DEMONSTRATION

Implementation of a Commercial Scalable, Multi-User Client Server Image Database for Pathology

Michael Feldman, MD, PhD, Jeremy Goldman, BS and John Tomaszewski, MD

Department of Pathology, University of Pennsylvania, Philadelphia, PA

ABSTRACT:

Background:

The use of digital photography for gross and microscopic pathology has grown rapidly in popularity and use. For maximal benefit (use in clinical care, research, and teaching) these images should be stored and indexed with metadata on a centralized server for access throughout the department or health system. A client server image database was deployed that features a centralized image archive, customizable field definition, keyword indexes and low cost and scalability.

Technology:

A Client-server image database from Cerious Software (www.cerious.com) was deployed using Microsoft SQL server (www.microsoft.com) on an HP netserver (www.hp.com) running Windows NT (www.microsoft.com). Nikon 990 digital cameras (www.nikon.com) for gross photography were deployed in the autopsy and surgical pathology laboratories. Digital microscope cameras from Polaroid (DMCle) (www.polaroid.com) and Diagnostic Instruments SPOT Insight digital camera (http://www.diaginc.com/contents.htm) are used for microscopic imaging.

Design

A client-server image database (ThumbsPlus) was deployed on a dual processor Windows NT server running Microsoft SQL7 with 1GB ram and 100 GB hard disk space. Secure access is by either Windows NT domain authentication or by SQL server authentication. Digital cameras are interfaced to client software using a TWAIN plugi-n form the camera manufacturer. Images are annotated based on keywords extracted from the image filename as well as data entered into fields within the database.

Results

The database has been running for 24 months and currently houses >40,000 images. A twenty-five user concurrent license and database was purchased and installed for $2500 (includes concurrent use license and SQL database). Digital cameras for gross (2) and microscopic pathology (8) total $42,000. Cost savings from reduction in 35 mm Kodachrome processing are $20,000/yr. Images are used for clinical documentation as well as development of UME and GME lectures and publications.

Conclusions

A low cost, scalable image database was deployed for support of education, research, and clinical care. The database solution is scalable from small departments with a single user to large sites with hundreds of users. A web front end is being developed to deploy the database to users without client software across the health system.

BENEFIT TO PARTICIPANTS ATTENDING SESSION:

¨ How to deploy a low cost digital image acquisition and archive for pathology

¨ Support of UME and GME education via a pathology image archive

Michael Feldman

3400 Spruce Street

Dept Pathology

6 Founders Bldg.

Philadelphia, PA 19104

Phone: 215-662-6503

Fax: 215-349-5910

Email: feldmanm@mail.med.upenn.edu

CO-AUTHORS:

Jeremy Goldman, BS

John Tomaszewski, MD