MacroVIEW

MacroVIEW Macro digital imaging system for diagnostic and forensic post mortem investigations
The MacroVIEW builds on our over 20 years of digital imaging experience to dramatically improve the standardization and documentation of pathology procedures.
Capture images of whole bodies, body parts, and large organ systems.
Add visual or audio annotations to the images and also record video to create a more descriptive record of the autopsy, necropsy, or forensic case.

Diagnostic post mortem
Forensic post mortem
Veterinary labs for necropsy of animals
DVI (Disaster Victim Identification)Benefits
Reduce turnaround time and cost.
See, capture and store images for areas of interest.
Eliminate extensive audio tape descriptions for future transcription and rechecking for errors.
Eliminate both traditional 35mm film photography and manual digital photography.
Edit images with annotation in the convenience of the pathologists office.
Compile a library of images readily available to the law enforcement officer at the end of
autopsy, after completion via USB ports.
Storage automatically images in conjunction with case ID number.
Process automatic sizing features integrated with imaging system.Flexibility
Organ examination. MacroVIEW can be positioned over the examining table to acquire
images and detail of excised organs.
Teaching/training.
In a teaching environment, by simply connecting the MacroVIEW to an LCD projector, the actual sequence of examination can be shown to a large audience.The simplicity of MacroVIEW Field of viewDigital Imaging Module
The imaging module with built-in camera and control monitor is mounted on a mobile
extended spring arm, to ensure ease-of-use and a full view of large specimens (human or
animal bodies)
The versatility of MacroVIEW
1 – Keyboard
2 – Control terminal
3 – Digital imaging module
4 – Mobile cart
5 – BatteryThe versatility of MacroVIEW
The medical-grade battery-powered mobile cart allows for enhanced flexibility in multiple table/
room facilities.Digital Imaging Module
The imaging module with built-in camera and control monitor is mounted on a mobile
extended spring arm, to ensure ease-of-use and a full view of large specimens (human or
animal bodies)The medical-grade battery-powered mobile cart allows for enhanced flexibility in multiple table/room facilities.The unique feature of MacroVIEW1. 5 LCD color monitor.
It enables the pathologist to easily check the field of view, without having to look at the main control terminal with thumb-operated control buttons on a flat, waterproof keypad2. 20 megapixel industrial digital camera. Autofocus, auto light adjusting, and 10x optical magnification, capture outstanding quality images, in JPG format.
Camera magnification range allows for capture of large to minute details3. Waterproof Control Terminal. Point Of Care (POC) unit features color touch-screen in a splash and dust-proof enclosure. Hard drive with USB ports4. USB Waterproof Keyboard with IP68 dust/water protection5. Heavy-duty mobile battery powers the unit for up to 8 hours of useThe user friendly MacroVIEW
1. Start a new case file.
2. Scan barcode or enter case data by keyboard.3. Capture a digital image of the requisition form.4. Press “save”.
Capture and store images.
Saved images appear as thumbnails on the right of the monitor.5. Create a library of images in JPG format, simply rapidly and economically.

6. Voice recording.
Audio recordings are saved in the MP3 format.

7. Video recording.
MacroVIEW records videos to support case descriptions with 4K resolution.

Annotations.
• Sizing/surface area
• Block sampling
• Freehand drawing
• Text and more

8. Generate assets for use in case reports.
An improved method for generating enhanced case reports.

Interfacing the MacroVIEW
In addition to stand-alone operation, MacroVIEW DM can interface with a PACS or LIS through coded solution or TWAIN mode.
Interfacing with LIS (Laboratory Information System)
1. Software running in the background monitors a local or network location for image additions.
2. MacroVIEW acts as a secondary application to the LIS. Patient case identifier is held by LIS.
3. LIS launches MacroPATH pro-x.
4. User completes image acquisition and annotation.
5. Assets are transferred to the LIS.
6. As new images arrive at that chosen location they are captured and transferred into the PACS server.

The MacroVIEW dramatically improves the standardization and documentation of pathology procedures. Capture images​of whole bodies, body parts, and​large organ systems. Add visual or audio annotations to the images and​also record video to create a more descriptive record of the autopsy, necropsy, or forensic case. MacroVIEW​ DM captures and stores images for the areas of interest, eliminating extensive audiotape descriptions that need future transcription and​rechecking for errors. This​in turns reduce turnaround time and costs. The system​edits images​with annotation in the convenience of the pathologist’s office and automatically stores images in conjunction with the case ID number: it compiles a library of images readily available to the law enforcement officer at the end of the autopsy, after the completion via USB ports.

Digital imaging includes both the digitization of signals from an analog video camera via a frame grabber card in a computer and the direct acquisition of digital images via a digital camera. Although initially the former approach was more common, use of cameras employing true digital capture is becoming more popular. Digital photography provides a number of advantages over routine 35-mm gross photography, especially with respect to image cataloging, storage, and retrieval.

