A mainstay of pathology – the trusty H&E stain – may have found a new digital companion through infrared light. “I was collaborating with cancer scientists in a spectroscopic imaging program and, over a period of four or so years, I learned that H&E staining was, for all intents and purposes, the only method they had for diagnosing cancer,” says Chris Philips, Head of the Optoelectronics Section at Imperial College London. “I also learned that it was very unreliable, which generated a huge unmet need in pathology. After a while, I realized that we could adapt our spectroscopic techniques to solve this.” The realization prompted Philips to lead a research team to investigate an H&E alternative that could offer histopathologists an objective way to measure biopsy sections. Their creation: Digistain (1).
Digistain technology uses mid-infrared light to highlight the concentration of nucleic acids in sectioned FFPE biopsies, before calculating a score based on nuclear-to-cytoplasmic ratio (NCR). According to its creators, Digistain is able to grant an objective, quantitative measurement that removes the “chance” from biopsy grading; their paper states that practitioners agree only 70 percent of the time on the results of gradings carried out by eye. Philips adds, “The Digistain test can be performed in parallel with the standard H&E stain and is quicker overall, so it adds no delay.” The downside to the technology is – of course – the extra cost, but the researchers believe balance will be provided by savings made in unnecessary treatment plans based on inaccurate grading. Philips also offers comfort to pathologists fearful of being supplanted by a machine: “We would never propose to replace pathologists. We recognize the critical importance of having a tried and tested protocol when approaching a medical problem as serious as cancer,” he says. “We propose only that this method is used to augment and inform the biopsy grading process, and to put it on a quantitative footing. In time, we hope that the pathology profession themselves will find ways of using it that will result in the ability to make much more secure grading decisions.”
The investigators are currently testing the technology in breast cancer biopsies, but because Digistain works with biomarkers, they say that it could one day be applicable across a range of cancers.
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References
- H Amrania et al., “Mid-infrared imaging in breast cancer tissue: an objective measure of grading breast cancer biopsies”, Converg Sci Phys Oncol, 4 (2018).
