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TEFI Endoscopic Technology Watches Changes in Retina

TEFI Endoscopic Technology Watches Changes in Retina

TEFI Endoscopic Technology Watches Changes in Retina

The monitoring and treatment of eye diseases that may cause blindness has taken a big leap forward, thanks to a new imaging technique that takes high quality colour photographs of the whole retina.

Using the new technique called ‘TEFI’ (Topical Endoscopic Fundal Imaging), Professor Andrew Dick, David Copland and the team from the University of Bristol’s Academic Unit of Ophthalmology, monitored changes in mice retina over time, without distress to the animals or the need for anesthesia.

The study focused on a condition in mice similar to human posterior uveitis, an inflammation that affects the back of the eye and which can be difficult to monitor using existing techniques. TEFI allowed the researchers to see changes to the eye that were previously undetectable.

“TEFI enhances our monitoring of clinical disease in a rapid and non-invasive fashion,” Copland said. “It will aid in the design of experimental protocols according to clinical observations.”

Professor Dick added: “Combined TEFI and histological methods enable the observation of clinical features and severity of disease, but information regarding the dynamics, phenotype, function and quantity of cellular traffic through the eye is only provided through detailed analysis of cell populations present in the eye at various stages of disease progression.”

The study, “The Clinical Time-Course of Experimental Autoimmune Uveoretinitis Using Topical Endoscopic Fundal Imaging with Histologic and Cellular Infiltrate Correlation,” was published this week in Investigative Ophthalmology and Visual Science. It featured the use of Topical Endoscopic Fundal Imaging (TEFI), a technique that uses an endoscope with parallel illumination and observation channels connected to a digital camera.

purpose. EAU is an established preclinical model for assessment of immunotherapeutic efficacy toward translation of therapy for posterior uveitis. Reliable screening of clinical features that correlate with underlying retinal changes and damage has not been possible to date. This study was undertaken to describe, validate, and correlate topical endoscopic fundus imaging (TEFI) with histologic features of murine experimental autoimmune uveoretinitis (EAU), with the intent of generating a rapid noninvasive panretinal assessment of ocular inflammation.

methods. EAU was induced in B10.RIII mice by immunization with the peptide RBP-3161-180. The clinical disease course (days 0–63) was monitored and documented using TEFI. Disease severity and pathology were confirmed at various time points by histologic assessment. The composition of the cell infiltrate was also examined and enumerated by flow cytometry.

results. TEFI demonstrated the hallmark features of EAU, paralleling many of the clinical features of human uveitis, and closely aligned with underlying histologic changes, the severity of which correlated significantly with the number of infiltrating retinal leukocytes. Leukocytic infiltration occurred before manifestation of clinical disease and clinically fulminant disease, as well as cell infiltrate, resolved faster than histologic scores. During the resolution phase, neither the clinical appearance nor number of infiltrating retinal leukocytes returned to predisease levels.

conclusions. In EAU, there is a strong correlation between histologic severity and the number of infiltrating leukocytes into the retina. TEFI enhances the monitoring of clinical disease in a rapid and noninvasive fashion. Full assessment of preclinical immunotherapeutic efficacy requires the use of all three parameters: TEFI, histologic assessment, and flow cytometric analysis of retinal infiltrate.

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Introduction

Experimental autoimmune uveoretinitis (EAU) is a suitable correlate to the spectrum of clinicopathologic features of human uveitides and, as a result, is a successful preclinical model for translation of immunotherapies.1 2 Furthermore, the model serves to dissect immunopathogenic mechanisms relating to immune-mediated tissue damage, which in turn highlight avenues for future immunotherapies.3 4 5 6 Murine EAU is generated after systemic activation of ocular-specific CD4+ T cells that are frequently located within or around photoreceptor segments.7 8 9 10 11 In particular, EAU can be induced via administration of dominant peptides from retinoid binding protein (RBP)-3 (previously called interphotoreceptor retinoid binding protein [IRBP]) in an appropriate adjuvant.12 Disease occurs subsequent to T cell infiltration into the target organ that recruits and activates macrophages into the eye, generating structural damage via mechanisms including secretion of nitric oxide (NO).13

To quantify the extent and severity of disease, which is clearly essential for validating the efficacy of preclinical therapies, two approaches have been used to date: nonvalidated clinical scoring and semiquantitative histologic scoring and grading. Clinical EAU assessment involves in vivo examination of the eye using indirect slit lamp biomicroscopy and scoring the features of retinal, anterior chamber, and pupil appearance during disease.11 In this regard, fundus photography has until now been limited by technical difficulties and the poor resolution of existing techniques for disease assessment.14 Immunohistochemical assessment of retinal sections, with grading according to the degree of inflammatory infiltrate and structural damage, has been used for assessment of disease severity,15 but this technique has inherent limitations, such as the fact that only a small proportion of the whole retina can be examined. Therefore, a new easy-to-use imaging system that facilitates rapid, reproducible, live clinical assessment of the whole fundus, closely correlating with histologic changes is required as an approach to monitor progression of retinal disease in experimental models, including EAU.

Topical endoscopic fundus imaging (TEFI) is a recently described compact system that allows high-resolution in vivo color photography of the retina in rodents and was developed in normal eyes of mice.16 TEFI is based on the use of an endoscope with parallel, lateral, crescent-shaped illumination connected to a digital camera. This technique facilitates rapid assessment and capture of high-quality images of the whole fundus, including the peripheral retina and ciliary body, without distress to the mouse or the requirement for general anesthesia.

The objectives of this study were to validate a platform by using the TEFI system for assessment of the clinical disease time course of RBP-3161-180–induced EAU in B10.RIII mice, and correlate clinical features to both matched published histologic severity scores and the extent of inflammatory retinal cell infiltrate determined by flow cytometric analysis.

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Materials and Methods

Mice

B10.RIII mice were originally obtained from Harlan UK, Ltd. (Oxford, UK) and a breeding colony established within the Animal Services Unit at Bristol University (Bristol, UK). All mice were housed in specific pathogen-free conditions with continuously available food and water. Female mice, immunized for disease induction, were aged between 6 and 8 weeks. Treatment of animals conformed to UK legislation and to the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research.

Reagents

The peptide RBP-3161-180 (SGIPYIISYLHPGNTILHVD) was synthesized by Sigma-Genosys Ltd. (Poole, UK). Peptide purity was >95% as determined by HPLC.

EAU Induction and Scoring

B10.RIII mice were immunized SC in one flank with 50 ?g/mouse RBP-3161-180 peptide in PBS (2% DMSO), in Complete Freud’s Adjuvant (CFA; 1 mg/mL; 1:1 vol/vol) supplemented with 1.5 mg/mL Mycobacterium tuberculosis complete H37 Ra (BD Biosciences, Oxford, UK), and 1.5 ?g Bordetella pertussis toxin (Sigma-Aldrich, Poole, UK) was given intraperitoneally. At various time points after immunization, the eyes were enucleated, oriented in optimal cutting temperature (OCT) compound (R. Lamb Ltd., East Sussex, UK), and carefully snap frozen. Serial 12-?m sections were cut and stored at -80°, before thawing at room temperature and fixation in acetone for 10 minutes. Sections were stained with rat anti-mouse CD45 monoclonal antibody (Serotec, Oxford, UK), counterstained with hematoxylin (ThermoShandon, Pittsburgh, PA), and then scored for inflammatory infiltrate (presence of CD45-positive cells) and structural disease (disruption of morphology). Cellular infiltrate was scored within the ciliary body, vitreous, vessels, rod outer segments, and choroid, whereas structural disease was scored within the rod outer segments, neuronal layers, and retinal morphology. Both scores were added together to calculate a final disease total (Table 1) .

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Table 1.

Summary of EAU Disease Scoring

Topical Endoscope Fundus Imaging

Using a method adapted from Paques et al.,16 we connected an endoscope with a 5-cm-long tele-otoscope with a 3-mm outer diameter (1218AA; Karl Storz, Tuttlingen, Germany) a digital camera (D80 with a 10-million-pixel charge-coupled device [CCD] image sensor and AF 85/F1.8 D objective (Nikkor; all from Nikon, Tokyo, Japan), with a additional +4.00-D magnifying lens. The settings of the camera were as follows: large and superfine image, manual focus; operating mode S (shutter speed priority), shutter set at 1/100 s, and white balance set at fluorescent. A xenon lamp (201315-20; Karl Storz) connected through a flexible optic fiber to the endoscope was used as the light source.

The pupils of the mice were dilated with topical tropicamide 1% and phenylephrine 2.5% (Minims; Chauvin Pharmaceuticals, Romford, UK), then topical oxybuprocaine 0.4% (Minims) and eye gel (Novartis Pharmaceuticals, Camberley, UK), were applied for corneal anesthesia and endoscope contact, respectively. For imaging, the camera with endoscope was attached to a bench-clamp, and the mouse was slowly moved toward the tip of the endoscope. Once contact with the gel covering the cornea was obtained, focus and illumination were adjusted by using the camera, and the fundus was examined and the image was captured. Images were transferred to computer for processing (Photoshop; Adobe Systems, Mountain View, CA). Images were cropped to a size of 6 × 4.85 in. The blue curves tool was used to render the image a natural color. We did not use RAW imaging, as no image manipulation (other than color adjustment) was required. We found that the superfine setting was more than adequate for our purposes and each image was around 3 MB in size. After numerous trials, we found that using the fluorescent light white balance setting generated the best image detail after further blue curve adjustment in the image analysis software.

