Digital Pathology Blog

Light Deactivates Anthrax

A new technique targets specific proteins, such as the dangerous anthrax toxin, and renders them harmless using nothing but light. The method could also be used to create new cancer treatments and antibacterial coatings.

Scientists have long been interested in wrapping proteins around carbon nanotubes, and the process is used for various applications in imaging, biosensing, and cellular delivery. But this new study at Rensselaer Polytechnic Institute (RPI) is the first to remotely control the activity of these conjugated nanotubes.

A team of RPI researchers led by Ravi S. Kane, professor of chemical and biological engineering, has worked for nearly a year to develop a means to remotely deactivate protein-wrapped carbon nanotubes by exposing them to invisible and near-infrared light. The group demonstrated this method by successfully deactivating anthrax toxin and other proteins.

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“By attaching peptides to carbon nanotubes, we gave them the ability to selectively recognize a protein of interest -- in this case anthrax toxin -- from a mixture of different proteins,” Kane said. “Then, by exposing the mixture to light, we could selectively deactivate this protein without disturbing the other proteins in the mixture.”

By conjugating carbon nanotubes with different peptides, this process can be easily tailored to work on other harmful proteins, Kane said. Also, employing different wavelengths of light that can pass harmlessly through the human body, the remote control process will also be able to target and deactivate specific proteins or toxins in the human body. Shining light on the conjugated carbon nanotubes creates free radicals, called reactive oxygen species. It was the presence of radicals, Kane said, that deactivated the proteins.

Kane’s new method for selective nanotube-assisted protein deactivation could be used in defense, homeland security, and laboratory settings to destroy toxins and pathogens. The method could also offer a new method for the targeted destruction of tumor cells. By conjugating carbon nanotubes with peptides engineered to seek out specific cancer cells, and then releasing those nanotubes into a patient, doctors may be able to prevent the spread of cancer.

Kane’s team also developed a thin, clear film made of carbon nanotubes that employs this technology. This self-cleaning film may be fashioned into a coating that, at the flip of a light switch, could help prevent the spread of dangerous bacteria, toxins, and microbes.

“The ability of these coatings to generate reactive oxygen species upon exposure to light might allow these coatings to kill any bacteria that have attached to them,” Kane said. “You could use these transparent coatings on countertops, doorknobs, in hospitals or airplanes -- essentially any surface, inside or outside, that might be exposed to harmful contaminants.”

Kane said he and his team will continue to hone the technology and further explore its potential applications.

Details of the project are outlined in an article in the December issue of Nature Nanotechnology. Co-authors of the paper include Department of Chemical and Biological Engineering graduate students Amit Joshi and Shyam Sundhar Bale, postdoctoral researcher Supriya Punyani, Rensselaer Nanotechnology Center Laboratory Manager Hoichang Yang and professor Theodorian Borca-Tasciuc of the Department of Mechanical, Aerospace, and Nuclear Engineering.

The group has filed a patent disclosure for the technology. The project was funded by the National Institutes of Health and the National Science Foundation.

For more information, visit: www.rpi.edu

Sharper X-rays Developed

LAUSANNE, Switzerland, Jan. 22, 2008 -- Using novel x-ray optical components instead of sophisticated crystal optics has allowed dark-field images to be produced at wavelengths used in common medical and industrial imaging equipment. The dark-field images provide more detail than ordinary x-ray radiographs and could be used to diagnose the onset of osteoporosis, breast cancer or Alzheimer's disease, and to identify explosives in luggage.

Researchers at the Paul Scherrer Institute (PSI) and the EPFL (Ecole Polytechnique Fédérale de Lausanne) in Switzerland developed the method. Until now, dark-field x-ray imaging required sophisticated optics and could only be produced at facilities like the PSI’s 300-m diameter, $200 million synchrotron. With the new nanostructured gratings described in this research, published online January 20 in Nature Materials, dark-field images could soon be produced using ordinary x-ray equipment already in place in hospitals and airports around the world.

Unlike traditional x-ray images, which show a simple absorption contrast, dark-field images capture the scattering of the radiation within the material itself, exposing subtle inner changes in bone, soft tissue, or alloys.

The overall clarity of the images is striking. The improved sensitivity in measuring bone density and hairline fractures could help diagnose the onset of osteoporosis. Because cancer or plaque cells scatter radiation slightly differently than normal cells, dark-field x-ray images can also be used to explore soft tissue, providing safer early diagnosis of breast cancer or the plaques associated with Alzheimer’s disease.

