Pa. is the World Leader in Chemical Imaging technology. We are looking for individuals with initiative, integrity and intelligence to join our exciting team. We seek candidates who demonstrate the independence to identify their own path within the organization, yet have the ability to contribute within a team environment.

REQUIREMENTS:

  • MS, PhD in Electrical Engineering, Applied Math, Chemistry or related, with emphasis in signal and image processing
  • Experience with digital pathology images of stained tissue sections
  • 3+ years strong Matlab programming experience
  • Solid understanding of multivariate statistics
  • Experience with hyperspectral image analysis, and/or chemometric techniques such as pattern recognition, calibration, classification and optimization
  • Well versed in current algorithm literature
  • Experience with imaging processing techniques such as image filtering, segmentation, multi-sensor image fusion and image registration
  • Experience in the development of commercial software in a Windows environment in either C# / C++ programming
  • A solid background in the .net environment is a plus
  • A strong background in the use of the Software Development Lifecycle and quality processes – especially as defined by the IEEE Software Engineering standards
  • Total commitment to quality and complete attention to detail
  • The ability to think logically
  • Excellent written and oral communication skills

COMPENSATION:

  • ChemImage offers a competitive salary, including an outstanding benefits package. We are an equal opportunity employer.

PLEASE SUBMIT YOUR RESUME TO:

Bob Schweitzer
Lead Algorithm Scientist
7301 Penn Avenue
Pittsburgh, PA 15208
Fax: (412) 241-7311
Email: schweitz@chemimage.com

Flagship Biosciences makes training courses available

Flagship Biosciences offers two hour training course in advanced topics in digital pathology. These courses are held once weekly, with enough time between courses for students to practice what is learned in the previous course.  Flagship Biosciences provides histopathology services to biotech,pharmaceutical, medical device and cosmetics companies.

They deliver their pathology services digitally, providing accurate measurements of efficacy and toxicity across an entire tissue section.

They also recently named Dr. Steven Potts formerly of Aperio as their new CEO and Chairman.  Bio below from Flagship Biosciences website.

Steven J. Potts, Ph.D., MBA. CEO and Chairman

Dr. Potts joined Flagship from Aperio, where he was Vice President of Life Sciences. He managed worldwide sales and marketing in the biopharma segment, where his team achieved global adoption by nearly all of the largest pharmaceutical companies. He defined and led the GLP product development and validation services for the use of whole slide images in regulated preclinical and clinical trials studies, as well as the development of image analysis techniques for angiogenesis. Prior to Aperio, he was Head of Bioinformatics and Biostatistics at Quest Diagnostics Nichols Institute, where his team supported the development of In Vitro Diagnostics Multianalyte Assays (IVDMIA) in oncology and other therapeutic areas. He was a product manager at Accelrys, where he created a protein-ligand data management system for medicinal and computational chemists, crystallographers, and biologists to provide structural bioinformatics data across multiple pharmaceutical departments. He earned a Ph.D. and M.S. in Biological Engineering, and an MBA from the University of California at Davis, and a B.S. in Physics from Wheaton College, Illinois. He has over 20 peer-reviewed publications and patents.

Dartmouth-Hitchcock Inks Deal with BioImagene

SUNNYVALE, Calif. - (Business Wire) BioImagene, the leading provider of innovative digital pathology solutions, announced that they have signed an agreement to equip Dartmouth-Hitchcock Medical Center (DHMC) with their complete suite of digital pathology solutions. DHMC will use iScan Coreo Au™ slide scanner and Virtuoso™ digital pathology application software to streamline laboratory workflow and enhance the Pathology Department’s educational and residency programs.

Arief A. Suriawinata, M.D., Section Chief, Anatomic Pathology at the Dartmouth-Hitchcock Medical Center explained, “The quality of images and the speed of whole slide scanning have improved to the point where they now have a positive impact on workflow efficiencies in the lab. We encourage our pathologists to stay current with this quickly advancing technology and utilize it for applications that were not possible using the microscope, such as creating digital archives, remotely reviewing cases, peer-to-peer collaboration on difficult cases and many more.”

Robin Weisburger, MS, HTL (ASCP), Manager, Anatomic Pathology, commented, “We anticipate that these solutions will improve operational efficiencies in the day-to-day work load for the two dozen pathologists that work at DHMC. By reducing glass slide logistics, digital pathology will improve the manner by which we collaborate with the various community practices. In addition, the technology will assist in the analysis of immunohistochemistry tests, which will aid in consistently accurate diagnoses.”

“We are honored to be working with the prestigious Dartmouth-Hitchcock Medical Center to implement a comprehensive digital pathology strategy,” commented Dr. Ajit Singh, Chief Executive Officer of BioImagene. “Leaders in healthcare like Dartmouth-Hitchcock have a crucial role in affecting a broad-based adoption of digital pathology.”

