Validation of Histology Tissue Processing and Stain Quality of Logos Rapid-Cycle Microwave Processor in Lean Continuous Flow Operations
Richard J Zarbo, Ruan C Varney, Michael J Dib, Beverly Mahar, Jason Wozniak. Henry Ford Hospital, Detroit, MI
Background: Pathology report timeliness can be enhanced by technology that reduces time waste in histology. The largest delay is overnight fixation and prolonged processor times. These throughput bottlenecks can be targeted by integrating tissue processors capable of rapid-cycle times especially when aligned with continuous flow Lean work design.
Design: Evaluation of a rapid-cycle microwave processor (Logos, Milestone Medical, Kalamazoo, MI) was performed at Henry Ford Hospital Histology Core Laboratory with aims to 1) integration of processor into continuous flow work process; 2) compare specimen quality in split samples processed by conventional overnight processors and the rapid-cycle instrument. We assessed technical quality of block processing, slide cutting and H+E staining by histotechnologists and quality of H+E, special and immunohistochemical stains by pathologists with a standard input form. 238 specimens were dissected fresh and split by 2 PAs. 3 part scheme with free text comments was used for histology assessment (High, Average, Low Quality) and pathologists' microscopic evaluation (Acceptable, Inferior, Unacceptable for Diagnosis). Analysis was stratified by tissue type and processed thickness.
Results: In 238 tissues (fat, liver, placenta, ovary, colon, stomach, endometrium, cervix, ovary, uterus, prostate, testis, skin, thyroid, gallbladder, soft tissue, heart, POC, lymph node, salivary gland, thrombus, esophagus, lung, larynx), no significant quality differences were noted between rapid-cycle and conventional processors in any parameter assessed in 49 needle biopsies (1mm), 28 small biopsies (2mm) and 161 large specimens (3mm). Technical cutting quality was at variance in a minority, better in 9 cases from the rapid-cycle processor with embedded tissue being less dry or brittle whereas only 3 of the conventionally processed tissues were noted of better cutting quality. Pathologists detected no difference between the 2 types of processed specimens in any H+E stain, 10 special stains and 30 immunostains. None were of inferior technical quality for diagnosis.
Conclusions: This study validates the technical, H+E and immunohistochemical stain quality obtained with a new rapid-cycle microwave processor over a range of tissue types and processed thicknesses. The abbreviated cycle time including fixation (1.25-3 hours) facilitates the Lean approach to continuous flow processing with continuous slide production. Used in this fashion, the instrument facilitates potentially shorter report turnaround times compared to conventional overnight processing.
Monday, March 19, 2012 1:00 PM
Poster Session II # 300, Monday Afternoon