Security screening equipment equipped with dark-field image capability could better identify explosives, whose microcrystalline structures strongly scatter x-ray radiation. And because x-rays penetrate a material without damaging it, dark-field images could help reveal scattering-producing microcracks and corrosion in structures such as airplane wings or the hulls of boats.

“Researchers have been working on dark-field x-ray images for many years,” said Franz Pfeiffer, a professor at EPFL and researcher at the PSI. “Up until now these images have only been possible using sophisticated crystal optical elements.”

Crystal optics, however, only work for a single x-ray wavelength and are highly inefficient. “Our new technique uses novel x-ray optical components, in the form of nanostructured gratings, that permit the use of a broad energy spectrum, including the standard range of energies in traditional x-ray equipment used in hospitals or airports,” said Christian David, Pfeiffer’s colleague at PSI. “This opens up the possibility for adapting current imaging equipment to include dark-field imaging.”

Pfeiffer plans to collaborate with the Center for Biomedical Imaging (CIBM), a joint center with the universities of Lausanne and Geneva and their associated hospitals, to develop an adaptation for existing medical equipment.

“When combined with the phase contrast imaging technique that we developed in 2006, we now have the possibility of providing the same range of imaging techniques in broad-spectrum x-ray imaging that we do with visible light,” he said.

For more information, visit: http://actualites.epfl.ch/ or www.psi.ch

from photonics.com - 1/22/2008
http://www.photonics.com/content/news/2008/January/22/90385.aspx

Digital Mammography Better Than Film for Some Women

Digital Mammography Not Good, Digital Mammography Good, Digital Mammography Better for For Some Women - Recent story from Washington Post on a recent study.

By Kathleen Doheny
HealthDay Reporter
Tuesday, January 29, 2008; 12:00 AM

TUESDAY, Jan. 29 (HealthDay News) -- For some women, digital mammography is a better bet than traditional film mammography, a new study confirms.

Women under the age 50 with dense breasts who are premenopausal or perimenopausal get more accurate results with digital mammograms, said study author Dr. Etta Pisano, the Kenan professor of radiology and biomedical engineering at the University of North Carolina, in Chapel Hill.

Pisano was the principal investigator for a landmark study published in 2005, known as DMIST, that compared digital to film mammography for all women. In this latest research, Pisano decided to reanalyze the original findings by looking more closely at subgroups of women.

In the original study, 33 U.S. centers enrolled more than 49,000 women and determined the breast cancer status of more than 42,000. This latest research evaluated the mammograms of the 42,000 women. The new report was expected to be published in the February issue ofRadiology.

The new analysis, said Pisano, "pretty much confirms what we found [in the original study]."

"In this latest study, we were trying to figure out which factor was most important," she said. To do that, they compared the accuracy results of digital versus film mammograms in 10 different subgroups of women, looking at combinations of the three factors -- menopausal status, age and breast density.

"And we couldn't figure out which factor was most important," Pisano said.

For other groups of women, no significant differences in accuracy were found between the two methods. The researchers did discover a trend toward improved accuracy of traditional film mammograms over digital ones for women over age 65 with fatty, rather than dense, breasts. However, the finding didn't reach statistical significance, Pisano noted.

Another expert, Dr. Carol H. Lee, chairwoman of the breast imaging commission of the American College of Radiology, agreed that the take-home message is for certain women to ask for digital mammograms.

"I don't think this [new study] says anything different than the original," Lee said. "They broke down the [original] subgroups into even more subgroups, They have 10 different ones. And they basically found that digital is very substantially better for pre- and perimenopausal women under age 50 with dense breasts."

Earlier this month, a study that appeared in theAnnals of Internal Medicinecrunched the same DMIST data and found that digital mammography was only cost-effective for this particular group of women.

In digital mammography, the X-ray film is replaced by "solid-state detectors that convert X-rays into electrical signals," according to the American College of Radiology. The detectors are akin to those found in digital cameras, and the electrical signals are used to produce breast images that can be viewed on a computer screen.

The denser the breast tissue, the more difficult it is to detect breast cancer on a mammogram, Lee explained. That's because dense tissue shows up as white on a mammogram and cancer shows up as white, too. "Fat shows up dark," she said. "So, cancer is easier to detect in fatty breasts."

