The Daily Scan

The ten most expensive iPhone apps ($180 digital pathology viewer is #9)

The Business Insider reports on the ten most expensive iPhone apps.  A $180 digital pathology viewer from Interpath was #9 on the list!

Provides remote access to pathology images for medical professionals, used for cancer diagnosis or other disease treatments.  Requires an image server like Aperio.requires an image server like Aperio.

I guess compared to a lot of iPhone apps $180 is pretty expensive - most are priced under $10 - but for a busy professional like a Pathologist, the time savings and convenience of being able to read digital slides anytime anywhere could be well worth it.  Imagine a stet surgery, where a frozen section must be analyzed in realtime while the patient is under anesthesia.  It could make a massive difference to that patient's care.

Radiology: Image display contrast variation negates consistent mammo readings

HealthImaging has an interesting little article with some ramifications for digital pathology; Radiology: Image display contrast variation negates consistent mammo readings:

A study published in the August issue of Radiology has determined that image display contrast variations account for the differences between digital and film-screen mammography in detecting cancer in the Digital Mammographic Imaging Screening Trial (DMIST).

In DMIST—co-sponsored by  the National Cancer Institute (NCI) and American College of Radiology Imaging Network (ACRIN), participants underwent both digital and film-screen mammography between September 2001 and November 2003. The diagnostic accuracy of digital mammography was found to be “significantly greater” than that of film-screen mammography for women with dense breasts, women younger than 50 and pre- and perimenopausal women.

...

The authors concluded that the “significantly better diagnostic accuracy” of digital mammography over film-screen mammography was most likely due to differences in image contrast, which were “attributable primarily to differences in the display and acquisition characteristics of the mammography devices rather than to reader variability.”

In digital pathology the debate has largely centered on whether digital images are "as good" as viewing slides through a microscope.  There are of course ways in which digital images are better; it is easier to view them remotely, archive and retrieval is better, they don't break or fade, and the tools are much better; you can view multiple images at once, view several views of the same slide (including looking at a thumbnail of the entire slide to orient high-magnification views), pan and zoom easily, measure objects accurately, and so on...  but few have claimed that digital images are better than viewing through a microscope.  Still, the tools to enhance contrast and change color balance are widely available, and could have the same kind of beneficial effect as found in this study.

Stay tuned!

Newly-Formed AFIP Laboratories Fills Critical Void Left by Scheduled Closure of Walter Reed Army Medical Center

EarthTimes reports Newly-Formed AFIP Laboratories Fills Critical Void Left by Scheduled Closure of Walter Reed Army Medical Center:

AFIP Laboratories, a premium provider of diagnostic consultative anatomic pathology services, today announced the formation of its team of professionals, made up of former civilian pathologists, radiologists and staff of the soon-to-be-closed Armed Forces Institute of Pathology.  The 150-year old Institute, which offers premium pathology consultation services to clients around the world, will cease operations when the Walter Reed Army Medical Center closes.

AFIP Laboratories will continue the Institute’s mission of providing pathology services to government, physicians and patients, with emphasis on all anatomic pathology specimens and related services.  Dr. Evan Farmer, M.D., an internationally recognized dermatopathologist who held previous positions as Dean and Provost of Eastern Virginia Medical School and Chairman of the Department of Dermatology at Indiana University, will serve as Director of AFIP Laboratories.  Dr. Farmer is board certified in dermatopathology and dermatology and received his M.D. from Johns Hopkins University.  He completed his residency at Johns Hopkins University and was the Osborne Fellow at the Armed Forces Institute of Pathology.  He maintains a part time faculty member position at both Johns Hopkins University and Virginia Commonwealth University.

This is excellent; the AFIP has one of the world's most comprehensive libraries of tissue and medical slides, and is a premier source of second opinions with expertise in a wide variety of areas.  They are also a pioneer in the use of digital pathology!

(Update: apparently the reports of the demise of the AFIP were exaggerated, they are continuing to serve, and this new commercial organization has renamed itself to AIP Laboratories.  I have updated the logo and link above accordingly...)

