1. Telepathology in Global Drug Safety Research Akira INOMATA, DVM, PhD Drug Safety Laboratories Eisai Co., Ltd. Oct 27, 2008

2. The Role of Telepathology in Eisai Global Drug Safety Research Along with accelerating overseas operations and the ever expanding role of pathologists today, the need for telepathology has been increasing. Today, I will introduce the current status and future vision for implementing telepathology in our drug safety research programs worldwide.

3. Contents Where are we? –Japan –Worldwide Past – Present – Future Hurdles

4. Tokyo Tsukuba Kawashima 400 km HOKKAIDO KYUSHU HONSHU SHIKOKU SEA OF JAPAN PACIFIC OCEAN Boston – NY 350Km Where are we? - Japan -

5. Boston Tsukuba Kawashima Where are we? - Worldwide -

6. Past – Present – Future Communication between pathologists Personal Face to face Teleconference with pdf/tiff/ppt images in shared data base Phone, e-mail, etc. …. Instrument Remote-operated microscope Very useful, but only ONE slide can be set and SLOW operation. Growing Needs for Efficient Telepathology System On-time, speedy operation, high-resolution, multiple slides, view images on PC …

7. Choosing Digital Microscope System Points taken into account Hardware: Speed, capacity, user-friendly Software: Regional technical service/staff and … how to convince pathologists Remote-controlled microscope Scan-scope Good sales performance Japanese representative Aperio ScanScope ® XT

8. Network formation ImageScope ® installation study pathologist, study director, project representative, histo-technician, etc. –Limiting one’s authority to access images/folders –Organizing folders to ensure easy access to images –Viewing images outside company via internal LAN Past – Present – Future KawashimaTsukuba Server PC

9. Feedback from users Past – Present – Future “Like a google map!” “Amazing!” “Want to analyze images” “Want to use this at scientific meetings!” “Can we use this for consultant’s review?”

10. Now we can … –observe prior to internal/peer review meeting –discuss on time with other pathologists –share with non-pathologists and explain –feedback of timely to overseas colleagues We are planning to … –allow outside consultants/experts to enable the above –facilitate meetings –Save time and budget Past – Present – Future

11. Network our sites worldwide and consultants from their offices Past – Present – Future Virtual Slide to Virtual Lab

12. Hurdles Network formation with outside company –Internal LAN? –Independent network? Compatible with GLP –Diagnosis by digital image It ’ s not a hurdle, but … pathologists will be unable to escape from their job anywhere in the world!

13. In the hotel room in New Jersey, July 21, 2008

14. Thank you for your attention!