If a mammogram report doesn't include information on breast density, Pisano suggested women ask their doctor or mammogram technician to provide that. Older women tend to have less dense breasts than younger women, but not always.

Digital mammography units aren't as plentiful in the United States as traditional units are, according to Arvind Gopalratnam, spokesman for GE HealthCare, a maker of digital mammography machines. About 20 percent of U.S. mammography units are digital; the other 80 percent are conventional.

The type of unit is only one factor playing a role in the accuracy of diagnosis, Lee added. The expertise of the technologist, as well as the skill of the radiologist who reads the mammogram, are also important, she said.

To learn more about mammography, visit the National Cancer Institute.

SOURCES: Carol H. Lee, M.D., chairwoman, breast imaging commission, American College of Radiology, and attending radiologist, Memorial Sloan-Kettering Cancer Center, New York City; Etta Pisano, M.D., Kenan professor of radiology and biomedical engineering, University of North Carolina, Chapel Hill; Arvind Gopalratnam, spokesman, GE HealthCare; February 2008,Radiology

ASCP's 2008 Leadership Exchange - Keynoters Focus on Lab Quality and Leadership

Keynote presenters will offer their unique perspectives on leadership and quality at ASCP's annual Leadership Exchange, Feb. 29-March 1, 2008, in San Francisco.

On Friday, Feb. 29, Colonel Paul T. Barnicott, BSC, MT(ASCP), a laboratory leader in the U.S. Air Force Medical Service, will discuss the challenges faced by today's young Air Force laboratory leaders. He will impart the motivational thinking and practices that have distinguished his own career and provide insights about handling critical situations that demand a "ready-for-anything" brand of laboratory leadership.

Saturday's keynote speaker is James O. Westgard, PhD, a world renowned expert on laboratory quality and developer of the Westgard Rules for laboratory quality control. He will share humorous stories and lessons he learned on the long road to quality. Westgard will demonstrate how the truth about quality is obtainable when the right metrics are used, how good quality and bad quality are defined, and how to recognize defective results that could lead to medically significant errors.

Visit the website for complete descriptions of sessions, keynotes, roundtables, and the networking reception. Early registration deadline has been extended to Jan. 31.

http://www.ascp.org/leadershipexchange/index.html

BioImagene appoints director to company board

CUPERTINO, Calif.--(BUSINESS WIRE)--BioImagene, a leading provider of innovative imaging software and systems for cancer diagnosis and research is pleased to announce Dr. Joseph Keegan’s appointment as a director to the company’s board.

Dr. Keegan brings over 25 years’ management experience in the life sciences tools industry. He is currently the President and CEO of ForteBio Inc. Previously Dr. Keegan was the CEO of Molecular Devices (MDC). During his 9-year tenure at MDC, Dr. Keegan grew the company's revenues from $30 million to $190 million and in early 2007 he oversaw its acquisition by MDS for $615 million. Prior to MDC, Dr. Keegan served in Becton Dickinson and company as President of Worldwide Tissue Culture. His executive management experience also includes Leica, Inc. where he was Vice President of Microscopy and Scientific Instruments Division.

“It is a pleasure to welcome Dr. Keegan to our Board at a time when the company is experiencing significant growth. Joe’s extensive medical device experience and proven track record of building and managing life science companies will be a significant asset to Bioimagene and its board of directors. Joe’s appointment will strengthen the board’s ability to effectively guide BioImagene in its efforts to become a leading digital pathology solutions company,” said Mohan Uttarwar, BioImagene CEO.

“I am pleased about my appointment to the BioImagene Board at this stage of the company’s development. It is an exciting time as more companies and laboratories are using digital pathology systems. BioImagene is well positioned to increase its market presence with a strong product pipeline. I look forward to helping BioImagene expand its successful business,” commented Dr. Keegan.

Telemedicine in diagnostic pleural cytology: a feasibility study between

Telemedicine in diagnostic pleural cytology: a feasibility study between
universities in Iran and the USA.

Ayatollahi H, Khoei A, Mohammadian N, Sadeghian MH, Azari JB, Ghaemi MR, Khoob
MK. J Telemed Telecare. 2007;13(7):363-8.

Department of Biochemistry and Nutrition, Faculty of Medicine, Mashhad University
of Medical Sciences, Mashhad, Iran.

