picture archiving and communication systems
Digital Pathology Systems Gear Up for Prime Time
Digital Pathology
Simply put, digital pathology is the utilization of digital photography to capture images on microscope slides. In the past (the early 1990s), there were a number of technical problems with digital imaging of anatomic pathology samples. Digital cameras captured the microscope slide images and stored them. However, the resolution of the digital photographs was not competitive with microscope optics and storage space was limited. A massive amount of data storage was required if the images of an entire microscope slide were to be archived. In addition, the task of capturing the entire microscope slide contents was time-consuming and laborious.
Dick Soenksen, CEO of digital pathology company Aperio Technologies, Inc., believes there are four requirements for effective digital pathology systems. They are:
1. Scanning ability.
2. Software to manage digital slides. In digital radiology they are called PACS (picture archiving and communication systems).
3. Information management systems.
4. The ability to perform image analysis on the digital slides.
Aperio Technologies, Inc.
If there is a leader in digital pathology systems–and it’s not clear that there is one–Aperio is probably it. Their headquarters is in Vista, California, with a European office in Bristol, U.K. Dick Soenksen, CEO of Aperio, says, “We are focused on digital pathology. That’s the only thing we do and it’s the only thing we’ve ever done. From our perspective, digital pathology is managing the information that’s generated by being able to digitize entire slides.”
One of the more interesting components of Aperio is their Digital Slide Scanning Service. Rather than invest in a system, the pathologist can ship their slides to Aperio and the company will use the ScanScope Scanner to digitize the slides, which are then returned along with a CD or DVD or via Internet access. Although the digital pathology market’s goal is undoubtedly to have all pathologists, labs, and hospitals using their technology in-house, this is a potential way to get pathologists to digitize early.
BioImagene
Cupertino, California-based BioImagene focuses on imaging systems for life sciences and digital pathology solutions. Mohan Uttarwar, President and CEO of BioImagene, says that their core competencies are, “The digitization of microscope slides, bringing in high-resolution image management, searching, mining of imaging data, and image analysis. Finally, the power of the Internet can be used to manage information, whether it’s a clinical report, educational content, peer reviews–formal or informal–or second opinions. All these pieces put together are something we as a company have focused on.”
Uttarwar cites four issues that are slowing adoption.
1. Lack of standardization.
2. Psychology, or resistance on the part of pathologists.
3. Ease of use and high quality.
4. Pricepoint.
Psyche Systems Corporation
Psyche Systems (Milford, MA) is not a digital pathology company per se, but a laboratory information system. They offer a number of different solutions for information management in a variety of laboratory areas, including anatomic pathology. Their AP solution is called the WindoPath Anatomic Pathology Information System, which has a modular, customizable design and can be integrated into several different laboratory information systems.
MIMvista Corporation
Based in Cleveland, Ohio, MIMvista recently made the news–somewhat contrary to Psyche’s comments about PocketPath–because of their development of a pathology imaging system specifically for Apple’s iPhone. MIM stands for Multi-modality Imaging, which has its roots in a digital radiology system dubbed Fusion.
Omnyx
As mentioned earlier, in June 2008, GE Healthcare and the University of Pittsburgh Medical Center entered into a joint agreement to start a digital pathology device company called Omnyx. Omnyx will be headquartered in Pittsburgh and also have a site in Piscataway, NJ, in addition to facilities in Israel and in Albany, New York. As yet, Omnyx does not have an actual product, although they plan to have a prototype device developed by the end of 2008 and expect to launch a product in 2010. Gene Cartwright, CEO of Omnyx says, “We believe it will be a little less than two years before we have a product. I think that we’ll be able to describe it in high level detail by the end of this year, but it’s the sort of product that needs FDA approval and that adds a certain amount of time to it.”
Cartwright believes the reason the field of digital pathology is receiving so much interest at the moment is that some of the technical hurdles are close to being solved. “The main ones are speed of acquisition of an image, quality of the image, ability to navigate around the image without having to wait for the image to come up, and then the ability to stream images. The cost of storage has dropped by 30 to 40 percent a year.”
Educational Use
John Woosley, MD, PhD, Professor of Pathology at the University of North Carolina at Chapel Hill, notes an increased use of digital slides in medical education. He sees it as an opportunity for medical schools to cooperate and share teaching materials, primarily because once a slide has been scanned, it costs nothing to duplicate
Conclusion
As noted, pathology is one of the last areas of clinical medicine to become digitized, following radiology and cardiac imaging. Typically the domain of microscope companies like Nikon, Zeiss and Olympus, a number of small companies have entered the market with new optics technology and digital information management software.
