The Daily Scan

Cancer Cure in Mice to Get Human Trials

RedOrbit reports Cancer Cure in Mice to Get Human Trials.

Clinical trials begin this week at Wake Forest University on a cancer therapy that has completely cured the disease in every mouse tested over the past few years.

The therapy involves the transfusion of white blood cells from cancer-resistant donors into cancer patients, letting loose a uniquely qualified army of disease fighters to attack the invading tumor.

Naturally skepticism is called for with such techniques, but using the body's immune system to fight cancer is a pretty promising technique.  Stay tuned!

Who owns "PACS"?

An interesting post on Bruce Friedman's blog: Who owns "PACS"?  This is a longtime debate, should the IT department run the PACS, or the Radiology department?  It is mirrored by a new question in Pathology, should the IT department run a Digital Pathology system like Aperio's Spectrum, or the Pathology department?  And what if the systems are shared, as increasingly they are?

Aperio and CAP Foundation to host annual Pathology Visions conference

Pathology Visions recently announced that the 4^th annual digital pathology solutions conference will be co-hosted by Aperio and CAP Foundation.  The conference, which will be held October 26-28 at the Manchester Grand Hyatt in downtown San Diego, serves as a platform for stimulating discussion about the uses of digital pathology in research, clinical, and veterinary pathology applications.  Attendees will have the opportunity to learn about exciting innovations in digital pathology, share best practices, and network with thought leaders and colleagues.

This year's Keynote Speakers are Richard C. Friedberg, M.D., Ph.D. Chairman, Department of Pathology, Baystate Health and John C. Reed, M.D., Ph.D., President & CEO, Burnham Institute for Medical Research.  A sampling of additional topics that will be discussed includes:

• Patient Stratification in Clinical Trials
• Development of a Case-Based Healthcare Education Resource
• Digital Morphology and Its Critical Role in Systems Biology
• Genomic Medicine: Implications and Opportunities for Pathology
• High Throughput Imaging and Analysis

Advance registration is now open.  For additional information on Pathology Visions 2008, please visit www.pathologyvisions.com or email info@pathologyvisions.com.

US adoption of electronic health records is abysmal

Ars Technica reports US adoption of electronic health records is abysmal.

The impact of computers to increase efficiency has been fairly widespread; try to imagine an architect, accountant, or administrator working without one in 2008. But some occupations seem to be holding out, and the medical profession is one of those. A new report in the New England Journal of Medicine paints a disturbing picture of just how slow adoption is.

Electronic health records (EHRs), as I found out recently while researching an article, are a byzantine and complex field, with tens of different platforms and products, both proprietary and open source. The US, unlike many other developed nations, lags behind in the widespread adoption of EHRs. Exact figures have been hard to come by in the past; numbers ranged between 9 and 20 percent among the sources I found, but those are actually overestimates, according to the NEJM report.

This is fascinating, because the value proposition is there.  Let's hope this changes, and who, knows, perhaps Digital Pathology can help drive adoption :)

Boost for NSF funding

The Scientist reports: Boost for NSF Funding.

The US Senate and House of Representatives have approved a 14 percent funding increase for the National Science Foundation (NSF) for 2009. A Senate appropriations subcommittee approved the measure yesterday (Jun 18), and a House subcommittee passed the bill last week.

The bill will now move to the Senate floor for a vote, which has not yet been scheduled.

The spending bill would net NSF, which is the second largest federal funder of academic research after the National Institutes of Health (NIH), $6.9 billion for FY 2009. More than 80 percent, or $5.6 billion, of this total budget would go towards research grants.

Good news for cancer research and indeed all healthcare, and indeed all science!

Medscape compares Her2 the FDA way to the ASCO/CAP way

Medscape has published an interesting study which compares scoring Her2 using the FDA approved guidelines vs the new ASCO/CAP guidelines....

