Hello Teri

We are using Chromavision ACIS since almost 2 years routinely for the search of disseminated tumorcells in bone marrow aspirates in patients with breast carcinoma. This module works very reliably and we won't miss it. The automated screening of slides saves a lot of time (although you loose part of it with the preparation of the slides for the computer, reading and verifying of the objects in the result galery and somewhat clumsy data handling). However, more important is the fact that the color recognition and the indefatigableness is better than that of a stressed microscopist. Detection of rare events in minimal residual disease is an increasing task, and for this purpose ACIS is our only way to keep up with the increasing demand.

We also tested it for the quantification (scoring) of the herceptin test. Again, the mechanics of the robot microscope and the image analysis is amazingly fast and reliable. However, we stopped usage for the following reasons: The clinicians are used to and want the DAKO scoring. The DAKO scoring is much faster. In the 2+ group we observed discrepancies between the scoring values of ACIS and DAKO. No matter who is right in these cases, FISH analysis will be the method of choice at least for such cases. Therefore, our strategy is now to score using the DAKO system and to fish the 2+ group.

The Ki67 module and related ones (p53, hormone receptors etc) is, to my mind, the best offer on the market for users who are not familiar with image analysis and which do not have the time to study unreadable handbooks of sophisticated image analysis programs. However, it is absolutely required that the immunohistochemistry is without background and the counterstain really allows the segmentation of the nuclear area against the background. One interesting application for us is to use it for quality control by measuring periodically slides of our in-house testblock for MIB1 and p53.

Finally, the support (in Europe) is very efficiently organized, no complaints. Most software adjustments are made overnight via the net.

Please feel free to contact me, if you have more detailed questions.
Best regards from Basel

Fred Gudat, MD
Institute for Pathology
Basel. Switzerland