RISKS AND REWARDS OF PATHOLOGY INNOVATION:Billion Dollar Bets
Ronald S. Weinstein, M.D., FCAPProfessor of Pathology
Director, Arizona Telemedicine ProgramUniversity of Arizona
Tucson, ArizonaDISCLOSURES: DMetrix, UltraClinics
No
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/No
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ases
Years
S-Curve of InnovationTelevision Microscopy/Telepathology
1968
No
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ites
/No
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ases
Years
S-Curve of Innovation
19861968
Television Microscopy/Telepathology
No
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ites
/No
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ases
Years
S-Curve of Innovation
19861968
Television Microscopy/Telepathology
No
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ites
/No
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ases
Years
S-Curve of Innovation
20001968
Virtual SlideTelepathology
S-Curves of Innovation
Robotic Microscopy Virtual Microscopy
Telepathology/Virtual Slide Telepathology
Tandem Curves
Virtual Slide Image Acquisition
Raster scanning
Virtual Slide Output/24 Hours
University of Arizona - Ultrarapid Virtual Slide Project
“Best of Breed” in Optics and Astronomy
Arizona College of Optical SciencesArizona College of Optical Sciences•200 Doctoral students
• 200 Post-doctoral students• 2 Nobel Laureates
• $100 million research budget• NASA - Phoenix Martian Lander
Reinvention of Light Microscopy
Miniaturized microscope
Year 2000
field-of-view
FOV 1 to 25 FOV 1 to 7
tissue
glass slide
GLASS SLIDE
PATHOLOGY WORKSTATION
S-Curves of Innovation
Single Axis Optics
Virtual SlideTelepathology
Tandem Curves
S-Curves of Innovation
Single Axis Optics Array Microscope Optics
Virtual SlideTelepathology
Tandem Curves
Array microscope optics vs. convention
Array microscpe
optics
Array microscpe
optics
Illumination
• Get as many photons to image sensor as possible in the least amount of time
• Solution:– Use LEDs in clusters– Use compound parabolic
concentrators (CPCs)
• Straightforward extension to multispectral imaging– Use multiple LED cluster
lamps
Image sensor wafer
2,500 frames/sec
How to handle glass slides quickly and gently
• Slides are hovered on a directed cushion of compressed air
• Direction of air flow determines direction of slide motion– In or out of a slide rack
• Bar code reader included (multiple codes)
• No damage to slides.
Array Microscope format considerations
• Two considerations:– How many objectives (Nobj)
needed to span width of object (W)?
– How many objectives fit into size of array?
• Constraints on array size:– Width of object (e.g., glass
slide) (W)– Length of array (L)
• Ratio () of field of view size (wFOV) to optics size– Conventional: ~1:25– Array microscope: ~1:7
Nobj W
wFOVNobj
W
wFOV
Nobj 2WL
wFOV2
Nobj 2WL
wFOV2
wFOVwFOV
NobjNobj
Initial Array Microscope Concept
DMetrix, Inc. Tucson, Arizona
Advanced TechnologiesAdvanced Technologies
• Monolithic multi-lens optical systems
• Aspheric optics (fabrications and QA)
• Super-high quality multi-channel sensor (CMOS sensor)
Lenslet array
1 inch
1 inch
Patient Name
S-14926-06
University Physicians HospitalTucson, Arizona
Patient Name
S-14926-06
University Physicians HospitalTucson, Arizona
DMetrix
DMetrix
DMetrix Ultra-rapid virtual slide scanner
• “Break though” technology Wall Street Journal
University of Arizona, Tucson, AZ
DMetrix-Enabled College of Medicine
1. University of Arizona College of Medicine (2004)
2. University Hospitals (2005)
3. Southern Arizona VA (2008)
4. U of A Neurobiology Institute (2008)
Clinical Services
• Multi-site Quality Assurance Programs
• Second Opinions
• Subspecialty Consultations
• Same-Day Laboratory Services
Quality AssuranceProgram
University Physicians HospitalTucson, Arizona
DMetrix
DMetrix
Virtual Slides in Residency Training
Telepathology Virtual Microscopy
Quality Assurance Program
Medical Education
• Virtual Slide Laboratories
• On-line Pathology Virtual Slides
• Residency Programs
• Fellowship Programs
U of A Medical College(Tucson, Phoenix
Campuses)
Virtual Slide Boxes
University of Arizona
DMetrix DMetrix Virtual Slide LaboratoryVirtual Slide Laboratory
Lab 1 Lab 2
Podium
University of Arizona College of MedicineDMetrix Virtual Slide Labs
DMetrixvirtual slide
DMetrix
DMetrix
DMetrix
No
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ites
/No
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ases
Years
S-Curve of Innovation
20071968
Virtual SlideTelepathology
No
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ites
/No
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ases
Years
S-Curve of Innovation
20081968
Virtual SlideTelepathology
No
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ites
/No
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ases
Years
S-Curve of Innovation
20081968
Virtual SlideTelepathology
DMetrix
No
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ites
/No
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ases
Years
S-Curve of InnovationTelepathology to Virtual Slide Telepathology
1968
2008
Television Microscopy ServiceMassachusetts General Hospital
Boston, Massachusetts, USA1968
DMetrix
DMetrix
DMetrix
1968-2008
No
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ites
/No
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ases
Years
S-Curve of InnovationVirtual SlideTelepathology
20081968
TrendsTrends (2008-2018)
• Convergence of digital radiology and digital Convergence of digital radiology and digital pathology pathology
• Next-generation workflow management Next-generation workflow management
systemssystems
• Improvements in virtual slide processing Improvements in virtual slide processing ~ 8-10 second scan times~ 8-10 second scan times
TRANSFORMING PATHOLOGY:Emerging technology driving practice
innovation
