College of American Pathologists
Printable Version






November 2009

Raymond D. Aller, MD
Hal Weiner

Mega-sized medical images a reality with Tissuescope Mega-sized medical images a reality with Tissuescope

When it comes to biomedical imaging, the creators of the Tissuescope 4000 believe bigger is better. The Tissuescope imaging system, developed by Waterloo, Ontario-based Biomedical Photometrics, has produced the largest pathology image ever—a 61 gigapixel image of breast tissue.

The mega-sized image was produced with Tissuescope as part of a research project on breast cancer at Sunnybrook Health Sciences Centre, an academic research hospital affiliated with the University of Toronto and a pioneer in the use of medical imaging devices and image-guided therapies.

The overall goal is to develop better assessment tools for measuring tumors, says Martin Yaffe, PhD, a senior scientist at Sunnybrook. Researchers use the large image to obtain more accurate information about tumor margins and to get a better idea of the volume of a tumor by doing serial sectioning and then putting together three-dimensional datasets, he explains.

“We really want to try and build up a volume that represents the disease and surrounding normal tissue from resection and correlate that to what was seen preoperatively from the diagnostic images,” Dr. Yaffe says. “So it gives us the ability to validate new [biomarker-based] imaging techniques and determine that they are giving us new and useful information.”

Tissuescope was developed about three years ago, says Ted Dixon, PhD, CEO and chairman of Biomedical Photometrics. The latest version, Tissuescope 4000, was released in 2008 and is quite different from the original version, he adds. “As far as we know, it’s the only instrument that will handle microscope slides up to five by seven inches.”

Using a proprietary laser-scanning technology, Tissuescope can image an area more than 100 times larger than that of a standard microscope, Dr. Dixon explains. Previous technology required that large samples be scanned using a tiling approach, in which many small scan sections are stitched together to form a large, contiguous image. Tissuescope eliminates this requirement and can complete scans in one-tenth the time, he says. Preview scans for finding tissue and setting fluorescence channel contrast can be accomplished at a speed 100 times that of a final scan speed.

Using a patented optical system that employs multiple fiber-coupled lasers and variable-contrast detection channels, Tissuescope can register a variety of scans, Dr. Dixon continues. For example, a researcher can collect three fluorescence images in sequence to check for overlap between different fluorophores. “The instrument will show each image separately and will automatically superimpose the three images if the researcher instructs the system to do so,” he explains.

Because Tissuescope’s fluorescence and brightfield detectors are always active, he adds, the system can acquire images from multiple light sources without changing magnification. “If you want to superimpose images, it is easy to do so.”

The instrument can also image three different fluorophores sim-ultaneously. “If you have a strong fluorophore, a medium fluorophore, and a weak fluorophore, we can have the gain right for all three of them,” says Dr. Dixon. Instruments that only expose as a function of time often bleach fluorescence specimens, he notes.

Dr. Dixon envisions the next version of Tissuescope, which is expected to be released in summer 2010, as a tool for clinical pathology that will handle traditional slides using an autoloader. Users will be able to stack slides, and the operator will simply let the machine run, transferring consistent images to a server for evaluation.

This will bring high-resolution imaging of brightfield and fluorescence within the reach of even small hospitals, he says.

For now, Dr. Dixon continues, the 61-gigapixel image is receiving great response, with comments like, “‘Boy, I think it’s time for us to look at this as a standard way of doing business.’ And that’s really quite exciting to me.”

Biomedical Photometrics posts sample images from Tissuescope at The Web site displays new images approximately every four to eight weeks.

BioImagene marketing digital pathology workstation BioImagene marketing digital pathology workstation

BioImagene has released Crescendo, its new digital pathology workstation.

Crescendo brings together data from such silos as laboratory information systems and radiology picture archiving and communication systems, as well as gross images, online references, and differential patient information.

“Crescendo, analogous to its musical namesake, is at the pinnacle of diagnostic intelligence,” says Ajit Singh, PhD, CEO of BioImagene. It “facilitates efficient and effective diagnosis, collaboration, and decision support.”

Orchard, Cardinal Health to co-market information systems Orchard, Cardinal Health to co-market information systems

Orchard Software and Cardinal Health have announced an exclusive agreement whereby Cardinal Health will team up with Orchard to offer the Orchard Harvest laboratory information system and Orchard pathology diagnostic information system to physician office laboratories.

