MIRAX SCAN The new way of looking at pathology

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Microscopy from Carl Zeiss MIRAX SCAN The new way of looking at pathology Greater reliability. Greater efficiency. Plus points for your diagnostics

Better. More efficient. Quality as a factor for success Whether in clinical laboratories, at research service providers or in pharmaceutical companies, the requirements that medical diagnostics must fulfill are increasing constantly, with people clamoring for optimum quality with enhanced efficiency. These days, a whole host of external factors impact on work processes in pathology: competition among clinical institutions has long been rife. More and more often, marginal cases are becoming legal cases. Everyday clinical activity is subject to an ever greater number of legal constraints. In pharmaceutical research, the requirements imposed by health authorities are becoming more stringent all the time, and laboratory standards more demanding. Added to this is the growing volume of work. High throughput is commonplace. Time is scarce and technology offers little relief. With MIRAX SCAN, Carl Zeiss is launching a fully automated system solution for digital pathology. MIRAX SCAN produces high-resolution digital data records for the entire sample, known as Digital Slides, thereby improving your diagnosis in two respects: quality and efficiency. With state-of-the-art technology for automated scanning in batch mode of up to 300 samples With spatial and temporal independence during evaluation With greater reliability in diagnosis due to quick receipt of second opinions MIRAX SCAN combines the optics and technology of Carl Zeiss with the experience of IBM in digital archiving. Now for the first time an integrated system solution exists for digital pathology that allows you to concentrate on the most important aspect: the evaluation. And the quality on offer is superb. 2

MIRAX SCAN 3

Available any time: Your samples as Digital Slides MIRAX SCAN is the system solution for digital pathology. It consists of a scanner, a high-resolution monitor, a dual processor PC and software modules. At the heart of MIRAX SCAN lies the scanner, which makes the specimens available as Digital Slides. Any time, from any place. In brilliant quality, with the same optical resolution as on a microscope. The Digital Slide will revolutionize your work processes in medical diagnostics. Greater flexibility Diagnosis and reporting take place directly on the screen. This can be in an entirely different location to the scanner. Data and results are communicated directly via internal networks or even the Internet. A plus for quick communication. Greater reliability in diagnosis Whole sections can be viewed. Several samples can be viewed simultaneously. Current and earlier sections can be compared directly and quickly. It is also possible to document the evaluation path on the section, and this can be traced at any time. Short access times All archive data can be accessed directly online on the network. This saves you time during complex evaluation processes and when comparing different samples. In clinical institutions, the pathological findings can be incorporated into the patient s electronic file and called up immediately. Maximum quality assurance IT structures are already used today to build up QA networks, obtain second opinions and carry out evaluations (example in Germany: the diagnosis network currently being set up for the detection of breast cancer). You too can prepare your pathology perfectly for the increasing quality requirements in medical diagnostics. Another advantage of Digital Slides: immunohistologic specimens are digitized before the samples bleach out. Starting MIRAX SCAN Inserting magazine and scanning Evaluating on the monitor 4

Digital Slide Integration into interconnected digital diagnosis systems The Digital Slide concludes the automated process from biopsy to digital archiving. As with other diagnostic methods (sonography, MRT, CT etc.), histology is now also integrated into the digital information systems for medical diagnostics, making these data available for the patient s electronic file a major plus for process reliability. PET Digital Pathology Thermography Sonography X-Ray CT MRT Paraffin Embedding Cutting Dehydration Staining Biopsy Digitalization Communication 5

Highest image quality, shortest scanning time: Up to 300 samples automatically As soon as the section specimens are available, MIRAX SCAN performs the usual routine steps for you. It generates Digital Slides automatically in a cycle of up to 300 specimens. Continuously, even through the night. High performance optics from Carl Zeiss deliver excellent results: now for the first time you can see things on a monitor that were previously only visible under a microscope with no loss of information, and on a 22" monitor with 9 million pixels. technique and structure. The magazine is then positioned automatically until the first sample is drawn in. The sample area for scanning is determined automatically. The barcode system Barcodes must be used if MIRAX SCAN is to run in fully automatic mode. MIRAX SCAN reads in the barcode before scanning. This prevents any mistakes in sample allocation. Inserting and starting Simply insert a magazine with automatic-compatible slides and select the samples for scanning. For optimum scanning results, the samples for a particular cycle should be similar in terms of staining From specimen to Digital Slide The MIRAX SCAN software enables you to track the area that is being scanned on the monitor. Depending on the size of the specimen, scanning takes between 2 and 20 minutes. 1. Magazine 2. Sample 3. Barcode reader 4. Preview camera 5. Halogen lamp 6. Objective 7. Scan camera 5. 6. 2. 4. 3. 1. 7. 6

Applications For routine and research applications MIRAX SCAN is very useful for standard sections and also for very large samples, which can be evaluated with ease on the large screen easily degradable samples (common in immunohistology, for example) that bleach out on glass after only a few months and can be archived as a file without limitation serial sections, because these can be evaluated on the screen in parallel alongside one another or as a three-dimensional stack. 6 µm thick paraffin section Organ sample: Colon tumor (human), stain: Pharm-DX EGFR IHC Application: Clinical study for a new pharmacological diagnostic procedure. EGFR-stained section of a colorectal tumor. The central region of the tumor shows clearly visible membrane marking. MIRAX SCAN also processes thick sections in a large variety of staining and embedding techniques. These can be inserted on slides with glass or plastic cover slips. The application images on this page have been produced at the Central Hospital of the Ministry of the Interiour, pathological department, Hungary, and at HistoGeneX in Belgium using MIRAX SCAN. They are printed by kind permission of P. Gombas, L. Andries and M. Kockx. 15 µm thick paraffin section Organ sample: Stomach (human), stain: Haematoxylin Application: Consultation. Infiltrating adenocarcinoid in a biopsy of the mucosa. 6 µm thick paraffin section Organ sample: Colon tumor (human), stain: P53 Application: Tumor research. Nuclear P53 marking in a cell cluster of a colon tumor.