Isolation of Retinal Infiltrating Cells

Infiltrating retinal cells were isolated by using a previously described method.17 In brief, the eyes were enucleated and the retinas (including the ciliary body) of each animal were dissected microscopically and washed in wash media (complete RPMI supplemented with 10% [vol/vol] FCS and 1 mM HEPES; all from Invitrogen, Paisley, UK). Retinas were then cut into small pieces and digested in 1 mL wash medium, supplemented with 0.5 mg/mL collagenase D (Roche, Welwyn Garden City, UK) and 750 U/mL DNase I (Sigma-Aldrich) for 20 minutes at 37°C. An additional 0.5 mg/mL collagenase D and DNase 750 U/mL was added before incubation for a further 10 minutes at 37°C. Cell suspensions were forced through a 40-?m cell strainer (BD-Falcon, Cambridge, UK), with a syringe plunger, and the cell suspensions were stained for flow cytometric analysis.

Flow Cytometry

The cell suspensions were incubated with 24G2 cell supernatant for 5 minutes at 4°C. For cell counting, retinal cell suspensions were stained with PE-Cy5-conjugated anti-mouse CD4 monoclonal antibody (mAb), APC-Cy7-conjugated anti-mouse CD11b mAb, and PE-Cy7-conjugated anti-mouse CD45 mAb (all BD Pharmingen, Oxford, UK), at 4°C for 20 minutes. Cell suspensions were acquired with a flow cytometer (LSR-II; BD Cytometry Systems, Oxford, UK). Analysis was then performed (FlowJo software; TreeStar, San Carlos, CA). The number of cells counted was calculated by reference to a known standard.

Statistical Analyses

Partial correlation was performed (SPSS Inc, ver. 14; SPSS, Chicago, IL) and used to explore the relationship between the number of CD45+ cells (after square root transformation) and histologic score, while controlling for time (days) after immunization.

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Results

TEFI Imaging of the Retina during EAU

TEFI is a system that allows high resolution in vivo color photography of the retina in rodents and was developed in the normal eyes of C57BL/6 and BALB/c mice.16 We found that high-quality panretinal images, with clear visualization of the peripheral retina could also be obtained in the B10.RIII mouse strain, when the pupil was suitably dilated. The optimal pupil dilation was achieved by using a drop combination of phenylephrine 2.5% and tropicamide 1%, instilled at least 5 minutes before initiating TEFI.

Using this adapted TEFI method, we sought to monitor the clinical changes in the retina that occur during disease progression in mice immunized for EAU. We used the highly susceptible B10.RIII mouse strain, in which the immunizing regimen generates reliable disease induction and consistent moderate disease severity in our hands, thus ensuring that any clinical changes to the retina would be clearly evident.

Mice were immunized SC with 50 ?g RBP-3161-180 emulsified in CFA, and pertussis toxin was coadministered intraperitoneally. In the initial experiment, 10 mice were immunized and the disease progression was monitored from days 0 to 63. The TEFI method enabled us to capture a variety of clinical images (Fig. 1) . Clinical features of EAU were clearly observed, including vasculitis and optic nerve swelling (Fig. 1A) ; exudative retinal detachment (Fig. 1B) ; retinal folds, observed as retinal flecks (Fig. 1E) ; and choroidal lesions, analogous to chorioretinal lesions in uveitis in humans (Fig. 1F) . The periphery of the retina could also be visualized, demonstrating the anatomy of the ciliary body and the drainage angle (Figs. 1C 1D) . Figure 1D demonstrates how we were able to increase the magnification of views of the ciliary body and drainage angle by virtue of imaging through the mouse lens.

Figure 1.

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Figure 1.

Clinical observations of EAU in B10.RIII mice using topical endoscopic fundus imaging. Shown are examples of clinical disease observed in a representative cohort of B10.RIII mice immunized for EAU using RBP-3161-180 in CFA. Images show raised and swollen optic nerve, with typical perivascular cuffing and caliber changes to vessels (arrowhead, A), and an inferior exudative retinal detachment (B), at day 20 pi. Images including the ciliary body demonstrate peripheral chorioretinal inflammation and inflammatory vascular changes of the marginal vein (C, D). Scattered flecks which correlate to histologic features of retinal folds, are typically observed after day 15 pi (E). Multiple choroidal lesions (arrowhead) associated with inflammatory vascular changes (perivascular cuffing) and swollen optic nerve persisted at day 28 pi (F).

The time-course of EAU in the right eye of a representative individual mouse demonstrates the significant changes that occurred during disease progression (Fig. 2) . The retina and vasculature remained normal in appearance, with no clinical evidence of disease from day 0 to 10 postimmunization (pi). However, by day 13 pi, we recorded swelling of the optic nerve that increased in severity to include the central retinal vasculature (analogous to retinal vasculitis in humans). With time (days 14–18 pi), vitritis (cellular infiltrate within the vitreous gel) made the fundus increasingly indistinct (vitreous haze). Despite this vitreous haze, large exudative retinal detachments were documented from day 17 pi onward and resolved after day 21 pi. From day 15 pi onward, white retinal flecks were observed uniformly throughout the retina, which are presumed to be clinical evidence of small retinal folds (described later). Accompanying resolution of the exudative detachments was clinical resolution of features of retinal vessel involvement (vasculitis) and optic nerve swelling. Over the time period examined, the retina did not regain its normal appearance, as clinical images from day 28 pi onward demonstrated persistence of retinal flecks throughout the resolution phase and up to and including day 63 pi. Examination of the contralateral eye in selected mice verified that there was similar clinical appearance between eyes at all time points (data not shown).

Figure 2.

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Figure 2.

Clinical features during the study time course in a B10.RIII mouse immunized for EAU. At each time point from days 10 to 63 pi, the right eyes were dilated and photographed.

Comparison of TEFI, Histologic Features, and Composite of Cellular Infiltrate during EAU

Given the relative ease and reproducibility of TEFI when used to monitor disease in immunized mice, we wanted to determine whether clinical features would correlate with histologic changes and the kinetics of cellular infiltrate.

We immunized 40 B10.RIII mice, and on days 12, 13, 14, 15, 18, 19, 21, 28, 35, 42, and 63 pi, TEFI images of the right eye were obtained from four mice at each time point (three mice on days 42 and 63) before death. The right eyes were enucleated and sections prepared for immunohistochemical staining with anti-CD45 antibody. Three sections per retina per time point were scored for inflammatory infiltrate and structural damage, as described previously (Table 1) .

Figure 3 shows our findings as a representative comparison of TEFI and histology images taken from the same eye. Observations from days 0 to 12 pi demonstrated a normal retinal appearance by TEFI, which was confirmed histologically in sections that displayed normal morphology and no inflammatory infiltrate. By days 13 and 14 pi, clinical changes that included a raised appearance of the optic nerve were observed in 75% of the mice, although at this stage there was no clinical or histologic evidence of altered retinal morphology. The increase in histologic disease score was secondary to infiltrate that arose at the ciliary body and scleral–choroidal interface in that area (Fig. 3 , inset).

Figure 3.

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Figure 3.

Comparison of clinical and histologic images during the EAU time course. Forty female B10.RIII mice were immunized for EAU using RBP-3161-180 in CFA. At the days after immunization indicated, clinical images were obtained before the mice were killed. The right eyes were enucleated, sectioned, and stained for CD45+ infiltrate. A 12-?m retinal section from the right eye with total disease score is shown next to the corresponding clinical image from the right eye at each day, representative of each group (n = 4). Histology images from days 13 and 14 include insets showing the ciliary body–ciliary marginal zone and surrounding CD45+ perivascular infiltrate.

From days 15 to 19 pi, exudative retinal detachments and signs of cellular infiltrate (white lesions) and perivascular sheathing (vasculitis) were evident in all (100%) animals examined at these times. Where severe vitritis in the mice prevented clear visualization of the retina, histologic assessment confirmed the characteristics of clinical disease. This result correlates with extensive retinal disruption and folding, vasculitis, and perivascular infiltrate associated with increased CD45+ infiltrate observed by histology. However, by day 21 pi, retinal detachments were reduced clinically, whereas perivascular infiltrate persisted and by histology, both infiltrate and retinal morphologic disruption remained clearly evident. The overall clinical appearance improved from days 28 to 63 pi in all (100%) animals, with reduced inflammation of the optic nerve and retina (as observed as reduced optic nerve head swelling, reduced perivascular infiltrate and reduced creamy chorioretinal deep presumed infiltrative lesion), although during the resolution phase (postpeak disease), white, worm-like retinal flecks persisted. Histologic assessment of the eyes, corroborated such findings and demonstrated markedly reduced infiltrate, but persistent small retinal folds, likely to represent flecks observed by TEFI, were still apparent. Such folds are similar to those previously documented in other models.18

Analysis of the inflammatory infiltrate and structural scores throughout the time course by histology exhibited the classic monophasic disease course of EAU in B10.RIII mice (Fig. 4A) . From days 12 to 14 pi, increased levels of CD45+ cell infiltrate were detected, while little or no structural damage was observed within the retina. Disease progressed from day 15 pi onward, with a peak of disease at day 19 pi, as reflected by high scores for inflammatory infiltrate and associated structural damage. The period from day 21 pi onward is often termed the resolution phase, and although disease scores are reduced, morphologic changes (structural damage) and CD45+ cellular infiltration persists through to day 63 pi. Although this infers a level of regulation and repair, neither the number of CD45+ cells nor retinal morphology returned to normal predisease levels.

Figure 4.

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Figure 4.

Comparison of histologic scores and retinal cellular infiltrate during the EAU time course. (A) Right eyes were enucleated at the post immunization day indicated. Eyes were snap frozen before cryosectioning and staining for immunohistochemical analysis of CD45+ infiltrate. Average disease score ± SD of inflammatory infiltrate and structural disease is shown (n = 4/time point). Histology demonstrated that the EAU was a monophasic disease that peaked at day 19 pi, but did not fully resolve or return to normal levels. (B) Left eyes were simultaneously enucleated at each time point, and the retina and ciliary body excised and digested with collagenase. The number of immune cells per eye was measured by flow cytometry. The total number of immune cells is detailed as follows: CD45+CD11b+ (CD11b), CD45+CD4+ (CD4), and CD45+CD11b-CD4- (CD45) (n = 4/time point). Elevated levels of retinal infiltrate were observed from day 12 pi, with an expansion of CD45+ cells including macrophages and T cells seen from day 15 pi, peaking at day 18 pi. From days 19 to 21 pi, the level of infiltrate was reduced but the cells persisted throughout the resolution phase.

