The preservation of certain labile cancer biomarkers with formaldehyde-based fixatives can be considerably affected by preanalytical factors such as quality of fixation. Currently, there are no technologies capable of quantifying a fixative’s concentration or the formation of cross-links in tissue specimens. This work examined the ability to detect formalin diffusion into a histological specimen in real time. As formaldehyde passively diffused into tissue, an ultrasound time-of-flight (TOF) shift of several nanoseconds was generated due to the distinct sound velocities of formalin and exchangeable fluid within the tissue. This signal was resolved with a developed digital acoustic interferometry algorithm, which compared the phase differential between signals and computed the absolute TOF with subnanosecond precision. The TOF was measured repeatedly across the tissue sample for several hours until diffusive equilibrium was realized. The change in TOF from 6-mm thick ex vivo human tonsil fit a single-exponential decay (Radj2≥0.98) with rate constants that varied drastically spatially between 2 and 10 h (σ=2.9 h) due to substantial heterogeneity. This technology may prove essential to personalized cancer diagnostics by documenting and tracking biospecimen preanalytical fixation, guaranteeing their suitability for diagnostic assays, and speeding the workflow in clinical histopathology laboratories.
Optical imaging techniques are being developed that promise to increase the information content related to specific
molecular reporters. Such modalities do not produce contrast in the structural context of the surrounding tissue, making
it difficult to reconcile molecular information with morphological context. We report a solution that enables
visualization of the tissue morphology on formalin-fixed, paraffin embedded sections prepared for analytical biomarker
imaging. Our approach combines modes of transmitted darkfield and fluorescence contrast and computer visualization to
produce 2-component image data analogous to the classical hematoxylin and eosin histological stain. An interferometric
hyperspectral image capture mode enables measurement of multiplexed biomarkers in annotated anatomic regions. The
system enables practical correlative analysis of molecular changes within areas of anatomic pathology.
Recently, it has been demonstrated that the preservation of cancer biomarkers, such as phosphorylated protein epitopes, in formalin-fixed paraffin-embedded tissue is highly dependent on the localized concentration of the crosslinking agent. This study details a real-time diffusion monitoring system based on the acoustic time-of-flight (TOF) between pairs of 4 MHz focused transducers. Diffusion affects TOF because of the distinct acoustic velocities of formalin and interstitial fluid. Tissue is placed between the transducers and vertically translated to obtain TOF values at multiple locations with a spatial resolution of approximately 1 mm. Imaging is repeated for several hours until osmotic equilibrium is reached. A post-processing technique, analogous to digital acoustic interferometry, enables detection of subnanosecond TOF differences. Reference subtraction is used to compensate for environmental effects. Diffusion measurements with TOF monitoring ex vivo human tonsil tissue are well-correlated with a single exponential curve (R2>0.98) with a magnitude of up to 50 ns, depending on the tissue size (2-6 mm). The average exponential decay constant of 2 and 6 mm diameter samples are 20 and 315 minutes, respectively, although times varied significantly throughout the tissue (σmax=174 min). This technique can precisely monitor diffusion progression and could be used to mitigate effects from tissue heterogeneity and intersample variability, enabling improved preservation of cancer biomarkers distinctly sensitive to degradation during preanalytical tissue processing.
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