Dark Report audio conference: Pathology and Radiology's Combined Future is Now at KU

The Dark Report presents a brand new audio conference: Pathology and Radiology's Combined Future is Now at KU: How Integrated Breast Cancer Diagnostics are Improving Patient Care.

In a pioneering effort at The University of Kansas, a radiologist and a pathologist are working side by side to review each other's primary images and issue a single, integrated diagnostic report for breast cancer patients.  The big surprise from this groundbreaking collaboration is a measurable improvement in diagnostic accuracy, leading to improved patient outcomes.

If you're a pathologist or radiologist, what does this mean for you?  More than likely, it means a future of increased collaboration.  Instead of separate clinical silos, pathologists and radiologists will work side by side, sharing each other's primary images and producing a single, unified diagnostic report for clinicians.

To understand the benefits of a collaborative working relationship between pathologists and radiologists, join us on August 19, 2009 for a special audio conference that features two innovators-pathologist Ossama Tawfik, M.D. and radiologist Mark Redick, M.D.—both from The University of Kansas (KU).  Targeting micro-calcifications in breast cancers, you'll learn how, together, their reviews of the radiology and pathology images triggered significant revisions to the original diagnostic reports from each specialist.

This is really an interesting study - and it wouldn't have been possible to do this kind of collaboration without digital radiology and digital pathology images.

A Blueprint for Blending Anatomic and Clinical Pathology

Bruce Friedman at LabSoftnews: A Blueprint for Blending Anatomic and Clinical Pathology:

My vision for an integrated discipline of pathology, then, is that all diseases will eventually be diagnosed using tissue and serum biomarkers interpreted by specialized algorithms.  Morphological observation of tissue and cells will continue to be very important for both the diagnosis of disease and the selection of the most appropriate sets of biomarkers and algorithms to use in a particular setting.  I would also suggest that pathology will grow closer to radiology such that the science and technologies of these two medical specialties will reinforce each other through integrated diagnostics.

One of the differences between Clinical and Anatomic Pathology is the instruments they use, of course; Clinical Pathologists have highly optimized diagnostic tools like blood chemistry analyzers (right, above), and Anatomic Pathologists now have sophisticated digital slide scanners to aid them in diagnosing from morphology (right, below).

I find it interesting that while much of medicine is bifurcating into narrower and narrower specialties, there is so much discussion in Pathology about combinations; Pathology with Radiology, and within Pathology, Anatomic and Clinical Pathology.  It seems to be that ultimately specialties will be defined by what you know and what you do rather than by the tools you use.

Contract research on the rise

TheScientist notes Contract research on the rise:

The global economic crisis has got most businesses pinching pennies just to stay afloat, and the drug development industry is no exception.  But at least one area of the biotechnology sector -- contract research organizations (CROs) -- is on the rise. 

CROs first showed up in the biotech industry in the late 1970s and quickly took on a significant role in research and development (R&D), eventually expanding from drug discovery and preclinical work to clinical trials, drug manufacturing, and even marketing.  According to a 2005 Thomson CenterWatch survey, the $15 billion CRO industry was growing at a rate of 12% each year, but data from the past two years show a substantially higher annual growth rate of nearly 17%.  In 2007, of the approximately $60 billion biotech and pharmaceutical companies spent on drug development, $15 billion (25%) was outsourced.  Last year, despite the economic recession, the CRO market grew to nearly $20 billion -- 29% of the $74 billion drug development budget.

Facilitating collaberation and communication between Biopharma companies and their CRO partners is a key value proposition driving the adoptin of digital pathology.

'Trojan horse' to fight cancer

Science Alert has an interesting article about a new way to fight pancreatic cancer: 'Trojan horse' to fight cancer:

Pancreatic cancer has a tough new opponent, a molecule described as a ‘Trojan horse’ and developed by a Western Australian Institute for Medical Research (WAIMR) team.

The molecule is able to target a type of pancreatic tumour, eventually enabling the body’s immune system to attack the cancer.

A strong inflammatory agent is packed into the molecule using lipid-nanotechnology, to target a site and attract millions of immune cells to kill the tumour.

Sounds like in interesting approach.  In addition to being more effective by penetrating the cancer cells to deliver the active agent, the encapsulating molecule also reduces side effects.