Digital imaging in pathology is here. It is practical, cost effective, and provides many advantages over traditional photography. Although most systems described in the literature have been implemented in a surgical pathology setting, use in an autopsy environment is possible and practical if equipment with the correct features is used. Digital imaging is also the first step toward opening the door to many future improved services.

An image-enhanced report (IER) containing color digital images can serve as an educational tool and document important gross and microscopic findings in anatomic pathology.
Color digital photography is becoming the imaging standard among pathologists. It is inexpensive, flexible, and widely available, and is well suited for the highly visual field of pathology. Digital color images of gross or microscopic specimens can be easily obtained, edited, enhanced, annotated, and archived. Attributes such as color, contrast, and hue can be adjusted to most closely match the original specimen, and text, rulers, arrows, and labels can be added. These images can then be used for presentations, conferences, publications, education, quality control, and diagnosis.
Given the illustrative power of a picture, pathologists may wish to enhance their patient reports with gross and microscopic specimen images. This is already possible with existing pathology-reporting software. The result is an image-enhanced report (IER) that visually documents features of the patient specimen in addition to the usual text descriptors. Color images may be used to demonstrate diagnostic findings, compare gross and histologic features, correlate with radiology, and illustrate extent of disease. It is the intent that clinicians use IERs to educate and inform themselves, residents, staff, and even the patient and the patient’s family.
Based on our experience, color digital images are perceived by clinicians as a valuable addition to the autopsy report. Since clinicians are often either unwilling or unable to attend the actual autopsy, the IER serves as a useful adjunct to the gross and microscopic descriptions. Although there was a relatively small number of respondents, the fact that autopsy images enhanced the understanding and utility of the report for most respondents supports this conclusion. In addition, all respondents stated they would (or did) use the images to educate themselves, medical students, residents, and/or the patient’s family. Additional studies are warranted to confirm the utility and benefits of IERs.
Selection of autopsy images for inclusion in the final report is an important consideration. Our departmental policy prohibits inclusion of face, genitalia, and whole-body images in our autopsy reports. In general, images of fetal cases are not included in reports, but may be done so with prudence. As our final report is generally sent directly to the clinician, the choice to share the images with the patient’s family is left to the primary physician. Fewer than half (44%) of the respondents in our survey stated they would use autopsy images for family education.
Once images are selected, they may need to be digitally processed, color and contrast may need to be adjusted, and annotations, labels, and pointers may need to be added. Numerous software programs are available for this purpose and provide remarkable editing flexibility. However, care must be taken to maintain the medical authenticity of the image. Since digital manipulation may be undetectable in the final image, the risk of unintentional misrepresentation, or even fraudulent manipulation, arises. We recently published guidelines to protect the authenticity of medical digital images.
As expected, the IER was not a strong motivator for clinicians to request an autopsy, and only 21% of survey respondents stated that the presence of images would increase their likelihood of requesting a future autopsy. However, as the IER becomes more commonplace, clinicians may come to expect images in all reports, including surgical pathology. Understandably, because of the extra labor, expense, maintenance, and training requirements, this expectation could meet with much resistance from pathologists. Some laboratories already routinely incorporate images into their surgical pathology reports, and this practice may provide them with a competitive edge in some markets. Ultimately, the decision to incorporate images into reports will be based on the potential educational, clinical, and financial benefits.
Once the decision is made to incorporate images into pathology reports, we recommend publicizing this addition to the potential readers. We believe that insufficient advertising explains why only half of our respondents noted the addition of color images to our autopsy reports. It may also be that busy clinicians read only the first page of the autopsy report and do not delve into the back pages containing the gross and microscopic descriptions and the images. Based on this deduction, we are now including a cover page with each IER, alerting the reader to the presence of color images. An alternative strategy is to feature the images in a prominent location in the report, such as on the front page.
With careful planning, the benefits of digital imaging are many. Color images can be stored on a shared pathology network drive and can be easily retrieved for conferences and presentations. Furthermore, incorporation into an image database could allow images to be retrieved based on disease process, diagnosis, organ system, or patient identifiers. In addition, gross and microscopic pathology images could potentially be made available hospital-wide through the MacroVIEW software. While used primarily by radiologists and cardiologists, this technology is potentially available to all image-based departments.
In summary, image incorporation into autopsy reports is perceived to increase the utility and educational value of autopsy reports among clinicians and has been well received at our institution. Our experience has led us to continue and encourage this practice. Because images are located at the end of the report, we also now attach a cover sheet to each autopsy report that contains color images, alerting the recipient to the presence of these images. Our success with this endeavor thus far, as well as advances in our digital photography and processing system, will facilitate a transition to surgical pathology IERs, should this project be undertaken.