Inflammatory Cell Infiltrate

Considering the clinical pictures obtained using TEFI and the close relationship we observed to the underlying histologic changes, we wished to determine whether the clinical features also related to the kinetics and levels of inflammatory cell infiltrate present in the eye during the course of EAU. The isolation and analysis of retinal infiltrate using flow cytometric methods has been used to determine the normal immune status of the eye,19 to quantify and monitor the kinetics of inflammatory infiltrate in the retina, and also evaluate the effects and efficacy of potential new immunomodulatory agents in EAU.17 Therefore, at the same time points described earlier, the left eye was also enucleated (as we noted synchronous bilateralism of clinical features during EAU), dissected, and single cell suspensions were prepared from the retina and the ciliary body. Cells were then stained with fluorochrome-conjugated monoclonal antibodies against CD11b (macrophages), CD4 (T cells), and CD45 (leukocytes) surface markers and analyzed by flow cytometry to enable quantification of total cell number and phenotype (Fig. 4B) .

We observed elevated levels of leukocytes compared with normal retina from day 12 pi forward. The number of CD11b+ and CD4+ cells increased steadily from day 13 pi onward, with the main expansion of both cell types occurring after day 15 pi, and at a maximum on day 18 pi. Furthermore, during this time CD4+ cells were present at lower levels, with a predominance of CD11b+ cells. Of note was the fact that an increased number of cells was detected before any evidence of clinical (TEFI images) or histologic disease. From day 19 to 21 pi, the level of inflammatory cell infiltrate reduced and CD45+ cell numbers remained throughout (to day 63 pi) at levels equivalent to those on day 13 pi. The number of cells never returned to normal predisease levels, indicating that CD45+ infiltrate persists and may contribute to the clinical changes observed during the resolution phase. The ratio of CD11b+ to CD4+ cells during this phase is also reduced with both cell types present in equal amounts at the later time points.

Correlation between CD45 Infiltrate and Histology

Figure 5A shows the change in the number of CD45+ cells compared with the change in histologic score with time after immunization. The data suggest an association between these variables with both staying low at days 12 to 13 pi, increasing between days 15 and 20 pi and then reducing again thereafter. Although the number of cells fell to levels similar to those at days 12 to 13 pi, the histologic score remained somewhat elevated, albeit lower than the peak scores. Partial correlation was used to explore the relationship between histologic score and numbers of CD45+ cells while controlling for time (days) after immunization. This confirmed that there was a strong, positive partial correlation (r = 0.78, df = 32, P < 0.001), with high histologic scores being associated with high cell counts (Fig. 5B) . The zero order correlation (r = 0.73) suggests that time has little influence on the strength of the association between these two variables.

Figure 5.

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Figure 5.

Correlation of infiltrate and histologic disease score. (A) Changes in the number of CD45+ cells and histologic score with time after immunization. (B) Scatterplot of total histologic score against the square root of total number of CD45+ cells. Partial correlation (r = 0.78, df = 32, P < 0.001) shows a strong, positive association between these variables while controlling for time after immunization.

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Discussion

TEFI has been an effective technique that permits high resolution in vivo imaging of the clinical changes that occur during EAU disease progression in mice. Previous techniques were limited, and TEFI now offers an improved, rapid, no-anesthesia approach to generating detailed panfundal images in mice. It also facilitates the reduction, replacement, and refinement goals now favored by ethics committees in animal experimentation. With TEFI, when comparisons and correlation are made with histologic scoring and flow cytometric assessment of retinal infiltrate, several important unrecognized features of this model become apparent. First, significant retinal cell infiltrate is observed whereas clinically the retina appears largely unaffected; second, the clinical resolution of peak disease is much faster than resolution of histologic disease, and finally, in the resolution phase of EAU, neither the clinical appearance or the extent and composition of CD45+ cells within the retina return to predisease levels (up to 63 days pi). Although we noted a correlation between histologic scoring and flow cytometric assessment of infiltrating leukocyte numbers, cell counts resolved faster than severity of histologic changes; and, with the use of TEFI, our results emphasize that significant changes may occur that are not always clinically manifest.

The objectives of this study were to validate a platform that uses the TEFI system for assessment of clinical time course of RBP-3161-180–induced EAU in B10.RIII mice and correlate clinicopathologic features to both histologic severity and the extent of inflammatory cell infiltration of the retina. The clinical images obtained using the TEFI approach overall closely associate to the pathologic features of disease observed by histology. Histologic assessment demonstrated that the disease in this model of EAU followed the classic monophasic profile, with peak disease severity observed at day 19. Analysis of the dynamics and kinetics of retinal infiltrate demonstrated that an expansion of CD45+ cells, including CD11b+ and CD4+ populations, was present before this peak. Although the number of infiltrating cells was reduced during the later resolution phase, histologic disease scores and infiltrate levels never returned to normal; this finding has not been appreciated in this model of autoimmune destruction of the retina. Statistical correlation analyses demonstrated a positive association between the number of infiltrating CD45+ cells and the resulting histologic disease severity.

By using TEFI, it is now possible to record and monitor the dramatic clinical changes that occur in B10.RIII mice during the normal disease course of RBP-3161-180–induced EAU. From the time of immunization until day 12 pi, the retina and vasculature appeared normal and healthy, followed by a series of clinical changes from days 13 to 18, including raised optic nerve, perivascular infiltration developing that manifests the perivascular infiltrate and vitritis normally appreciated as hallmarks of this model. The development of large exudative retinal detachments from day 17, which resolve, along with the other clinical features of perivascular infiltrate and vitritis, can also be observed. The emergence of retinal flecks, uniformly distributed across the retina is demonstrated from day 15 pi. The retinal flecks correspond to the retinal folds we observed histologically. Clinically and histologically, retinal integrity never normalizes to the predisease state during the EAU time course. We also noted with TEFI that clinical features of EAU were constant between contralateral eyes.

EAU serves as a model for the spectrum of human posterior uveitis including sympathetic ophthalmia and Vogt-Koyanagi-Harada syndrome (VKH; particularly in relation to exudative retinal detachments), multifocal choroiditis, ocular sarcoidosis, and other forms of idiopathic disease.1 20 For example, the clinical features seen in this study correlate well with clinical features of VKH, in which resolving exudative retinal detachments are observed. After resolution of acute VKH, the classic clinical features of sunset-glow retina with its appreciated degenerative features are seen, again correlating with our TEFI images from day 28 onward.

Flow cytometric analysis of cells isolated from the retina demonstrated that the elevated levels of inflammatory infiltrate observed from day 12 onward during the time course of EAU, consisted of macrophages, T cells, and other CD45+ leukocytes. Infiltration of cells at this time has been examined by histology, which demonstrates the perivascular accumulation of CD45+ cells in the retina,21 although this static analysis cannot fully assess the dynamics of infiltration. The infiltration kinetics revealed that the main expansion of cells occurred after day 15 pi, culminating in a peak at day 18, and during this time, the proportion of CD4+ cells present was reduced compared to the number of CD11b+ cells. After the infiltrative peak, total CD45+ cells were greatly reduced over the remainder of the time course, but never returned to predisease levels. During this resolution phase, both the main CD11b+ and CD4+ populations were present at equal levels. Persistence of elevated levels of infiltrate in the eye would suggest that resolution and recovery do not equate to normal leukocyte counts, and may further suggest that certain regulatory mechanisms are maintained in the eye after inflammation.22 23 Similarly assessment of immunotherapeutic agents, given our current findings of temporal disparity between clinical appearance and cell infiltrate in the earlier stages of disease, and together with previous observations of maintained cellular infiltrate despite reduced histologic scores,24 shows that it is plausible that changes in constituents and number of infiltrating cells are not appreciated in the face of normal clinical phenotype and may conversely not always indicate preservation of function.

Nevertheless, TEFI is a method that allows confirmation of disease status and severity. It will aid in the design of experimental protocols according to clinical observations. TEFI will also greatly assist with current approaches to preclinical testing of experimental eye models, as it allows direct observation and assessment of therapeutic efficacy of new potential ocular therapy. It will also provide a rapid assessment to determine potential adverse effects incurred due to invasive procedures including intravitreous or subretinal injections.

Although, unlike experimental autoimmune encephalomyelitis (EAE),25 in which we are unable to ascribe directly functional deficit (paralysis) to histologic change or with the more technically demanding imaging of cellular infiltrate in the CNS,26 we are now able in EAU to directly correlate and assess clinical changes with histologic and flow cytometric analysis of cellular infiltrate. In both models, we now understand that significant cellular infiltrate occurs before the onset of clinical signs in the fundus of EAU and clinically in EAE.

Furthermore, the current published clinical grading of disease17 27 28 in both B10.RIII and/or C57BL/6 mouse models have been developed without incorporating evolution of clinical phenotype and comparison of such temporal characteristics with respect to the extent and timing of leukocytic infiltration (e.g., by flow cytometry analysis) and contemporaneous histopathologic appearances throughout the course of EAU. Although these scores may still be used, and indeed clinical features we show can mirror underlying histologic change, ascribing scoring of clinical severity or damage in light of this new data necessitates further investigation of EAU progression with larger groups of mice and in other strains (C57BL/6) to generate and then validate such a proposed grading system. The most recent report29 in C57BL/6 model of TEFI grading of clinical changes in chronic EAU supports our findings in this model of EAU. The advantage of adapting TEFI is therefore highlighted in both models and serves to assess more reproducibly the signs of inflammatory disease and correlate with underlying histologic and flow cytometric data.