Abstract
We evaluated the concordance rate and diagnostic accuracy of digital cytology
slides reviewed by experienced pathologists at the University of Miami and the
Ohio State University in comparison with review of conventional glass slides by
the pathologist at the Mashhad University of Medical Sciences. In addition, we
evaluated interobserver reproducibility in telecytology diagnosis in pleural
effusion smears between Ohio State and Miami University. For this, we selected 50
pleural effusion smears with different diagnoses. For each case, digital images
were sent via the Internet to the consulting pathologists at the two US
universities. The accuracy of the telecytology diagnoses was 83% and 87% at the
two US universities and the accuracy of glass slide review was 89%. The
inter-observer reproducibility of telecytology diagnosis between these two
universities was 0.71. The concordance rate, inter-observer reproducibility and
diagnostic accuracy of telecytology diagnosis in pleural effusion smears between
the three institutions were good. Telecytology diagnosis of pleural effusion
smears is potentially useful in screening and diagnosis and may allow more
efficient use of scarce cytopathologist resources and expertise.

PMID: 17958939 [PubMed - in process]

Virtual Microscopy at Indiana University

Microscopes at Indiana University have virtually gone digital. Thanks to Mark Braun and Anthony Mescher, professors at Indiana University's Bloomington campus, students in their respective classes can study and examine various slides of microscopic tissue samples on their laptops via a virtual microscope instead of looking at textbook examples.

"It's not just that a textbook example doesn't require any search and discovery," said Braun of the slide images. "No patient or disease knows to look exactly like the textbook example every time. This provides real-world learning."

The program, which Braun has used in his human pathology -- or "sick" condition -- class for second-year medical students, was introduced to Mescher's histology class -- which teaches the healthy or "normal" condition -- for first-year medical students last semester.

Both professors believe the virtual microscope program enhances the students' learning in several ways.

The high-tech program allows students to collaborate and view slides as a team, says Braun, a physician and a clinical professor of pathology in the medical science program at IU. Previously, team collabaoration could be a cumbersome and tedious task. Now, instead of having to show students one by one how to examine a slide, Braun can project his actions for the entire class to see at once.

It's a resource for which Mescher, a professor of anatomy and a senior fellow at the IU Institute for Molecular and Cellular Biology, shares Braun's enthusiasm.

"Scanning our slides into the digital microscope program is a technical breakthrough we're very excited about," said Mescher. "I didn't think it would work several years ago, but Mark was so successful with it in his classes that we decided to incorporate it into histology. It is a wonderful tool for the students to have."

The program, produced by Bacus Laboratories in Lombard, Ill., provides an exact replica of the physical slides which have been used in class for decades. The virtual slides can be examined and studied with the same magnifications and clarity available from a traditional microscope. (To see the program in action, visit Braun's website at http://medsci.indiana.edu/c602web/602/c602web/toc.htm.)

"I'm continually impressed with the clarity and resolution of the slides," said Mescher. "It's equivalent to working with lenses of the cleanest microscope."

Each slide owned by the department underwent a series of high resolution pictures -- 20,000 for each slide -- taken at the eight magnification levels available on traditional microscopes. The Bacus program organizes the pictures so that students can manipulate them exactly as if they were using a microscope. Each slide is about two gigabytes in size, and together all of the slides comprise an entire terabyte, or 1,000 gigabytes, of data.

Now, with the last batch of slides from Mescher's histology class recently completed, second-year students can review healthy samples from their first year and compare them side-by-side to the sick samples they are currently studying. Additionally, students can view slides from home rather than relying upon a lab microscope being available when they want to review for a test. Plus, they don't have to worry about microscope maintenance, dirty lenses or breaking expensive slides.

The virtual microscope program doesn't replace physical microscopes, however. Students still learn how to use them and are assessed on their abilities to do so, because once they graduate to hospitals and research labs, they will rely upon the tried and true instrument. The scanning process required to use virtual microscope program is simply too slow for a fast-paced diagnosis lab.

Although the software that streams the images is proprietary and does come with a yearly fee, the university saves money on microscope maintenance and new slides, which can easily be broken or scratched. Both Mescher and Braun think the program is well worth the money.

"The university was wonderful in supplying us with a $15,000 high-speed Internet II grant through the Abilene Project several years ago to cover the initial costs," said Braun. "We wouldn't be where we are today without that generosity."

