Digital Pathology Blog

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

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

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

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

View some images we took with the zPix"

A Repository for Bottled Monsters - 500,000 digital pathology images review

The Repository for Bottled Monsters, the unofficial blog for the National Museum of Health and Medicine (nee the Army Medical Museum) at the Armed Forces Institute of Pathology in Washington, DC, has a series of 4 posts recently finished describing the work done to date on scanning in several parts of their extensive collection and how the process took place that is worth reading.

 

A staggering number of over 500,000 images are anticipated to be digitized from a wide variety of collections by year's end. 

 

 

Get blog posts as MP3 files

With the proliferation of "small screen" technologies such as the iPhone, blackberry devices and Palm's new Pre, we have an increasing amount of rapid access to data and information in the palm of our hands.  This extends to video and audio devices as well.

You can now listen to postings as MP3 files with several audio receivers and players. My own iTunes has been successful at receiving the feeds and playing the content. While the speech conversion is rudimentary with some errors, the MP3 format allows another element of connectivity and the conversion technology is only going to improve.

My hope is that pathology organizations, societies and medical journal publishers offer similar technologies to "stay connected" with relevent content & information easily accessible when, where and how you want to receive that information. 

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IBM GMAS SOFTWARE OFFERS INDUSTRY FIRST INNOVATION

More news from RSNA in Chicago.  IBM announces a new software feature for their GMAS storage application.  Of note, digital pathology applications are mentioned amoung other high throughput applications that require reliable and efficient storage.  Will continue to see where this goes but more positive traction in the digital pathology space.

 

IBM also announced today new software features for the IBM Grid Medical Archive Solution (GMAS), a high performance, grid-based storage solution. Its new software component, GAM 2.1 will now support applications in digital pathology, mass spectrometry and high throughput screening that require ultimate performance and very reliable NAS storage.

 

GAM was invented to manage and store huge amounts of archive data, such as CT scans and mammograms, which are generally written only once and rarely updated but must be frequently accessed. However, many healthcare and research applications also produce vast amounts of transactional data which needs to be captured, analyzed, shared, be actively written, re-written and modified before it is archived or deleted. The new GAM 2.1 Distributed Gateway feature adds scalable NAS capability to GMAS for transactional and research data, enabling exceptional performance and support for up to 1 billion objects. This Distributed Gateway also acts as a traditional GMAS gateway that can be used to archive and protect data for life across any storage tier and location. As a result, medical and research facilities can leverage GMAS for both research and transactional as well as reference data while eliminating the complexity, hassle and cost of managing multiple solutions. The GAM v2.1 Distributed Control Node also adds more advanced control node software replication features to improve image access and network performance while still enabling universal data access from any location.

‘Can You Hear Me Now?’

For the past several months I have queried folks at CAP, ASCP and USCAP as well as other professional societies as well as journal editors and publishers when they are going to adopt new technologies beyond member e-mail updates and hard copy publications (albeit most are available on-line). 

I have suggested downloadable podcasts to update on issues affecting the particular organization or society or updates on regulatory issues.  A review of their scientific publications as a short podcast with particular articles I think would also be welcome. 

On your drive in, or at the gym, updates to your iPod or MP3 player are at your disposal for a synopsis of the most critical issues or scientific findings published. 

It now appears that ASCP is taking a lead on this with an MP3 message from the chair of the ASCP Council of Laboratory Professionals. 

I hope this kind of information continues to become availalbe in this format.

Below is a short synopsis about "speaking" to colleagues from the chair of this council.

October 2008 Chair's Message, ASCP Council of Laboratory Professionals by Lynnette G. Chakkaphak, MS, MT(ASCP)

Now you can LISTEN to this message or you can save an audio version of this message to your iPod or MP3 player. [Download Audio MP3]

You probably recognize the catchy phrase above from a well known advertisement used by a prominent American company to promote its cellular service. “Can you hear me now?” reminds me of the exciting new opportunity I will have as chair of the ASCP Council of Laboratory Professionals to reach out and “speak” to so many of my fellow laboratory professionals. This rare opportunity to address colleagues from across the US and around the world is quite an honor.

3D Images a Click Away

Researchers at the Veterans Administration are expanding the use of 3D imaging software so that physicians can have a virtual roadmap of a patient’s anatomy. An article appearing in the July/August 2008 newsletter issue of the “VA Research Currents R&D” discusses how Roy Soetikno, MD, a gastroenterologist and researcher at the VA Palo Alto Health Care System and Stanford University School of Medicine, is looking to greatly expand the use of this technology. He has helped to spearhead a new program at the Palo Alto VA called the “Collaborative Imaging Initiative” that may serve as a model for other VA sites and possibly for medical practices outside of the VA.

Currently doctors typically depend on radiology specialists to create and show them 3D images based on CT or other scans on high end imaging workstations. Since doctors are unable to view the images on their own computers, they need to study the images and essentially memorize them. Dr Soetikno envisions a system where doctors won’t have to memorize the images but have a system that works like a futuristic 3D GPS map.

The system at Palo Alto relies on low cost software and hardware. Computers are linked together via an existing data network and physicians are able to view the images on any computer in the secure VA network. The software also provides for real-time web-based videoconferencing where a medical team, the patient, and family members can all look together at the same 3D image and manipulate the view in any number of ways as they discuss treatment options.

The system also enables any physician with an Apple computer to not only view 3D images but also to create or customize them independently. One click can render a set of two-dimensional images into a 3D image.