Arguably, to fully assess preclinical immunotherapeutic efficacy requires the use of all three parameters: TEFI, histologic assessment, and flow cytometric analysis of retinal infiltrate. Combined TEFI and histologic methods enable the observation of clinical features and severity of disease, but information regarding the dynamics, phenotype, function and quantity of cellular traffic through the eye is only provided through detailed analysis of cell populations present in the eye at various stages of disease progression.

Researchers at the University of Bristol have developed a new diagnostic modality to monitor the retina, a technique that produces high resolution color images like the ones above.

Using the new technique called ‘TEFI’ (Topical Endoscopic Fundal Imaging), Professor Andrew Dick, David Copland and the team from the University of Bristol’s Academic Unit of Ophthalmology, monitored changes in mice retina over time, without distress to the animals or the need for anesthesia.

The study focused on a condition in mice similar to human posterior uveitis, an inflammation that affects the back of the eye and which can be difficult to monitor using existing techniques. TEFI allowed the researchers to see changes to the eye that were previously undetectable.

“TEFI enhances our monitoring of clinical disease in a rapid and non-invasive fashion,” Copland said. “It will aid in the design of experimental protocols according to clinical observations.”

Professor Dick added: “Combined TEFI and histological methods enable the observation of clinical features and severity of disease, but information regarding the dynamics, phenotype, function and quantity of cellular traffic through the eye is only provided through detailed analysis of cell populations present in the eye at various stages of disease progression.”

The study, “The Clinical Time-Course of Experimental Autoimmune Uveoretinitis Using Topical Endoscopic Fundal Imaging with Histologic and Cellular Infiltrate Correlation,” was published this week in Investigative Ophthalmology and Visual Science. It featured the use of Topical Endoscopic Fundal Imaging (TEFI), a technique that uses an endoscope with parallel illumination and observation channels connected to a digital camera.

source : http://www.bris.ac.uk/news/2008/6045.html

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Barco’s New Breast Tomosynthesis Monitor

Barco’s New Breast Tomosynthesis Monitor

Barco’s New Breast Tomosynthesis Monitor

Visualization specialist Barco has launched the Mammo Tomosynthesis 5MP, the first display system that has been cleared by the US Food and Drug Administration (FDA) for breast tomosynthesis. The display comes with some groundbreaking technologies specifically developed for multi-modality mammography.

“Breast tomosynthesis provides radiologists with three-dimensional images of the breast for better lesion visibility. These multi-frame images give rise to a need for solutions to optimize reading and interpretation. That’s why Barco developed the Mammo Tomosynthesis 5MP, a display system for digital breast imaging”, says Albert Xthona, Product Manager at Barco Healthcare.

“Its unique technologies for brighter and faster tomosynthesis visualization enable detection of the smallest details, providing radiologists with a new degree of diagnostic confidence and performance. With the Mammo Tomosynthesis 5MP, images are displayed more efficiently and more clearly so the radiologist can make the most effective diagnosis”, Xthona concludes.

Precise results

The Mammo Tomosynthesis 5MP efficiently displays high-quality multi-modality images. Barco’s proprietary RapidFrame™ technology speeds pixel refresh when reviewing multi-frame image sequences such as tomosynthesis or breast MRI, eliminating blurring or ghosting. Combined with Barco’s patented Per Pixel Uniformity™ (PPU) to remove disturbing screen noise, the display renders mammograms with the best image quality, helping radiologists make accurate diagnoses while speeding up their workflow.

Equipped with the powerful DuraLight Nova™ backlight, the Mammo Tomosynthesis display offers twice the calibrated brightness (1,000 cd/m²) of conventional displays, while more than doubling the lamp lifetime (50,000 hours). This luminance enables radiologists to see fine details in dense breast tissue and renders near skin-line details more clearly. The display also provides an I-Luminate™ ‘hot light’ button for extra brightness, which can reveal subtle details, even in dark areas.

Comfortable reading

The Mammo Tomosynthesis 5MP comes with an adjustable dual-head stand and allows users to angle the displays to their preferred position for optimum viewing. Additionally, the display can be viewed from a wide angle, without sacrificing contrast or black level. Images can now be read from any seat at the reading station, allowing radiologists to discuss the images with colleagues in the room or use them for educational purposes.

The display system’s intrinsic brightness reduces eye fatigue and enables reading in a more pleasant ambient room light, preserving visibility of low-contrast details. It also includes the integrated I-Guard™ sensor which automatically checks contrast and luminance. This provides radiologists with an optimal work environment, boosting diagnostic performance and productivity.

Guaranteed compliance

To ensure long-lasting image quality and high-grade Quality Assurance, Barco’s Mammo Tomosynthesis 5MP is bundled with MediCal QAWeb, an innovative web-based tool for automated and worry-free calibration. Together with I-Guard, the system guarantees consistent DICOM accuracy and uptime of all displays throughout the facility to ensure a consistent diagnostic outcome.

The standard of care

The Mammo Tomosynthesis 5MP is covered by a 5-year warranty and demonstrates that precision and productivity can go hand in hand. Equipped with the ultra-fast 10-bit MXRT display controller and technologies to enable consistent cost-effective workflow, the display for multi-frame mammography offers a high return on investment and the best standard of care.

Barco at SBI 2011

Barco’s Mammo Tomosynthesis 5MP will be showcased at SBI 2011 – booth #200 – in San Antonio, USA, from 18 to 20 May, 2011. Commercial availability is planned for the third quarter of 2011.

About Barco

Barco, a global technology company, designs and develops visualization products for a variety of selected professional markets. Barco has its own facilities for Sales & Marketing, Customer Support, R&D and Manufacturing in Europe, North America and Asia Pacific. Barco (NYSE Euronext Brussels: BAR) is active in more than 90 countries with about 3,500 employees worldwide. Barco posted sales of 897 million euro in 2010.

Optimized for digital breast tomosynthesis

Barco’s Mammo Tomosynthesis 5MP has been developed to optimize reading and interpretation of digital breast tomosynthesis, a groundbreaking imaging modality that significantly improves accuracy of breast cancer detection. Its unique technologies for tomosynthesis visualization increase conspicuity of the smallest details, providing radiologists with a new degree of diagnostic confidence.

The Mammo Tomosynthesis 5MP is the first display system available for breast tomosynthesis. It is cleared by the US Food and Drug Administration (FDA) for use in standard and multi-frame digital mammography as well as breast tomosynthesis.

Quick readings, exceptional results

The Mammo Tomosynthesis 5MP ensures instant delivery of images without motion blur, increasing correct diagnosis and swift workflow.

Bright images, more details

Featuring twice the brightness of conventional systems and lasting twice as long, the Mammo Tomosynthesis 5MP offers unrivalled image precision and visibility of the most subtle details.

Less noise, improved accuracy

Screen noise often hides subtle details. That’s why the Mammo Tomosynthesis 5MP ensures pixel-perfect images without disturbing screen noise, offering clearer visibility of differences in tissue density.

Guaranteed compliance, diagnostic confidence

Automated checks of contrast and luminance, in combination with an online calibration service, result in an optimal working environment and worry-free readings.

Barco has just received the first ever FDA approval for a computer monitor to be used for viewing breast tomosynthesis imagery. Tomosynthesis involves sequential movie-like playback of images of the breast taken from different angles, so the monitor has to properly render each frame quickly and with precision.

From the product page:

RapidFrame ™: vq34sdff Barcos New Breast Tomosynthesis MonitorRapidFrame technology counteracts motion blur when scrolling through a stack of images due to a high pixel refresh rate.

Per Pixel Uniformity™: PPU measures and adjusts the luminance of each pixel, making every pixel permanently DICOM compliant.

SmoothGray™: SmoothGray generates ultra-precise representations of grayscale images and eliminates quantization artifacts, reducing the overall noise in the images.

DuraLight Nova™: the DuraLight Nova backlight ensures a diagnostic luminance of 1,000 cd/m². In addition, they last twice as long without increasing power consumption.

I-Luminate™: a push on the ‘hot light’ I-Luminate button will temporarily boost display brightness, allowing inspection of subtle details or comparison of digital exams with film-based priors.

I-Guard™: the integrated I-Guard sensor continually guards and adjusts the luminance output of the display, ensuring continuous compliance with the DICOM standard.

QAWeb: the innovative MediCal QAWeb system is an easy-to-use, web-based tool for automated calibration and Quality Assurance.

Adjustable dual-head stand: the dual-head stand allows users to angle the displays to fit their preferred position for optimum viewing.

Source : http://www.barco.com/en/News/Press-releases/barco-launches-first-display-system-for-breast-tomosynthesis.aspx

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Project Aims for Medical Isotope Production Without Use of Nuclear Reactors

Project Aims for Medical Isotope Production Without Use of Nuclear Reactors

Project Aims for Medical Isotope Production Without Use of Nuclear Reactors

SASKATOON, SK – Producing medical isotopes safely, cheaply and reliably without using a nuclear reactor or weapons-grade uranium is the aim of a research project led by the Canadian Light Source (CLS) along with the National Research Council of Canada (NRC), NorthStar Medical Radioisotopes and medical researchers from the University of Ottawa Heart Institute and Toronto’s University Health Network.

The CLS Medical Isotope Project will receive $10 million from the Government of Canada and $2 million from the Province of Saskatchewan to study the technical and economic feasibility of producing medical isotopes using high energy X-rays from a particle accelerator.