Software Intelligent and extendable: Always the right software MIRAX SCAN comprises several software modules. With MIRAX SCAN Control Software, you determine the mode of operation and basic settings for scanning. MIRAX Viewer is the software you work with as a pathologist or scientist. Here you choose the Digital Slide, frame and magnification etc. on screen and you can also document your diagnosis. Additional, optional modules of MIRAX Viewer are Teleconsulting for teleconsultations with colleagues or partners via IT networks 3D Visualisation for displaying serial sections threedimensionally Imaging Analysis Gland as an example of a specialized application MIRAX SCAN Control Software The basic software MIRAX SCAN Control Software is the software that controls automatic operation of MIRAX SCAN. This is where it is decided which slides from which magazine will be scanned. The Digital Slides are then generated. The scanning parameters, such as the threshold value for the overview camera and fine and coarse focus controls, are specified. During scanning, the viewer also has the option of arranging for each field of view to be displayed briefly. MIRAX Viewer Evaluating on the monitor MIRAX Viewer is the software you use to display and evaluate the Digital Slides. With MIRAX Viewer it is possible to view Digital Slides individually or in groups. To achieve the best possible overview of a sample, the main frame is accompanied by two other views. The overview shows you which frame you have already examined. When viewing several samples simultaneously, you have the option of moving the samples in parallel alongside one another. This enables you to view and evaluate the same region on several sections. The sample can be magnified up to 40 times. The quality of the image is brilliant. The sample is viewed on a 22" monitor with 9 million pixels. An optional 4x zoom window also enables additional details to be brought into view. MIRAX Viewer Control Software 8

1. MIRAX Viewer Module Image Analysis Gland 2. MIRAX Viewer Module 3D 3. MIRAX Viewer 1. 2. 3. Optional modules for MIRAX Viewer Teleconsulting Co-evaluating with colleagues With this module you can conduct teleconsultations with colleagues or partners. This software provides you with the best preparation for the more stringent quality requirements that will apply in the future. It enables two or more pathologists to view and evaluate a Digital Slide together via the TCP/IP protocol, ensuring an extremely reliable diagnosis. 3D Visualisation Display of serial sections This 3D visualisation software allows serial sections to be displayed three-dimensionally. With consecutive sections, the software rotates the Digital Slides so that the sections are stacked correctly. This is particularly helpful when evaluating nodal tumors, for example, as it enables the evaluation of lower-lying regions. Image Analysis Gland For specialized applications This image processing module can be used in medical and pharmacological research, but not, however, in clinical diagnostics. It enables automatic detection and counting of glandular cells and is a specialized application for the evaluation of glandular tissue. The software detects glandular cells on Module Teleconsulting the basis of their shape, marks them automatically and is able to display them in various ways. Intelligent IT storage solutions for archived quality The Digital Slide shows the same optical information as the microscope. With absolutely no loss. With the right storage solution, the brilliant quality of the Digital Slides is preserved, even if archived for a long time. Greater memory requirement The amount of data that the specimens hold varies, according to size, between 100 MB and approx. 2 GB. Assuming roughly 1 GB per section, approx. 100 sections a day and 220 working days a year, this results in a memory requirement of 22 TB (terabytes). Individual IT solutions Here scalable, transparent storage solutions consisting of hard disks and tape streamers are offered. Even large volumes of data remain immediately available at any time. All data, e.g. from the last half year, can be accessed within milliseconds on the hard disk. Older archive data can be loaded from the tape streamer into the MIRAX Viewer within a matter of seconds. IT partners of Carl Zeiss For queries relating to data storage we recommend IBM Business Solutions and its partners. Please ask your local Carl Zeiss sales partner for the IBM business partner in your area. Of course, existing IT partners may also be used. 9

Technical data* MIRAX SCAN Dimensions: 74x45x53 cm (width x height x depth) Weight: 25 kg Wattage: 50 W Image digitization 1/3-inch progressive scan IT CCD Pixels: 4.65µm x 4.65µm Pixel resolution with 20x objective: 0.23 µ with 1x adapter Special monitor LCD TFT monitor IBM T221 Visible diagonal: 22.2" Maximum resolution: 3840 x 2400 pixels Dual processor PC XEON 2.8 GHz dual processor workstation Memory: at least 1024 MB RAM *Subject to alterations 10

System overview 11

All the benefits at a glance Automation Automatic scanning and digitization of up to 300 slides Precision High performance optics and reliable mechanics from Carl Zeiss Image quality Same resolution as on a microscope, presented on 22" flat screen with 9 million pixels Evaluation Parallel evaluation of current samples and comparison with archive images Communication Quick, location-independent exchange of digital data worldwide Integration into IT systems Integration of pathology into interconnected digital clinical diagnosis systems Long-term archiving Medium-term conversion of slide stores into purely digital data storage Quality improvement Further increase in reliability of findings due to quick receipt of expert opinions Investment reliability Carl Zeiss and IBM as dependable partners for microscopy and digital archiving Carl Zeiss Light Microscopy P.O.B 4041 37030 Göttingen Phone: ++49 551 5060 660 Telefax: ++49 551 5060 464 E-Mail: micro@zeiss.de www.zeiss.de/miraxscan MIRAX SCAN is developed, produced and licensed exclusively to Zeiss by 3D Histech Kft. Hungary Printed on environment-friendly paper, bleached without the use of chlorine. Design, equipment and technical develop-ments are subject to change without notice. 46-0064 e 11.2004