Although a number of companies and researchers have approached digital pathology over the last ten to fifteen years, they were hampered largely by the difficulty of acquiring high-resolution images of the entire microscope at high enough quality to be clinically useful. As digital image capture technology improved along with increased digital storage capacity at lower prices, digital pathology may have reached a tipping point where the technology is available at a reasonable cost.
It’s not clear how large that market may actually be. Omnyx’s Cartwright says, “The assumption is the market will adopt digital pathology at the same rate that digital radiology was adopted. So in several years we believe–and at the price points we’re assuming the market will support–that the market will be worth about $2 billion.”
Aperio’s Soenksen is more optimistic. “We’ve looked at the market and we’ve made a hypothetical full-adoption in the market and say it’s close to $4 billion a year. That’s about twice the size of what GE had in their analysis. We see more value in digital diagnosis that could be applied to automate things that pathologists are currently spending time on.”
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How Can Radiology PACS Help Your Medical Facility Run More Efficiently
Radiology PACS are Picture Archiving and Communication Systems that allow you to produce, view, archive and transmit digital images. Digital radiology systems utilize both specialized software and hardware, yet many of the systems can be run on personal computers and networks with which you likely are already familiar.
Like all digital products, the cost of radiology pacs systems has dropped over the past several years. This means that Radiology PACS are now within the reach of small to medium-sized medical offices and facilities.
Storage of your digital medical images will also save your medical facility money. In the past, prints had to be made, which were then stored in file folders in large storerooms. It was also a big task to retrieve film images, because you had to wade through all of the files to find the ones you needed. This is a thing of the past with digital radiology systems. With a couple of mouse clicks, you can sort through thousands of digital images files to find the one you want in a matter of seconds. Costs typically associated with storage, including storage space, paper, files, as well as chemicals used to print film images, are completely eliminated with digital radiology systems.
Radiology PACS also help you stay in compliance of HIPPA regulations for the storage of patient records and medical images much more easily than in the past, when up to seven years of hard-copy records had to be stored and backed up. Digital images can be backed up onto CDs and DVDs as well as offsite archiving on hard drives and in databases by using radiology pacs systems.
Radiology pacs systems also allow you to take advantage of teleradiology, where digitized medical images and records can be sent to authorized personnel via the Internet. Radiology PACS enables physicians anywhere with Internet service to access medical digital images, thus enabling real-time collaboration with physicians down the hall or around the world. In this way, radiology PACS benefits patients, by giving them better care at a fraction of the traditional cost.
Another advantage that comes from using digital radiology systems is that it utilizes the same computer technology with which you and your office staff are already familiar. Computers are turned into workstations with radiology systems software. Peripherals such as scanners and printers are used in conjunction with radiology pacs systems to allow you to scan hard copy documents and turn them into digital images, or to print out digital images.
All this efficiency is possible through the use of PACS and digital medical imagery.
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Radiology Pacs Makes Digital Imaging Possible At Your Medical Office
In days past, you would take images using film. The films would have to be developed using costly chemicals. The images would need to be carefully handled and stored in large storage rooms, requiring medical staff to maintain the records, file them and retrieve them. Over time, film could become damaged and the picture could degrade. The images could be completely lost in the case of a fire or flood. These are all reasons why so many hospitals and medical offices are making the switch to Radiology PACS. With dicom pacs, the patient images are now all digital, and can be viewed using a personal computer that you already have at your office. Digital images can be retrieved through the use of a search feature quickly and easily. These images can also be stored in a fraction of the space once needed, and backup can be done both on and offsite, so that you are safe should disaster strike. A pacs system also allows for more accuracy in imaging. Digital images can be enhanced by using Radiology PACS so that the picture can be cropped or rotated, panned or zoomed, all with the click of a mouse. Brightness and contrast can easily be adjusted, allowing you to see more than you might have ordinarily been able to using traditional film imaging. Radiology PACS also allows you to distribute images easily by using the speed of the Internet.
Digital images can be accessed through a pacs system by authorized personnel from offsite locations anywhere around the world or in your medical office. Digital images can be sent ahead by referring physicians to specialists easily when they are sent via your pacs system. Many offices use a ris pacs system to streamline their patient scheduling and records. Ris pacs connects a radiology information system to the picture archiving system, saving you a great deal of time and effort in processing patients. A ris pacs can help your staff with patient registration and scanning, along with the entry of results and reports that are produced. Patient tracking and results delivery are all accurately accomplished via ris pacs. Smaller clinics may benefit through using mini Radiology PACS. There are web based, all-in-one units that are very budget appropriate for medical offices, chiropractic and orthopedic clinics. Whatever your facility size, Radiology PACS are available that can help you meet all of your digital imaging needs.
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