Dr. Soetikno hopes that the system can be replicated through the VA system and even meshed with the VA’s electronic medical record system. He stresses that doctors with the ability to use the 3D system could really help improve care for rural veterans.

Digital Slides, DICOM and PACS

The Daily Scan has an interesting post defining the terminology and issues associated with digital slides, DICOM and PACS. 

Macnification Manages Digital Electron Microscopy Workflow

Orbicule announced the launch and immediate availability of Macnification on Tuesday. The new software allows the scientist to import, organize, find, annotate, analyze, adjust, compare, visualize and publish microscopic images.

"All major image file formats can be imported into Macnification, in addition to many proprietary formats including e.g. Gatan Digital Micrograph (dm3), JEOL SEM images (tiff + txt), MetaMorph Stack (stk), Open Microscopy Environment (ome.tiff) and Zeiss (lsm). Support for more formats is forthcoming. Metdatata is imported as well, and can be viewed and edited in a fully customizable metadata view," Peter Schols said.

The full screen image allows for the various kinds of measurements of the display, and results can be exported to spreadsheet apps, including Numbers, with a single click. The entire workflow is non-destructive of the original image.

The application was written from the ground up for Leopard and takes advantage of Core Animation when viewing virtual cuts. It also leverages Core Image to offer the fastest Extended Depth of Focus (EFI) algorithm of any platform. "In addition, Macnification integrates tightly with Quick Look, Spotlight, Time Machine, Core Data, ImageKit, QuickTime, and many other Mac OS X technologies. It takes full advantage of multiple processor cores," Mr. Scholl added.

Macnification requires Mac OS X 10.5, Leopard, and is priced at €249 (about US$400). A free 30-day trial is available.

Filmless cameras? From Silver to Pixels

My father was a professional photographer for 18 years among his other professions.  He did it all - door to door making house calls for baby photographs, weddings, bar mitzvahs, studio portraits, magazine covers, trade publications, transferring images to ceramic tiles for headstones, etc... I would spend hours taking photographs and developing my film and shooting prints.  I can still smell the difference between the developing solution and fixing solution, a hint when you are working in darkness.  The viscosity was different too.   There was a man who would come around and recover silver from the impregnated paper in the solutions somehow.   It was a little bit different than uploading a memory card device to your local retailer or buying color toner cartridges. 

I recall him telling me in the late 70's, early 80's that there would be filmless cameras.  Of course his photography colleagues couldn't imagine that.  Particularly, with 2x2 plate film, complicated lighting, meters, filters, etc...  Of course by 2000 digital cameras started to become mainstream in American households and now you can't find a professional photographer who shoots anything but.

It is everything technology should be - faster, cheaper, easier, more cost-effective (particularly for unwanted shots or if proofs are never reviewed....albums ordered....), there is less loss.  You print want you want, disregard the rest, no negatives to store.  Memory is so cheap you can keep the others for viewing and sharing.  Of course all of this has led to other issues with the ubiquitous ability to capture images through compact cameras and camera cell phones with seamless uploading and invasion of privacy.

Of course, outside of mammography, most hospital radiology departments are using digital X-ray and pathologists' microscope cameras are digital.  I doubt if most instutional medical photography and illustration services departments even have the capability to develop film.  I posted a previous note on Kodak's transformation from film to digital and now there is news from FUJIFILM of the same (see below). The digital drive has helped cut loss and spurred new growth and revenue.

A far cry from shooting 35 mm slides and printing powerpoint slides to slide for lectures and presentations and that wasn't so long ago. Our residents do not know of that, hoping your slides are correct and back on time or slide projectors or even microcasette recorders for that matter. 

The power and ability to view digital slides seems more of an evolution rather than revolution, starting with increasing use in education, research and shortly I believe in widespread clinical use as discussed here with FDA clearances and the like.  The residents of today will be making diagnoses from monitors in conjunction with microscopic diagnoses.  Much like the photographers of today know not of mechanical but digital and have adopted it into their profession, replacing silver with pixels.

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Fujifilm phases out medical film production in the US

STAMFORD, CT, USA - (HealthTech Wire) - FUJIFILM Medical Systems USA, Inc. announced today that the production of medical imaging film products at FUJIFILM Manufacturing USA Inc. in Greenwood, S.C., will be phased out. It is anticipated that production of these products will be discontinued by April 1, 2008.

Over the past decade, the medical imaging industry has been undergoing a steady transition from the use of medical imaging film including double and single emulsion and dry films, to digital image acquisition and softcopy diagnosis via Picture Archiving and Communications Systems (PACS).

In fact, Fujifilm is the world market leader in digital X-ray with more than 52,000 CR systems sold, and a leading PACS provider with well more than 1500 Synapse® PACS installations around the globe. Although Fujifilm Greenwood has been producing X-ray film products, the market shift to PACS systems has led to significant declines in the overall sales of medical film. As a result, FUJIFILM Corporation has decided to consolidate the production of all medical film to one facility in Japan.

"While we must adapt our business to the changing landscape of the medical imaging market, Fujifilm remains unwavering in our efforts to meet the existing demands for medical film," said FUJIFILM Medical Systems USA President and CEO Makoto Kawaguchi. "As is our history with all of our medical imaging products, Fujifilm is committed to the quality and innovation of our extensive medical film lines. The ongoing and stable delivery of film to our medical customers will continue without interruption," Kawaguchi said.

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