The Daily Scan

The Daily Sign-Out

I just wanted to call your attention to an interesting new blog "out there", The Daily Sign-Out, "Surgical pathology and laboratory medicine for the practicing pathologist", from Dr. Mark Pool.

Among other things he's posted a Digital Case Challenge:

(please click for larger window)

History: 70 year-old man with history of smoking and solitary right upper lobe mass incidentally found by CT during work-up for abdominal aortic aneurysm.

Please join me in welcoming Mark to the blogosphere, and if you have thoughts about the Digital Case Challenge please leave them as a comment on his blog.

Aperio and Cerner Develop Integrated Technology Solution for Anatomic Pathology

I try not to blog about Aperio press releases too often - if you're interested in them, you probably get them anyway :) - but this seems worthy of note: Aperio and Cerner Develop Integrated Technology Solution for Anatomic Pathology:

Aperio Technologies, Inc., a global leader in digital pathology for the healthcare and life sciences industry, and Cerner Corporation, a leading supplier of healthcare information technology, announced today the development of an interface between Spectrum™, Aperio’s digital pathology information management system, and the Cerner CoPathPlus®, pathology laboratory information system (LIS). The interface is designed to optimize workflow and facilitate access of digital slide images and case data between the two systems. The new technology was recently displayed at the APIII annual conference on Pathology Informatics and Diagnostic Imaging at the Marriott City Center in Pittsburgh, Pa.

As Aperio's Spectrum system is adopted in more and more clinical labs, we invariably find one of the most pressing needs our customers have is tight integration with their LIS.  Since Cerner's CoPath is the leading LIS, this interface is going to make a lot of customers happy.

It should be noted that Spectrum is an "open" system which supports standard HL7 messaging as well as all manner of custom interfaces, and have previously announced other interface relationships including one with Impac, makers of Powerpath, and with McKesson's AP-LIS.

Why Current Breast Pathology Practices must be Evaluated

Thinking about Aperio's new SecondSlide service, which is designed to make sharing digital slides really easy (and hence to facilitate secondary consultations, among other uses), I recalled this great report from the Susan G. Komen foundation in 2006: Why Current Breast Pathology Practices must be Evaluated (PDF).

The report lays stress on the importance of second opinions:

Another option to improve diagnostic accuracy is to encourage or mandate that appropriate patients receive a second opinion on their pathology and to ensure that reimbursement is available for such serivces.  Which patients require a second opinion remains to be determined.  Certain diagnoses may be more difficult to make and therefore may require a mandated expert review.

Anecdotally when I speak to pathologists they all universally acknowledge the value of second opinions, as a safety net as well as a way to ensure difficult diagnoses are rendered with more confidence.  The barriers are the inconvenience and expense of shipping slides, and the time elapsed.  Our hope is that SecondSlide will lower these barriers significantly, making secondary consults more prevalent and thereby improving patient care.

HeartIT Launches website for patients to share medical images

HealthImaging reports HeartIT Launches website for patients to share medical images:

Heart Imaging Technologies (HeartIT) has launched a free website (www.webpax.com) which allows patients to upload and share diagnostic-quality medical images using a standard web browser. Patients can email a web link that allows the recipient to view movies of a beating heart, according to Brent Reed, vice president for sales and marketing for the Durham, N.C.-based company.

Viewing of DICOM-formatted medical images traditionally requires dedicated workstations, which in turn are connected to PACS; however, Web 2.0 technologies allow patients to manage DICOM images from their exams. The company said that security on its site is based on the same technologies used for online banking. As an added precaution, private information, such as names and dates, are automatically removed from the DICOM header during uploading.

This is really interesting, similar in concept to Aperio's SecondSlide service, announced recently, except that SecondSlide is optimized for the really large whole-slide images used in Pathology.

Senate OKs big NIH bump

From TheScientist: Senate OKs big NIH bump:

The US Senate, which is furiously debating the details of the economic stimulus package making its way through Congress, passed an amendment yesterday (Feb. 3) to add $6.5 billion in National Institutes of Health funding on top of the $3.5 billion already allotted to the agency in the bill.

...

The House (with no support from Republicans) passed a version of the stimulus bill, which provided $3.5 billion in NIH funding, last week. Democrats and Republicans in the Congress will continue thrashing out the finer points of the bill, and the legislature is expected to have a version ready for President Barack Obama to sign by mid-February. Exactly how an NIH funding increase will be spent remains to be determined.

Wow.  I'm not sure about all this "spending to stimulate the economy", but if the government is going to spend [our] money on infrastructure this is certainly a worthwhile target.

National Cancer Institute to open molecular imaging clinic

HealthImaging.com reports National Cancer Institute to open molecular imaging clinic.

The National Cancer Institute (NCI) is scheduled to open a new molecular imaging clinic this month, where a multidisciplinary team of imaging scientists, chemists, physicists, engineers, oncologists and molecular biologists will use the latest imaging tools in an effort to learn how drugs function in cancer patients.

"Our goal is to use advanced imaging technologies to accelerate the development of therapies for cancer," said Peter Choyke, MD, the director of the molecular imaging program at the NCI Center for Cancer Research.

Many studies will be done in partnership with other institutions or pharmaceutical or imaging equipment companies. NCI's Division of Cancer Treatment and Diagnosis was instrumental in the development of the clinic and will continue to supply materials, such as radioactive imaging agents. The new facility will have the various scanners, including a PET/CT unit and a 3T whole-body MRI.

"Our mission is to use the cameras to do translational studies that will make drug development faster. There are very few imaging centers dedicated to drug discovery and research," said Karen Kurdziel, MD, the director of the new molecular imaging clinic.

These guys obviously need some ScanScopes!

Invention turns cell phone into mobile medical lab

How cool is this?  CNN reports Invention turns cell phone into mobile medical lab. 

Professor Aydogan Ozcan of UCLA has taken a typical Sony Ericsson phone, and by adding a few off-the-shelf parts that cost less than $50, he can get it to produce a remarkable image that shows the thousands of cells in a small fluid sample such as human blood.

"It is a new way of doing images of cells and bacteria," said Ozcan, an assistant professor in UCLA's electrical engineering department. While other small imaging systems use bulky optics, his group's invention offers "true miniaturization of a laboratory" because there are no lenses and the results are quick and accurate, he said.

The device is called LUCAS, which stands for lensless ultra-wide-field cell monitoring array platform based on shadow imaging. It uses a short wavelength blue light to illuminate a sample of liquid -- blood, saliva or another fluid -- on a laboratory slide.

LUCAS captures the image to a chip in the cell phone. If the phone is loaded with an algorithm program, it then counts the microparticles much faster than a human can. The image also can be transmitted wirelessly to a computer, which analyzes it and sends back a text message with the results.

This is pretty cool.  Isn't not clear this device has diagnostic quality images, but if this one doesn't, the next one will; the writing is on the wall that this kind of imaging is the future.