College of American Pathologists

  Press Release


Published on September 16, 2010

Contact: Candace Robertson
Phone: (847) 832-7764

Medical imaging standard extension for pathology will help advance health information interoperability

Northfield, Ill., Sept. 16, 2010— The College of American Pathologists’ (CAP), a member of the Digital Imaging and Communications in Medicine (DICOM) Standards Committee, contributed to the expansion of the DICOM medical image exchange standard Supplement 145—the first for pathology.

The standard will enable electronic display, sharing, storage, and management of the image of the “entire microscope slide”—or large images usually associated with pathology. It will also allow health care professionals flexibility, such as panning and zooming, when interacting with the image.

“This is a significant leap for pathology,” said Louis D. Wright, Jr., MD, FCAP, CAP governor and co-chair of CAP’s Diagnostic Intelligence and Health Information Technology (DIHIT) Committee, which is committed to advancing health IT standards, practices, and tools. “Pathology will now have a universal language for digitizing microscope slides. This, in turn, will help pathologists assure the quality of these digital slides.”

The adoption of whole slide digital imaging into hospitals and laboratories is desirable for advancing pathology and improving patient care. Currently, most hospitals use a PACS (Picture Archiving and Communication System) to manage and store radiology images. Until now, PACS software and the DICOM core standard did not accommodate pathology whole slide images.

Supplement 145, the new standard for “Whole Slide Microscopic Images,” will facilitate health information interoperability of pathology medical images, various whole slide imaging equipment manufacturers, PACS, and electronic health records (EHRs).

“The field of pathology is undergoing a transformation in which digital imaging is becoming increasingly important, due to the commercial availability of instruments for digitizing microscope slides,” said Bruce A. Beckwith, MD, FCAP, chair, Department of Pathology, North Shore Medical Center, Salem, Mass. and DICOM Working Group 26 co-chair. “Industry efforts to work with DICOM Supplement 145 will advance interoperability in pathology."

Dr. Beckwith, a member of the CAP DIHIT Committee, leads the DIHIT Standards and External Affairs work group. DIHIT initiatives include the CAP Diagnostic Work Station and standardized electronic reporting, such as the CAP electronic Cancer Checklists (CAP eCC). (Please note: Dr. Beckwith will be presenting courses, unrelated to DICOM, at the CAP ’10 THE Pathologists’ Meeting™ in Chicago, September 26-29, 2010 and will be available for interviews related to Supplement 145.)

Harry Solomon, interoperability architect, GE Healthcare, and Supplement 145 editor, said, “The whole slide imaging standard has two additional aspects that make it transformative for anatomic pathology: it is aligned with the DICOM data structures and network services for workflow management; this means we are closer to true plug-and-play integration of imaging components with laboratory information systems. Use of the single standard for medical imaging, DICOM, means that we can foresee better clinical integration across radiology, pathology, surgery, and radiation oncology, enabling a comprehensive evidentiary trail from screening to biopsy to diagnosis to treatment.”

What’s next for Supplement 145? The Rosslyn, Va.-based DICOM Standards Committee, and Working Group 26, Pathology, which has been working on the standard since 2005, will reach out to the international LIS (laboratory information systems) vendors to bring them on board in the process of advancing medical pathology imaging standards and moving toward a vision of a true, enterprise-wide PACS system that can be used by all specialties in health care systems.

DICOM, ISO (International Organization for Standardization) standard 12052, is the global standard for medical imaging and is used in all electronic medical record systems that include imaging as part of the patient record. Its continuing evolution is managed by a collaboration of 40 professional societies, government agencies, trade associations, and imaging equipment manufacturers, under the Medical Imaging and Technology Alliance (MITA).

The CAP’s DIHIT Committee contributes to the DICOM Standards Committee, Working Group 26, Pathology, along with international representatives from health care systems, software vendors, and academia.

Widely considered the leader in laboratory quality assurance, the CAP has more than 40 years of experience in standardized clinical terminology development—resulting in the creation of SNOMED Clinical Terms® (SNOMED CT®)—as well as industry experience in health information technology and standards development including DICOM, HL7, IHE, and IHTSDO.

CAP TODAY, the CAP’s monthly news magazine, will feature an article on Supplement 145 in its September 2010 issue.

CAP STS (SNOMED Terminology Solutions™), a division of the College of American Pathologists (CAP), is a leader in transforming health information. CAP STS’ Professional Services, leading the pursuit of semantic interoperability for EHRs, specializes in customized best-practice health information solutions from strategy and planning to implementation and maintenance. CAP STS’ goal is to ultimately improve patient care through supporting the pathologist’s role as chief diagnostician/clinical care advisor and advancing interoperable EHRs.

CAP STS’ DIHIT (Diagnostic Intelligence and Health Information Technology) team is committed to advancing health IT standards, practices, and tools, such as the CAP Diagnostic Work Station initiative; and standardized electronic reporting, including the CAP electronic Cancer Checklists (CAP eCC).

The College of American Pathologists is a medical society serving more than 17,000 physician members and the laboratory community throughout the world. It is the world's largest association composed exclusively of board-certified pathologists and is widely considered the leader in laboratory quality assurance. The College is an advocate for high-quality and cost-effective patient care. For more information, visit or write to

SNOMED CT® is a copyrighted work of the International Health Terminology Standards Development Organisation. ©2002-2010 International Health Terminology Standards Development Organisation (IHTSDO®). All rights reserved. SNOMED CT® was originally created by the College of American Pathologists. “SNOMED,” “SNOMED CT,” and IHTSDO are registered trademarks of the IHTSDO. All other trademarks used in this document are the property of their respective owners.

The College of American Pathologists (CAP) is a medical society serving about 17,000 physician members and the laboratory community throughout the world. It is the world’s largest association composed exclusively of pathologists and is widely considered the leader in laboratory quality assurance. The CAP is an advocate for high quality and cost-effective patient care.