The virtual microscope is just one tool in Braun's impressive Web site. Continually updated, it boasts annotated slides, virtual quizzes, audio lectures, practice exams and clinical cases.

The clinical cases provide real-world examples of how to diagnose a patient. Each case provides a set of facts, a movie interview with the "patient," and access to x-rays, virtual slides and other tests. The Web site allows students practice in diagnosing patients.

Although some of the Web site's content is password protected, much of it is available to anyone. Braun has received e-mails of thanks for his Web site from Poland, France and even a Pakistani student studying in China.

"Today's students come from a virtual world," said Braun. "It's time we face that fact and join it."

Microsoft, Mayo Clinic join to empower patients, protect privacy

By  Diana Manos, Senior Editor

01/25/08

Healthcare IT News

Microsoft and the Mayo Clinic announced today they will partner to provide patients with the power to manage their own personal health records.

Mayo Clinic Health Solutions and Microsoft's Health Solutions Group say they will collaborate on developing tools to facilitate closer patient-to-physician connections.

"We are committed to finding new technology solutions that put the patient and consumer in control," said Brooks Edwards, MD, chief medical officer of Mayo Clinic Health Solutions. "Our work with Microsoft is an exciting opportunity to create tools that empower patients to be in the very center of their own healthcare environment."

Peter Neupert, corporate vice president of the Redmond, Wash. -based Microsoft Health Solutions Group, said consumers demand and deserve tools that make their lives easier, facilitate communication and help them take action to manage their health.

"Building on the Microsoft HealthVault platform, our groups are committed to providing individuals with solutions that are dynamic, secure and focused on the needs of the user, in order to effectively improve health and well-being," Neupert said.

Microsoft's partnership with the Mayo Clinic will use Microsoft's newly announced HealthVault, technology supported by healthcare providers, patient activists and device manufacturers.

Deborah Peel, MD, founder of the Patient Privacy Rights Foundation, one of 50 organizations that comprise the Coalition for Patient Privacy, said the system is the first to pass muster with the coalition's tough standards for patient privacy.

The two industry giants said they hope to announce further details on the project before the end of this year.

CAP Tops 17,000 Members

For the first time since the College of American Pathologists was established in 1947, the CAP’s total membership (inclusive of Fellows, Juniors, Affiliates, and Emeritus) has exceeded 17,000. CAP membership now stands at 17,189 of which 10,433 are Fellows. In a time when many other associations’ membership is flat or declining, the College is aggressively increasing its membership.

Coming Soon — CAP Foundation Surgical Pathology Case of the Month with Whole Slide Imaging

The College of American Pathologists (CAP) Foundation and CAP Surgical Pathology Committee, in cooperation with Aperio, are pleased to offer select cases from the CAP Performance Improvement Program in Surgical Pathology Program (PIP) archives. This exciting anatomical pathology non-CME educational program is designed to expose those interested in whole slide imaging to select cases presented using advanced developments in and use of information technology for the practice of pathology.

One of the purposes of the program is to explore other ways pathologists can view slide images as a diagnostic modality. Digital pathology using whole slide imaging is a computerized, image-based environment for managing and interpreting information enabled by a whole slide image. It gives pathologists a method of assessing their diagnostic skills through electronic means and comparing their performance with that of their peers. This program is open to CAP members and non-CAP members interested in whole slide imaging.

A selected case from the PIP and/or anatomic archives with a patient history will be posted on a Foundation Web page each month. The participant selects the appropriate diagnosis from a master list of diagnoses provided with each case. An on-line case critique of each case will be provided, including the diagnosis, comments, and references. The cases will represent a variety of neoplastic and non-neoplastic lesions, including inflammatory and infectious diseases, and encompass essentially all organ sites.

After completion of the slide review, the participant will:

• Have an increased understanding for the use of digital pathology with whole slide imaging in the practice of pathology.
• Identify lesions from a variety of sites and specimen types.
• Recognize unusual diseases as well as uncommon presentations of common diseases.
• Assess diagnostic skills in surgical pathology.

To evaluate the usefulness of the program, survey questions on ease of comfort to use as a diagnostic tool will be posted on the Web site for participants’ response. An e-mail will be sent to all CAP members when this program is released. Visit the Foundation area of the CAP Web site, and click on Program and Events for more details.

This program is made possible through an unrestricted education grant from Aperio.