The project, one of four being funded by Natural Resources Canada’s Non-reactor-based Isotope Supply Contribution Program (NISP), was announced by Minister of Natural Resources Christian Paradis at an event in Sherbrooke, QC and by Mr. Brad Trost, M.P. for Saskatoon-Humboldt, and Saskatchewan Innovation Minister Rob Norris at the CLS in Saskatoon.

“The Government of Saskatchewan is pleased to partner with the Government of Canada to support this leading edge research in nuclear medicine,” says Minister Norris. “Saskatchewan’s investment represents a return by our province to the forefront of R&D in nuclear medicine at the University of Saskatchewan where the first use of cobalt-60 for cancer therapy was pioneered 60 years ago.”

“We are grateful to the Government of Canada and the Province of Saskatchewan for their leadership and support of our project,” says Mark de Jong, CLS Director of Accelerators and the project’s principal investigator. “This is an outstanding example of how the CLS and NRC, partnering with research and development leaders from industry and the academic community can solve problems of critical importance to the health of Canadians.”

The project will use a high energy linear accelerator to bombard coin-sized discs of molybdenum-100 with X-rays to produce molybdenum-99 isotope. The molybdenum-99 decays into technetium-99m, the isotope used in approximately 5500 diagnostic medical procedures in Canada every day.

“The National Research Council of Canada has a long history of solving critical S&T problems for Canadians”, says NRC President John R. McDougall. “This initiative holds the promise of a reliable, stable supply of medical isotopes for the needs of Canadians at an affordable cost. This is an excellent example of how partnerships between the private and public sector can drive innovation and pave the way to technological breakthroughs.”

The proposal calls for the construction and testing of a prototype production facility at the CLS to assess the technical and economic feasibility of the approach. NRC will provide design expertise as well as theoretical modeling and technical support, using an automated radionuclide separator from NorthStar to harvest the isotopes. Finally, clinical validation studies will be conducted by researchers with the University of Ottawa Heart Institute and the University Health Network in Toronto.

“The Heart Institute’s significant expertise as a national medical research facility will be put to work evaluating radiotracers labelled with technetium-99m produced with this new technology for its application in effectively diagnosing heart disease,” said Dr. Terrence Ruddy, Chief of Cardiology at the University of Ottawa Heart Institute. “Our advanced technology in nuclear imaging will enable researchers to carry out preclinical and clinical validation studies leading to widespread application in patients.”

“Currently, there are only a handful of nuclear reactors globally that generate medical isotopes. With the breakdown of Chalk River’s nuclear reactor in 2009 there was a world-wide shortage,” notes Dr. Kieran Murphy, the University Health Network’s Deputy Chief of Radiology. “With high-energy particle accelerators we could produce medical isotopes in a much cheaper, cleaner and more efficient way. It would change the economics of nuclear medicine – not only in Canada or North America, but all over the world.”

The team’s preliminary calculations indicate that three facilities similar to the prototype to be built at the CLS would meet all of Canada’s demand for technetium-99m.

-30-

About the Canadian Light Source:

The Canadian Light Source is Canada’s national centre for synchrotron research and is a global leader and a recognized centre of excellence in synchrotron science and its applications. Since 2005 the CLS has hosted over 4,000 user visits from academic institutions, government, and industry, and delivered over 15,000 experimental shifts to users from across Canada and 16 countries. CLS operations are funded by Western Economic Diversification Canada, Natural Sciences and Engineering Research Council, National Research Council of Canada, Canadian Institutes of Health Research, the Government of Saskatchewan, and the University of Saskatchewan. www.lightsource.ca/media/quickfacts.php

About the National Research Council of Canada:

Recognized globally for research and innovation, the National Research Council of Canada is a leader in the development of an innovative, knowledge-based economy for Canada through science and technology. www.nrc-cnrc.gc.ca

About University Health Network:

University Health Network consists of Toronto General, Toronto Western and Princess Margaret Hospitals. The scope of research and complexity of cases at University Health Network has made it a national and international source for discovery, education and patient care. It has the largest hospital-based research program in Canada, with major research in cardiology, transplantation, infectious diseases, neurosciences, oncology, surgical innovation, and genomic medicine. The Toronto General Research Institute has more than 350 scientists, students and support staff, more than $65 million in external funding, and its staff is published in more than 600 publications a year. University Health Network is a research and teaching hospital affiliated with the University of Toronto. www.uhn.ca

About University of Ottawa Heart Institute:

The University of Ottawa Heart Institute is Canada’s largest and foremost cardiovascular health centre dedicated to understanding, treating and preventing heart disease. We deliver high-tech care with a personal touch, shape the way cardiovascular medicine is practiced, and revolutionize cardiac treatment and understanding. We build knowledge through research and translate discoveries into advanced care. We serve the local, national and international community, and are pioneering a new era in heart health. www.ottawaheart.ca

The supply of radioactive isotopes for medical use is regularly at risk due to a limited number of suppliers and the fact that nuclear reactors are involved. The Canadian government just allotted funds to sponsor a project which may lead to the generation of molybdenum-99 using X-rays powered by a linear accelerator.

From an announcement by the Canadian Light Source, which received C$12 million to fund the Medical Isotope Project:

The project will use a high energy linear accelerator to bombard coin-sized discs of molybdenum-100 with X-rays to produce molybdenum-99 isotope. The molybdenum-99 decays into technetium-99m, the isotope used in approximately 5500 diagnostic medical procedures in Canada every day.

The proposal calls for the construction and testing of a prototype production facility at the CLS to assess the technical and economic feasibility of the approach. NRC will provide design expertise as well as theoretical modeling and technical support, using an automated radionuclide separator from NorthStar to harvest the isotopes. Finally, clinical validation studies will be conducted by researchers with the University of Ottawa Heart Institute and the University Health Network in Toronto.

Image: Diagram of the proposed process. An electron beam from a linear accelerator is used to produce high-energy X-rays. X-rays shine on a target consisting of molybdenum-100 (Mo-100) discs. An X-ray strikes the nucleus of a Mo-100 atom, knocking away a neutron to create molybdenum-99 (Mo-99), which decays to become technetium-99m (Tc-99m). A radionuclide separator separates the Tc-99m from the Mo-100 so that it can be injected into patients undergoing medical tests. The Mo-100 can then be recycled into new targets.

Source : http://www.lightsource.ca/media/media_release_20110124.php

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The endogo® Portable Endoscopic Camera

The endogo® Portable Endoscopic Camera

The endogo® Portable Endoscopic Camera

The endogo® endoscopic camera is a hand-held, world’s first battery operated endoscopic video camera that is so small that it can fit in the palm of your hand. It is a product of Envisionier Medical Technologies, LLC, a Rockville, MD company. The camera is designed for a wide range of uses such as difficult intubations, and diagnostic exams by ENT / Urology / Ob Gyn / ER.

457634end2 The endogo® Portable Endoscopic Camera

The endogo® Portable Endoscopic Camera is the world’s first battery operated, portable, hand-held endoscopic video camera with integrated viewing and archiving capability which fits in the palm of your hand. The endogo® can be used with current optical flexible or rigid endoscopes in any clinical setting requiring simple, inexpensive, and easy to use video endoscopy with/without archiving the examination. Once the camera is turned on, it is ready for live viewing of an examination on the 2.4? TFT flip screen. Examination may continue without recording or the user may take video or still photos of the area to be examined.

Video compression in DV quality is performed using MPEG-4 video compression. Stills are compressed using a JPEG compression algorithm: both are industry standard methods for data compression. After use, images may be transported from the removable flash RAM drive (SD RAM) or transmitted via USB-2 to another computing device.

Image viewing can also be performed live via the USB-2 cable to a computing device or via the AV output to a compatible video monitor. Voice recordings may also be captured while recording to annotate clinical findings.

Source : http://envisionier.com/?page_id=13784

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Kaiser Permanente Makes Electronic Medical Records Accessible to Patients

Kaiser Permanente Makes Electronic Medical Records Accessible to Patients

Kaiser Permanente Makes Electronic Medical Records Accessible to Patients Through Android App and Mobile Website

Nearly 9 Million Kaiser Permanente Health Records Securely Available on Mobile Devices

Patient information securely available with a touch of a finger with new app and mobile-optimized kp.org

OAKLAND, Calif. — Kaiser Permanente already has the largest electronic medical record system in the world. Today, the health care organization announced that 9 million Kaiser Permanente patients now can easily access their own medical information anywhere in the world on mobile devices through a mobile-optimized website.

Nearly 9 Million Kaiser Permanente Health Records Securely Available on Mobile Devices

Kaiser Permanente has released a new app for Android devices, and users of other mobile devices, including the iPhone, can also get full access to that information from the Kaiser Permanente health record system with the mobile-optimized version of kp.org. An additional app for iPhone will be released in the coming months, but iPhone users can easily download a shortcut icon onto their home screens that will take them directly to the mobile-friendly kp.org with a touch of the finger.

Kaiser Permanente has led the health care world in providing online access to information for its patients. In 2011 alone, more than 68 million lab test results were made available online to Kaiser Permanente patients. The mobile-optimized site and the new app make that information, and much more, securely available at members’ fingertips.

Kaiser Permanente patients will have 24/7 access to lab results, diagnostic information, direct and secure email access to their doctors, and will also be able to order prescription refills. Kaiser Permanente patients have been able to email their doctors for five years, with more than 12 million e-visits in 2011 alone. Kaiser Permanente expects that number to increase significantly with the new app and mobile-optimized site.

The Android app is available now in the Android Market at no charge. Users of other mobile devices can access the same set of care-support tools at no charge through the new secure, mobile-optimized member website, which is available through smart-phone Internet browsers.

With the new offering, Kaiser Permanente patients have 24/7 access from their mobile devices to view their secure personal health record, email their doctors, schedule appointments, refill prescriptions and locate Kaiser Permanente medical facilities. Members who have the ability to act on behalf of a family member on kp.org now can accomplish the same tasks. Those caring for an elderly parent or someone with a chronic condition can now more easily check lab results, refill prescriptions and communicate with the doctor’s office on behalf of the patient.

