TISSUE SCIENCES Slide preparation


For molecular diagnostics tests a number of additional sections are prepared. Those tissue slides remain unstained. An H&E stained slide is included for reference and identification of the region of interest.


Slide digitisation


Both the H&E-stained and the unstained slides are scanned and the digital images are stored.


Region of interest (ROI) marking


All images are made available case by case to the pathologist in a convenient user interface for ROI selection and marking, supported by intuitive annotation tools.


algorithms to automatically map the marked ROI images to the dissection images. They can then be dissected with a high degree of precision using a robotic arm and dissection knife. The coordinates of the transferred annotations are used to guide the robotic dissection device so that it removes the material from the region of interest with high precision. The same device can subsequently collect and transfer the material to the sample tube. The system automatically disposes of the scraping head further minimising the risk of cross-contamination. No liquids are used in the entire process to make it fully compatible with all molecular sample preparation protocols.


Full traceability and quality control are Slide overlay The marked ROIs are automatically transferred from the H&E to each


dissection slide image using state of the art image registration technology. The result can be reviewed and corrected or rejected by the pathologist if required.


Digital guided tissue dissection The dissection instrument scrapes the tissue fully automatically from the


dissection slides in the defined ROIs using a disposable scraping head with high precision. The dissected tissue is collected from all slides of a particular case and then automatically transferred into the sample vial.


provided, including the ability to take and analyse images after dissection. Pathologists will be given an early look at the new platform in November at the Annual Molecular Pathology meeting with the global launch across all territories starting in March 2023. Mr du Pree pointed out that other automated tissue dissection solutions, like laser capture micro-dissection (LCM), do provide high precision for research purposes, but were not feasible for routine diagnostic workflows. The LCM systems require highly skilled operators, are time consuming and cannot be fully integrated.


Quality control


After dissection, images arre taken of the dissection slides and analysed. The dissected areas are calculated and compared to the marked ROI.


Sample ready for molecular analysis Fig 1. Workflow for automated histopathology.


Digitising dissection slides For hospital-based histopathology, the digitisation of whole-slide imaging is already transforming workflow with artificial intelligence (AI)-based algorithms becoming available for assessing tissue morphologies, classifying cancer subtypes and segmenting the tumour area. “Xyall technology takes this one step


further, by digitising the sample selection process and designing it to integrate into routine clinical practice,” said Mr du Pree. “Our unique technology addresses existing limitations, delivering a fully automated tissue dissection process,


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while matching the resolution needs of routine clinical practice,” as shown in Figure 1.


While the overall digital pathology solution of the laboratory is responsible for scanning the stained haematoxylin and eosin (H&E) slides, the new Xyall instrument makes it possible to digitise the unstained dissection slides. Further, using Xyall’s dedicated software package (VAR), pathologists can also view the H&E images at the right magnification for convenient and accurate ROI selection. The Tissector TT exploits the recent availability of image registration


Accuracy and reproducibility “A platform designed for routine clinical practice does not need the high spatial resolution of LCM (1 μm). Xyall’s solution, the Tissector TT, offers an accuracy of <100 µm and far greater reproducibility than manual dissection, particularly for very small specimens and samples with minute, subpopulations of tumour cells,” Mr du Pree explained. “Additionally, our automated device will be able to run continuously, delivering a more consistent and higher throughput than manual tissue dissection.” Mr du Pree referred to recent global


research commissioned by Xyall that pinpointed how accuracy and cross- contamination were two of the biggest concerns of molecular diagnostic laboratories worldwide.


“Clinicians and laboratory scientists


recognise the vulnerabilities of manual detection and need faster and more accurate tissue dissection so that precision medicine could become a reality.”


The Xyall findings also warned that workloads for handling breast, lung and colon cancers were set to increase exponentially over the next three years. Current practices of manual dissection of tissue were seen as a hindrance to


SEPTEMBER 2022 WWW.PATHOLOGYINPRACTICE.COM


Amended from Xyall BV


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