Our findings indicate the following: (1) The FDA and ASCO/CAP grading schemes for HER-2/neu evaluation differently select patients for trastuzumab therapy. (2) Major discordance is present in the group with low-grade, borderline HER-2/neu amplification, and tumors classified in the FDA system as low-grade, borderline would be reclassified as without HER-2/neu amplification or as polysomic. (3) Polysomy of chromosome 17 and high-grade and low-grade, borderline HER-2/neu gene amplification are 3 major molecular patterns still significantly present in the group graded by the ASCO/CAP scheme; however, major concordance is present between strong 3+ immunohistochemical cases and high-grade, granular HER-2/neu amplification.

The authors go on to suggest FISH as a more objective means of quantifying Her2 for the purpose of determining whether patients should be treated with Herceptin…

It would be really interesting to do the same comparison with computer quantification. We have found that human quantification of Her2 is so subjective and difficult that these results are not surprising. I believe a goal of the new ASCO/CAP guidelines was to make quantifying Her2 expression easier and more consistent, for humans, rather than necessarily making it more accurate as a prognostic indicator.

Economist: stem cells and cancer...

The Economist reviews some fascinating research by Dr. Sanford Barksky at Ohio State University regarding the connection between stem cells and cancer.

DOCTORS track the long-term health of organ-transplant patients in registries.  Such registries make it possible to uncover  trends or long-term problems in the population that may be missed in smaller samples.  But they can also be pressed into service to support basic research.  And a group of researchers led by Sanford Barsky of Ohio State University College of Medicine in Columbus has done just that.  As they reported on June 2nd to a meeting of the American Society of Clinical  Oncology, in Chicago, they have used one such registry to support the increasingly popular  idea that many if not all  cancers are caused by stem cells gone bad.

This is excellent; of course understanding the root causes of cancers is a great way to discover new treatments...

AlterNet: How Breast Cancer Became Big Business

AlterNet: How Breast Cancer Became Big Business. 

"Since 2002, the group Breast Cancer Action has promoted its 'Think Before You Pink' campaign.  It's fighting 'pinkwashing,' which is when corporations try to boost sales by associating their products with the fight against breast cancer.  Pinkwashing is a form of slacktivism - a campaign that makes people feel like they're helping solve a problem, while they're actually doing more to boost corporate profits.  Pinkwashing has been around for a while, but is now reaching almost unbelievable levels"

Huh, very interesting...  as they say, please read the whole thing...

Andrew Evans - Making the Transition to Digital Pathology

Here's a fascinating article from Andrew Evans: Making the Transition to Digital Pathology.

The article discusses how the University Health Netwrk in Toronto went about adopting digital pathology for remote frozen section analysis, the challenges they faced, and the results and benefits.  It also mentions their plans for expanding their use of digital pathology in other areas, such as after-hours remote diagnosis of organ transplant biopsies to determine if rejection is taking place.

Dr. Evans, pictured at right reading a frozen section using digital pathology, is a Staff Pathologst at Toronto General Hospital.

Michael Montalto: Pathology re-imagined

Here's an interesting paper by Michael Montalto of GE's new Omnyx startup: Pathology re-imagined (the history of digital radiology and the future of anatomic pathology).

The analogies between digital pathology and digital radiology are extensive, as Michael discusses.  Digital pathology images are larger - on average, perhaps two orders of magnitude - which imposes extra performance demands on computers and networks, but fortunately Moore's Law is helping as the cost of storage, processors, and network bandwidth continue to drop.

In my opinion a key point of this article is this one:

"Although great progress has been made on scanners, storage, and browsers, there are critical missing pieces that are needed to capture true value; namely, an infrastructure whose mission is to capture efficiency in the overall pathology workflow."

We see this the same way, and Aperio's Spectrum system is designed to provide exactly that infrastructure.

One final point; I think Michael misses one of the key value propositions of digital pathology; the capability of automated image analysis to speed examination on digital slides and improve accuracy of diagnosis.  Just like Computer Aided Diagnosis (CAD) is making Radiologists more efficient and accurate, image analysis in digital pathology is doing so for Pathologists.