Cardinal Health is a manufacturer and supplier of medical and surgical products and serves clinical laboratories, hospitals, pharmacies, and ambulatory care sites.

Halfpenny releases Web portal for sharing laboratory data Halfpenny releases Web portal for sharing laboratory data

Halfpenny Technologies has launched a Web-based portal that allows physicians to order laboratory procedures and review lab results in a secure, HIPAA-compliant environment through a standard Web browser.

Halfpenny’s ITF-Portal is being introduced in conjunction with the release of version 3.0 of its proprietary integration technology framework health information exchange platform. The platform is a specialized interface engine that connects physician electronic medical record systems with hospitals and labs.

ITF-Portal features Google-like search capability and streamlined single-page order entry. It also supports PDF generation for facilities that cannot transmit or receive discrete data. Among the new enhancements to ITF version 3.0, which is tightly integrated with ITF-Portal, are improved redundancy, scalability, and alerting, as well as centralized management.

The newly enhanced integration technology framework is intended to extend the functionality of legacy laboratory and hospital information systems.

Cerner launches platform to generate client input Cerner launches platform to generate client input

Cerner has rolled out the uDevelop platform, coupled with its online uCern Store, to enable health care professionals who use the company’s solutions to share knowledge, solve collective problems, and develop innovations.

The uDevelop platform, modeled on the principle of open-source software development, will allow users of Cerner products to provide direct feedback on those products and help customize and develop Cerner solutions.

The innovations created through the uDevelop platform will be made available through the uCern Store. Cerner clients who visit the uCern Store will be able to browse through a menu of offerings, upgrade packages and enhancements, and make other purchases.

Registered Cerner clients can access the uDevelop platform at and the uCern Store at

Quest offers electronic prescribing service Quest offers electronic prescribing service

Quest Diagnostics is providing a six-month, risk-free trial of its Care360 ePrescribing service to physicians using the company’s Care360 Labs & Meds service. Other U.S. physicians can also opt in at no obligation if they begin using the electronic prescribing service before Dec. 18.

Physicians who use Care360 ePrescribing can access formulary information, act on FDA alerts, handle refills, send and print prescriptions, and take advantage of Centers for Medicare and Medicaid Services incentives.

“Because we currently work with approximately half of all physicians and hospitals in the U.S., we are uniquely positioned to drive interest in this new technology, particularly among smaller and medium-sized physician practices,” says Surya N. Mohapatra, PhD, chairman and CEO of Quest.

Care360 ePrescribing, which is certified by the Surescripts electronic prescribing network, is a service of the Quest Diagnostics Care360 suite of health information technologies.

Whole-slide imaging makes list of top medical innovations Whole-slide imaging makes list of top medical innovations

The Cleveland Clinic recently released its list of top 10 medical innovations for 2010, as determined by a panel of Cleveland Clinic physicians and scientists. Included in the hospital’s prediction of the 10 emerging technologies that will shape health care next year was whole-slide imaging for managing digital data in pathology.

To be considered for the list, an innovation was required to have significant potential for short-term clinical impact—that is potential to be of significant patient benefit or greatly enhance health care delivery; have a high probability of success; be available commercially or nearing availability; and generate sufficient data to support its nomination.

Also on the list of leading innovations were oral thrombopoeitin receptor agonists for stimulating platelet production, fertility preservation through oocyte cryopreservation, non-vitamin K antagonist oral anticoagulants, and continuous-flow ventricular assist devices.

The Cleveland Clinic’s complete list of top medical innovations is available at


Haemonetics Corp. has signed an agreement with Blood Centers of America under which it will provide BCA member blood centers with access to its integrated Symphony suite of blood-management software and eQue automated interview and assessment donor-screening system. West Warwick, RI-based Blood Centers of America is a cooperative of community blood centers.

Mediware Information Systems has licensed its LifeTrak blood donor management software to Richmond, Va.-based Virginia Blood Services, a nonprofit corporation that serves numerous hospitals throughout Virginia.

Dr. Aller is director of automated disease surveillance and team lead for disaster preparedness Focus B, Los Angeles County Department of Public Health. He can be reached at Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at