Check out Mayachitra imago. Started using this a few weeks ago and haven't used all the features but some nice image management features pathologists with large image files may like.
Mayachitra imago is an image management tool designed for microscopic images. imago can be thought of as an "iPhoto for Scientists", but with significantly more capabilities. imago has many special features to help scientists to easily manage, organize, and analyze a large collection of images.
imago's unified search feature enables users to search images in one place by image name, annotation, user's own tags, image content, or any combination of the above. Besides image archival and retrieval, imago also provides integrated image analysis tools. For example, imago has a built in wizard that enables scientists to count cells in their microscope images of tissues. imago received very positive reactions from some early customers who have used the cell counting wizard.
The other major capability provided by imago is the ability to automatically register (align) images together. This unique tool has been particularly helpful to early imago customers who work with microscopes, since by design microscopes have a very narrow field of view. With the help of imago, scientists can automatically stitch hundreds of such images together to get a detailed and highly accurate picture of the whole specimen without sacrificing the resolution of the images. imago is available on the web for free download now (see http://mayachitra.com/imago).
From their website:
Mayachitra imago is an advanced image database and analysis system for scientific images. imago is a simple yet powerful tool that allows scientists to easily manage, organize, analyze a large collection of images. imago provides a powerful unified search functionality that enables you to search images in one place by image name, annotation, your own tags, image content, or any combination of the above. Besides image archival and retrieval, imago also provides integrated image analysis tools, such as automatic image registration and automatic cell counting. See Mayachitra imago in action.