“This is the future of health care. Health care needs to be connected to be all that it can be. This new level of connectivity is happening real time, and it is happening on a larger scale than anything like it in the world,” said George Halvorson, chairman and chief executive officer of Kaiser Permanente. “The fact that a Kaiser Permanente patient in an emergency room in Paris or Tokyo can simply pull out their mobile device and have immediate and current access to their own medical information is an evolutionary and revolutionary breakthrough for medical connectivity.”

“Our members love our current connectivity tools,” said Christine Paige, senior vice president of marketing and Internet services. “Now we will extend our entire connectivity tool kit for patients through a mobile phone. Our mobile-optimized site and app take connectivity to the next level by making the mobile experience easy and enjoyable. We believe that convenience, paired with a great user experience, will meet members’ needs and will ultimately result in improved health and patient-physician relationships.”

iPHONE SHORTCUT ICON

Go to kp.org on your iPhone mobile Web browser

Click on the middle icon at the bottom of your screen

Choose “Add to Home Screen”

A short cut will be added to your iPhone icons

Members using the Android app have access to their kp.org accounts by touching the app icon on their phones. Those visiting kp.org from a mobile phone Internet browser are seamlessly redirected to the mobile-optimized website, which was designed for optimal viewing on a mobile-phone screen. In both cases, a streamlined menu of mobile-optimized features helps members find what they need quickly and easily with minimal taps.

“Providing our patients with clear and convenient access to their health information is a step forward in connectivity and improving the health care experience for patients, no matter where they are,” said Jack Cochran, MD, executive director of The Permanente Federation. “We already have complete connectivity among Kaiser Permanente care sites through Kaiser Permanente HealthConnect®. This new level of connectivity extends the reach of information to our patients in a more convenient and user-friendly format. This new app and mobile-optimized site is very good for patient care and will revolutionize connectivity by bringing health care for the first time to the level of connectivity other parts of our economy have achieved.”

Users’ personal health information is safe and secure while using the new app and the mobile-friendly kp.org, which employ the same security safeguards that protect patient information on the traditional kp.org website, including secure sign-on and automatic sign-out after a period of inactivity.

“The benefits of mobile extend beyond member engagement,” said Philip Fasano, executive vice president and chief information officer of Kaiser Permanente. “Mobile solutions can have a positive impact on health. Health care, itself, will be much more convenient for many people. The mobile-friendly site and app are also a springboard for new innovations that will inspire members to be aware of their health and take steps to improve it.”

The Pew Internet Project reported that 40 percent of American adults access the Internet via their mobile phones, and in some cases, mobile phones are their primary source of Internet access. Twenty-five percent of smart-phone owners go online primarily using their phone; of these, roughly one-third have no high-speed home broadband connection.

“There has been an explosion in the growth of mobile devices and users are looking for new and improved ways to manage their lives online,” Halvorson said. “It is time to make health information easily accessible from mobile devices.”

“Edelman’s 2011 Health Barometer reported that 68 percent of those who use digital tools to manage or track their health believed it helped them improve their health,” Paige said. “Nearly 80 percent of kp.org users agreed that the website helps them stay healthy. The tools and services available on kp.org are even more powerful in the palm of your hand.”

This is a major new connectivity offering, but it is not Kaiser Permanente’s first mobile app. Other, more targeted tools, were released earlier. Kaiser Permanente launched its first mobile application, KP Locator for iPhone, in July 2011. The facility-finder app has been downloaded 42,000 times. KP Locator combines the power of kp.org’s robust facility directory and the iPhone’s GPS capabilities to make searching for Kaiser Permanente facilities fast and easy for patients on the go. It answers three of the most basic, but vital, user questions thoroughly and simply — where are the Kaiser Permanente locations close to me, how can I contact and get to them, and what departments and services can I access there? Kaiser Permanente also released its Every Body Walk! app two months ago to help encourage people to walk and maintain healthy activity levels, and that app was rated No. 5 in the Top 100 Green Apps by Eco-Libris.

Kaiser Permanente is known for its leadership in the use of health information technology. The Kaiser Permanente electronic health record is the largest non-governmental medical record system in the world. KP HealthConnect enables all of Kaiser Permanente’s nearly 16,000 physicians to electronically access the medical records of all 8.9 million Kaiser Permanente members nationwide and serves as a model for other care systems. Kaiser Permanente has received numerous awards for its health IT expertise, including four 2011 eHealthcare Leadership Awards. You can learn more about how patients, clinicians and researchers are using My Health Manager and KP HealthConnect by checking out Kaiser Permanente’s YouTube channel: www.youtube.com/kaiserpermanenteorg. Kaiser Permanente also has what might be the world’s most complete electronic medical library to support its caregivers by providing convenient access to the best and most current medical science. That electronic medical library is for internal use only.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We serve approximately 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

Kaiser Permanente, the largest managed care organization in the United States, has unveiled an Android app and mobile-optimized website through which its 9 million patients can access their own medical information anywhere in the world on their mobile devices. The app and mobile website contain the same information and possibilities that were already available through kp.org, i.e. lab results, diagnostic information, secure email access to doctors, ordering of prescription refills, scheduling appointments and locating of healthcare facilities. It is also possible for family members to get access on behalf of a patient and accomplish the same tasks.

The Android app is available for free from the Android market. An iPhone app will be released in the coming months, but for now iPhone users will have to do with the mobile website.

Source : http://xnet.kp.org/newscenter/pressreleases/nat/2012/012412kporgmobileoptimized.html

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The Latest on Cellscope’s Smartphone-Based Microscope and Otoscope

The Latest on Cellscope’s Smartphone-Based Microscope and Otoscope

The Latest on Cellscope’s Smartphone-Based Microscope and Otoscope

If you’re an experienced mobile or web developer interested in disrupting the way healthcare is delivered, you’ve come to the right place. We are builders, tinkerers and coders with a big vision and plenty of challenges to go around.

CellScope’s patent-pending devices and diagnosis support tools are currently being tested in hospitals, medical practices and homes around the country. We’re turning your smartphone into the first ever digital first aid kit.

At the University of California Berkeley, a few handy researchers modified an off-the-shelf camera cellphone to produce a mobile microscope capable of 50x magnification. Coupled with the phone’s natural ability to send out images, the device may help to virtually bring dermatologists, pathologists and oncologists to remote areas of the world.

35354ber2 CellScope for Rural Microscopy On The Go

Using Bluetooth, wi-fi and cellular networks, a phone needs no modification itself. Capable of 50x magnification today, the devices could provide twice that. A smaller prototype features its own light source.

“This could be useful even at home,” suggests Fletcher [Associate Professor of Bioengineering at Berkeley --ed.], “where, for example, early warnings of a change in the shape of a mole could be sent to your clinician on a regular basis to monitor.”

In addition, cancer patients could conduct their own blood cell counts that today require larger microscopes and particle counters.

Dr. Lam, Pediatric Oncologist at UCSF, is one of the grad students working on CellScope. He adds, “By no means do we think this is going to replace those large particle counters. It’s just a good adjunct for the patient to have at home.”

CellScope, a mobile health company based in San Francisco, is now focused on commercializing technologies for at-home diagnostic applications. We covered the startup before—most recently in 2009, and since then, the company has made significant progress. “Our first two products will be an otoscope and a dermascope attachment for common problems like ear infections and skin conditions, enabling telemedicine diagnosis from home,” Erik Douglas, the company’s CEO told Medgadget. “We use lower-magnification optics to capture a wider field, and a new illumination system to leverage the phone’s LED flash,” he says. The company is currently conducting pilot studies with doctors around the Bay Area.

The company’s technology uses a cell phone’s camera to capture diagnostic images. It could be used for skin exams and for analyzing blood samples. The smartphone-based otoscope could enable remote diagnosis of pediatric ear infections, which cause 30 million doctor visits annually in the United States.

The idea behind the company was hatched in the lab of UC Berkeley bioengineering professor Dan Fletcher several years ago when the firm’s CEO, Erik Douglas, was a post-doc at the university.

The company, which was a graduate of incubator Rock Health’s first class of startups in 2011, recently announced that it has received $1 million in seed funding from Kholsa Ventures.

In the video below, Douglas explains how the company is still figuring out how the technology “fits within the healthcare landscape [and] how traditional fee for service doctors can get paid for these sorts of things—even when it is more efficient for them, it is quicker for them, it is the same diagnosis, often better than what they would get in the traditional setting.”

source : http://cellscope.com/

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Kaiser Permanente Makes Electronic Medical Records Accessible to Patients Through Android App and Mobile Website

Kaiser Permanente Makes Electronic Medical Records Accessible to Patients Through Android App and Mobile Website

Kaiser Permanente Makes Electronic Medical Records Accessible to Patients Through Android App and Mobile Website

Nearly 9 Million Kaiser Permanente Health Records Securely Available on Mobile Devices

Patient information securely available with a touch of a finger with new app and mobile-optimized kp.org

OAKLAND, Calif. — Kaiser Permanente already has the largest electronic medical record system in the world. Today, the health care organization announced that 9 million Kaiser Permanente patients now can easily access their own medical information anywhere in the world on mobile devices through a mobile-optimized website.

Kaiser Permanente has released a new app for Android devices, and users of other mobile devices, including the iPhone, can also get full access to that information from the Kaiser Permanente health record system with the mobile-optimized version of kp.org. An additional app for iPhone will be released in the coming months, but iPhone users can easily download a shortcut icon onto their home screens that will take them directly to the mobile-friendly kp.org with a touch of the finger.