The iScan Coreo Au is a brightfield slide scanner that allows walk?away scanning of up to 160 slides, and includes several other features including an automated turret with multiple objectives, volume scan (zstacked) images with multiple planes, and iScan Coreo Au Live, an application supporting remote microscopy and collaboration. BioImagene’s Virtuoso digital pathology application software works with BioImagene’s iScan™ family of slide scanners to provide an end-to-end workflow solution. Some of the unique features in Virtuoso include fastest image viewing experience, work-list management and real-time collaboration between users.

Definiens Invites Speakers for First International Definiens Symposium this October in Spain

Definiens is proud to announce the First International Definiens Symposium in Madrid, Spain.


Announcement PDF


When: October 7?8, 2010

Where: CNIC ? Melchor Fernández Almagro, 3, 28029 Madrid, España.


The annual Definiens Symposium serves as the premier forum for developers and users of the Definiens image analysis platform and applications from around the world to present their latest techniques and research in life science image analysis. Speakers and attendees will attend from international institutions, bio?pharmaceutical companies, industry partners, and the healthcare industry.

The Definiens Symposium 2010 will be the place to exchange the latest ideas related to state of the art image analysis and to meet international experts from the Definiens community. It will be hosted by Dr. María Montoya, CNIC.


Sessions will include:

? Digital Pathology Image Analysis 

? Cell, Confocal, and Small Animal Image Analysis

?      The Developer Perspective: Life Science Image Analysis Solution Strategies


Definiens is now accepting applications for speakers. Participate in the Definiens Symposium 2010 in Madrid alongside image analysis thought leaders from industry and academia; and Prof. Gerd Binnig, Nobel Laureate and Founder of Definiens.


Speaking slots are limited. Talks will be 20 minutes in length, followed by a question / answer period. Speakers are encouraged to submit papers for the conference proceedings.


Due Dates:

Speaker Titles and Abstracts Due: June 30, 2010

Submit Title, Abstract, and .PDF of slide deck to:

The Definiens Academy

Email: academy@definiens.com

CMS issues NPRM to credential telemedicine

The Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking (NPRM) to revise the conditions of participation (CoPs) for both hospitals and critical access hospitals to allow a new credentialing and privileging process for physicians and practitioners providing telemedicine services.

The proposed rule, published in the May 26 Federal Register, would apply to all hospitals and critical access hospitals participating in the Medicare and Medicaid programs.

“CMS has become increasingly aware, through outreach efforts and communications with the various stakeholders in the telemedicine community…of the urgent need to revise the CoPs in this area so that access to these vital services may continue in a manner that is both safe and beneficial for patients and is free of unnecessary and duplicative regulatory impediments,” stated the NPRM.

The proposed revisions to the hospital CoPs for the credentialing and privileging of telemedicine physicians and practitioners are contained within two separate CoPs: “Governing body” and “Medical staff.”

According to the NPRM, the governing body CoP would require the hospital’s governing body to ensure that, when telemedicine services are furnished to the hospital’s patients through an agreement with a Medicare-participating hospital (a "distant-site hospital"), the agreement must specify that it is the responsibility of the governing body of the distant-site hospital providing the telemedicine serves to meet the existing requirements in regard to its physician and practitioners who are providing telemedicine services.

“The proposed requirements would allow the governing body of the hospital whose patients are receiving the telemedicine services to grant privileges based on medical staff recommendations[;] a more efficient means of privileging the individual distant-site physicians and practitioners providing the services,” the NPRM stated.

The proposed “medical staff” CoP requirement would provide a basis on which the hospital’s governing body could choose to have its medical staff rely on information furnished by the distant-site hospital when making recommendations on privileges for individual physicians and practitioners providing such services.

“This option would allow the hospital’s medical staff to rely upon the credentialing and privileging decisions of the distant-site hospitals…and not prohibit a medical staff from continuing to perform its own periodic appraisals of telemedicine members of its staff, not would it bar them from continuing to use the traditional credentialing and privileging process required under the current regulations.”

According to the NPRM, the proposed requirements for critical access hospitals are modeled after the hospital requirements with little difference in regulatory language. "[W]e would make a minor change to the critical access hospital CoPs that do not have an equivalent provision in the hospital CoPs," the NPRM said. "We are proposing...a new requirement that would allow the distant-site hospital to evaluate the quality and appropriateness of the diagnosis and treatment furnished by its own staff when providing telemedicine services to the critical access hospital."

CMS will receive public comment on the NPRM until 5:00 pm Eastern Time July 26.