Kaiser Permanente has led the health care world in providing online access to information for its patients. In 2011 alone, more than 68 million lab test results were made available online to Kaiser Permanente patients. The mobile-optimized site and the new app make that information, and much more, securely available at members’ fingertips.

Kaiser Permanente patients will have 24/7 access to lab results, diagnostic information, direct and secure email access to their doctors, and will also be able to order prescription refills. Kaiser Permanente patients have been able to email their doctors for five years, with more than 12 million e-visits in 2011 alone. Kaiser Permanente expects that number to increase significantly with the new app and mobile-optimized site.

The Android app is available now in the Android Market at no charge. Users of other mobile devices can access the same set of care-support tools at no charge through the new secure, mobile-optimized member website, which is available through smart-phone Internet browsers.

KAISER PERMANENTE MOBILE APPS

With the new offering, Kaiser Permanente patients have 24/7 access from their mobile devices to view their secure personal health record, email their doctors, schedule appointments, refill prescriptions and locate Kaiser Permanente medical facilities. Members who have the ability to act on behalf of a family member on kp.org now can accomplish the same tasks. Those caring for an elderly parent or someone with a chronic condition can now more easily check lab results, refill prescriptions and communicate with the doctor’s office on behalf of the patient.

“This is the future of health care. Health care needs to be connected to be all that it can be. This new level of connectivity is happening real time, and it is happening on a larger scale than anything like it in the world,” said George Halvorson, chairman and chief executive officer of Kaiser Permanente. “The fact that a Kaiser Permanente patient in an emergency room in Paris or Tokyo can simply pull out their mobile device and have immediate and current access to their own medical information is an evolutionary and revolutionary breakthrough for medical connectivity.”

“Our members love our current connectivity tools,” said Christine Paige, senior vice president of marketing and Internet services. “Now we will extend our entire connectivity tool kit for patients through a mobile phone. Our mobile-optimized site and app take connectivity to the next level by making the mobile experience easy and enjoyable. We believe that convenience, paired with a great user experience, will meet members’ needs and will ultimately result in improved health and patient-physician relationships.”

iPHONE SHORTCUT ICON

Go to kp.org on your iPhone mobile Web browser

Click on the middle icon at the bottom of your screen

Choose “Add to Home Screen”

A short cut will be added to your iPhone icons

Members using the Android app have access to their kp.org accounts by touching the app icon on their phones. Those visiting kp.org from a mobile phone Internet browser are seamlessly redirected to the mobile-optimized website, which was designed for optimal viewing on a mobile-phone screen. In both cases, a streamlined menu of mobile-optimized features helps members find what they need quickly and easily with minimal taps.

“Providing our patients with clear and convenient access to their health information is a step forward in connectivity and improving the health care experience for patients, no matter where they are,” said Jack Cochran, MD, executive director of The Permanente Federation. “We already have complete connectivity among Kaiser Permanente care sites through Kaiser Permanente HealthConnect®. This new level of connectivity extends the reach of information to our patients in a more convenient and user-friendly format. This new app and mobile-optimized site is very good for patient care and will revolutionize connectivity by bringing health care for the first time to the level of connectivity other parts of our economy have achieved.”

Users’ personal health information is safe and secure while using the new app and the mobile-friendly kp.org, which employ the same security safeguards that protect patient information on the traditional kp.org website, including secure sign-on and automatic sign-out after a period of inactivity.

“The benefits of mobile extend beyond member engagement,” said Philip Fasano, executive vice president and chief information officer of Kaiser Permanente. “Mobile solutions can have a positive impact on health. Health care, itself, will be much more convenient for many people. The mobile-friendly site and app are also a springboard for new innovations that will inspire members to be aware of their health and take steps to improve it.”

The Pew Internet Project reported that 40 percent of American adults access the Internet via their mobile phones, and in some cases, mobile phones are their primary source of Internet access. Twenty-five percent of smart-phone owners go online primarily using their phone; of these, roughly one-third have no high-speed home broadband connection.

“There has been an explosion in the growth of mobile devices and users are looking for new and improved ways to manage their lives online,” Halvorson said. “It is time to make health information easily accessible from mobile devices.”

“Edelman’s 2011 Health Barometer reported that 68 percent of those who use digital tools to manage or track their health believed it helped them improve their health,” Paige said. “Nearly 80 percent of kp.org users agreed that the website helps them stay healthy. The tools and services available on kp.org are even more powerful in the palm of your hand.”

This is a major new connectivity offering, but it is not Kaiser Permanente’s first mobile app. Other, more targeted tools, were released earlier. Kaiser Permanente launched its first mobile application, KP Locator for iPhone, in July 2011. The facility-finder app has been downloaded 42,000 times. KP Locator combines the power of kp.org’s robust facility directory and the iPhone’s GPS capabilities to make searching for Kaiser Permanente facilities fast and easy for patients on the go. It answers three of the most basic, but vital, user questions thoroughly and simply — where are the Kaiser Permanente locations close to me, how can I contact and get to them, and what departments and services can I access there? Kaiser Permanente also released its Every Body Walk! app two months ago to help encourage people to walk and maintain healthy activity levels, and that app was rated No. 5 in the Top 100 Green Apps by Eco-Libris.

Kaiser Permanente is known for its leadership in the use of health information technology. The Kaiser Permanente electronic health record is the largest non-governmental medical record system in the world. KP HealthConnect enables all of Kaiser Permanente’s nearly 16,000 physicians to electronically access the medical records of all 8.9 million Kaiser Permanente members nationwide and serves as a model for other care systems. Kaiser Permanente has received numerous awards for its health IT expertise, including four 2011 eHealthcare Leadership Awards. You can learn more about how patients, clinicians and researchers are using My Health Manager and KP HealthConnect by checking out Kaiser Permanente’s YouTube channel: www.youtube.com/kaiserpermanenteorg. Kaiser Permanente also has what might be the world’s most complete electronic medical library to support its caregivers by providing convenient access to the best and most current medical science. That electronic medical library is for internal use only.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We serve approximately 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.

Kaiser Permanente, the largest managed care organization in the United States, has unveiled an Android app and mobile-optimized website through which its 9 million patients can access their own medical information anywhere in the world on their mobile devices. The app and mobile website contain the same information and possibilities that were already available through kp.org, i.e. lab results, diagnostic information, secure email access to doctors, ordering of prescription refills, scheduling appointments and locating of healthcare facilities. It is also possible for family members to get access on behalf of a patient and accomplish the same tasks.

The Android app is available for free from the Android market. An iPhone app will be released in the coming months, but for now iPhone users will have to do with the mobile website.

Source : http://xnet.kp.org/newscenter/pressreleases/nat/2012/012412kporgmobileoptimized.html

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IBA’s Proton Therapy with Philips Ambient Experience

IBA’s Proton Therapy with Philips Ambient Experience

IBA’s Proton Therapy with Philips Ambient Experience

BOSTON, October 28, 2012 — IBA Group, a leader in advanced cancer diagnosis and therapy technologies, and Royal Philips Electronics (NYSE: PHG, AEX: PHI) today announced their first-ever installation of a state-of-the-art, patient-centered proton therapy treatment room in the United States. A new addition to the Willis-Knighton Cancer Center in Shreveport, La., will be the first IBA installation to incorporate the Philips Ambient Experience.

Designed and engineered by Philips Healthcare, the Philips Ambient Experience promotes patient relaxation during proton treatments by permitting patients to selectively add comforting light, sound and images to the treatment room environment before they begin therapy. This will help improve the patient and staff experience, turning a cold, impersonal environment into one that comforts and reassures as the patient becomes an active participant in the process.

“This new installation is the first to come to fruition from the Philips-IBA cooperative agreement,” said Olivier Legrain, Chief Executive Officer at IBA. “It is demonstrative of a successful collaboration with Philips in offering highly advanced, patient-centered care, and we are delighted it will be integrated into our new proton system installations.”

“Ambient Experience enhances our ability to provide superior cancer care,” said Dr. Lane Rosen of the Willis-Knighton Cancer Center. “The soothing and empowering atmosphere will make our patients more comfortable, which will allow our staff to work more efficiently. IBA and Philips have been excellent partners, so it made sense to work with them to bring this unique experience to our patients.”

Willis-Knighton will be the first center to utilize Proteus®ONE, IBA’s single-room compact gantry solution for those looking for a more cost-effective, smaller footprint option. The $40 million project is expected to begin treating cancer patients with protons in early 2014.

Together with Philips, IBA is demonstrating a life-size model of the ProteusONE proton therapy room combined with the Philips Ambient Experience solution in booth #3019 at the 54th annual meeting of ASTRO, the American Society for Radiation Oncology, in Boston.

IBA Group (Louvain-la-Neuve, Belgium) has partnered with Philips to create an attractive new patient experience for their proton therapy system. Upon entering the facility patients choose the music, visuals, and lighting they prefer via a tablet. This is built on the foundations of the Philips Ambient Experience, a set of principles and design ideas that aim to turn diagnostic imaging and therapy sessions into a less anxiety inducing experience.

The first such system is being installed at the Willis-Knighton Cancer Center in Shreveport, Louisiana.

Source : http://www.newscenter.philips.com/main/healthcare/news/press/2012/20121028-Philips-and-IBA.wpd

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Study Finds That iPhone App Can Make Accurate Stroke Diagnosis

Study Finds That iPhone App Can Make Accurate Stroke Diagnosis

Study Finds That iPhone App Can Make Accurate Stroke Diagnosis

Ross Mitchell, PhD, shows off his iPhone application. It has been approved for use by Health Canada. New research from the University of Calgary’s Faculty of Medicine shows that doctors can make a stroke diagnosis using an iPhone application with the same accuracy as a diagnosis at a medical computer workstation. This technology can be particularly useful in rural medical settings. This allows for real-time access to specialists such as neurologists, regardless of where the physicians and patients are located

Neuro-radiologists in the study looked at 120 recent consecutive noncontrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram (CTA) head scans that were obtained from the Calgary Stroke Program database. Scans were read by two neuro-radiologists, on a medical diagnostic workstation and on an iPhone. The research is published in the May 6th edition of Journal of Medical Internet Research. The study was designed by Dr. Mayank Goyal, and involved the iPhone software technology originally developed by Dr. Ross Mitchell, PhD, and his team at the Hotchkiss Brain Institute (HBI), then further enhanced and commercialized by Calgary Scientific Inc.

“This iPhone app allows for advanced visualization and our studies show it is between 94% and 100% accurate, compared to a medical workstation, for diagnosing acute stroke,” says Mitchell who is from the University of Calgary’s Faculty of Medicine. “In a medical emergency, medical imaging plays a critical role in diagnosis and treatment, time is critical in acute stroke care, every minute counts.”

Fellow HBI member, Dr. Mayank Goyal who is also the director of research in the department of radiology and one of the neuro-radiologists in the study who analyzed the data. “Time is critical for diagnosing stroke and starting treatment. There are definitely benefits for doctors to have the ability to analyze and diagnose these images from virtually anywhere. We were pleasantly surprised at our ability to detect subtle findings on the CT scan, which are often very critical in patient management, using this software,” he says. “Another strength of this platform was its ability to handle massive imaging datasets of over 700 images seamlessly over the iPhone.” Goyal is also a member of HBI’s Stroke and Vascular Dementia Program.

The study was done using Calgary Scientific Inc.’s ResolutionMD Mobile, an application for iPhone and Android smart-phones. In April 2010, the application was approved by Health Canada so Canadian doctors can now legally make a primary diagnosis using the device.

Resolution MD is different from other medical image applications as a server does all the computing work and streams images to display on a smart-phone in real time. Doctors can see and manipulate medical images in seconds unlike other apps that can take 10-20 minutes to download raw medical images to an iPhone before they can be displayed. It is also unique as all medical images are secure. The confidential patient images remain behind hospital firewalls to prevent any patient data from being lost or stolen. The technology can also be used over great distances. By placing a server in a remote community, distant medical experts, such as stroke neurologists and radiologists, can have immediate secure access to patient scans anywhere, using a device they carry in their pocket.

The images can be viewed on an iPhone, iPad, Android smartphone or web-browser.

Calgary Scientific has licensed the application to many medical imaging companies and over 50,000 hospitals around the world will have access to it in the next 24 months as it’s installed in their networks.

The research was funded by Alberta Innovates Health Solutions, Alberta Innovates Technology Futures, and the Heart and Stroke Foundation of Alberta., NWT and Nunavut.

Background: Recent advances in the treatment of acute ischemic stroke have made rapid acquisition, visualization, and interpretation of images a key factor for positive patient outcomes. We have developed a new teleradiology system based on a client-server architecture that enables rapid access to interactive advanced 2-D and 3-D visualization on a current generation smartphone device (Apple iPhone or iPod Touch, or an Android phone) without requiring patient image data to be stored on the device. Instead, a server loads and renders the patient images, then transmits a rendered frame to the remote device.

Objective: Our objective was to determine if a new smartphone client-server teleradiology system is capable of providing accuracies and interpretation times sufficient for diagnosis of acute stroke.

Methods: This was a retrospective study. We obtained 120 recent consecutive noncontrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram (CTA) head scans from the Calgary Stroke Program database. Scans were read by two neuroradiologists, one on a medical diagnostic workstation and an iPod or iPhone (hereafter referred to as an iOS device) and the other only on an iOS device. NCCT brain scans were evaluated for early signs of infarction, which includes early parenchymal ischemic changes and dense vessel sign, and to exclude acute intraparenchymal hemorrhage and stroke mimics. CTA brain scans were evaluated for any intracranial vessel occlusion. The interpretations made on an iOS device were compared with those made at a workstation. The total interpretation times were recorded for both platforms. Interrater agreement was assessed. True positives, true negatives, false positives, and false negatives were obtained, and sensitivity, specificity, and accuracy of detecting the abnormalities on the iOS device were computed.

Results: The sensitivity, specificity, and accuracy of detecting intraparenchymal hemorrhage were 100% using the iOS device with a perfect interrater agreement (kappa = 1). The sensitivity, specificity, and accuracy of detecting acute parenchymal ischemic change were 94.1%, 100%, and 98.09% respectively for reader 1 and 97.05%, 100%, and 99.04% for reader 2 with nearly perfect interrater agreement (kappa = .8). The sensitivity, specificity, and accuracy of detecting dense vessel sign were 100%, 95.4%, and 96.19% respectively for reader 1 and 72.2%, 100%, and 95.23% for reader 2 using the iOS device with a good interrater agreement (kappa = .69). The sensitivity, specificity, and accuracy of detecting vessel occlusion on CT angiography scans were 94.4%, 100%, and 98.46% respectively for both readers using the iOS device, with perfect interrater agreement (kappa = 1). No significant difference (P < .05) was noted in the interpretation time between the workstation and iOS device.

Conclusion: The smartphone client-server teleradiology system appears promising and may have the potential to allow urgent management decisions in acute stroke. However, this study was retrospective, involved relatively few patient studies, and only two readers. Generalizing conclusions about its clinical utility, especially in other diagnostic use cases, should not be made until additional studies are performed.

ResolutionMD™ Mobile is our state-of-the-art medical viewing product, enabling instant access to radiology diagnostic images and reports from mobile devices. FDA-cleared for diagnostic viewing on the iPhone and iPad, ResolutionMD Mobile brings together all of the viewing tools needed to make a diagnosis including 2D, MIP/MPR, 3D and interactive collaboration.

ResolutionMD Mobile is in use at multiple world-renowned medical institutions – including the Yale-New Haven Hospital and the Mayo Clinic Hospital in Phoenix, Arizona – where pilot studies have provided evidence to support regulatory approvals.

Researchers from the University of Calgary have shown that doctors can make a stroke diagnosis using an iPhone application just as accurately (and faster) than they can on a traditional computer. In a study recently published by Journal of Medical Internet Research, two neuro-radiologists looked at 120 consecutive noncontrast computed tomography (NCCT) scans and 70 computed tomography angiogram (CTA) head scans. cuqf1gz9 Study Finds That iPhone App Can Make Accurate Stroke Diagnosis One used a diagnostic workstation and the other using Calgary Scientific‘s ResolutionMD Mobile app. The study results showed that using the ResolutionMD app is between 94%-100% accurate in diagnosing acute stroke, compared to a medical workstation.

In addition to accurately diagnosing a stroke, the app was also praised for its ability to handle a large number of images seamlessly and to detect subtle, but potentially critical findings in CT scans. Moreover, the mobile nature of the app gives doctors the ability to analyze and diagnose strokes from practically anywhere.

ResolutionMD Mobile was released last April and allows doctors to quickly and securely access medical images from central hospital servers and manipulate them to assist in making an accurate diagnosis. Of note, our friends at iMedicalApps have a review of ResolutionMD, and anyone can download the app for free from the iTunes Store.

Source : http://medicine.ucalgary.ca/about/iPhone_medical_application

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IBA’s Proton Therapy with Philips Ambient Experience

IBA’s Proton Therapy with Philips Ambient Experience

IBA’s Proton Therapy with Philips Ambient Experience

BOSTON, October 28, 2012 — IBA Group, a leader in advanced cancer diagnosis and therapy technologies, and Royal Philips Electronics (NYSE: PHG, AEX: PHI) today announced their first-ever installation of a state-of-the-art, patient-centered proton therapy treatment room in the United States. A new addition to the Willis-Knighton Cancer Center in Shreveport, La., will be the first IBA installation to incorporate the Philips Ambient Experience.

Designed and engineered by Philips Healthcare, the Philips Ambient Experience promotes patient relaxation during proton treatments by permitting patients to selectively add comforting light, sound and images to the treatment room environment before they begin therapy. This will help improve the patient and staff experience, turning a cold, impersonal environment into one that comforts and reassures as the patient becomes an active participant in the process.

“This new installation is the first to come to fruition from the Philips-IBA cooperative agreement,” said Olivier Legrain, Chief Executive Officer at IBA. “It is demonstrative of a successful collaboration with Philips in offering highly advanced, patient-centered care, and we are delighted it will be integrated into our new proton system installations.”

“Ambient Experience enhances our ability to provide superior cancer care,” said Dr. Lane Rosen of the Willis-Knighton Cancer Center. “The soothing and empowering atmosphere will make our patients more comfortable, which will allow our staff to work more efficiently. IBA and Philips have been excellent partners, so it made sense to work with them to bring this unique experience to our patients.”

Willis-Knighton will be the first center to utilize Proteus®ONE, IBA’s single-room compact gantry solution for those looking for a more cost-effective, smaller footprint option. The $40 million project is expected to begin treating cancer patients with protons in early 2014.

Together with Philips, IBA is demonstrating a life-size model of the ProteusONE proton therapy room combined with the Philips Ambient Experience solution in booth #3019 at the 54th annual meeting of ASTRO, the American Society for Radiation Oncology, in Boston.

IBA Group (Louvain-la-Neuve, Belgium) has partnered with Philips to create an attractive new patient experience for their proton therapy system. Upon entering the facility patients choose the music, visuals, and lighting they prefer via a tablet. This is built on the foundations of the Philips Ambient Experience, a set of principles and design ideas that aim to turn diagnostic imaging and therapy sessions into a less anxiety inducing experience.

The first such system is being installed at the Willis-Knighton Cancer Center in Shreveport, Louisiana.

Source : http://www.newscenter.philips.com/main/healthcare/news/press/2012/20121028-Philips-and-IBA.wpd

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