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Untethering From the FISH Microscope in Cytogenetics


Over the last decade, the Cytogenetics community has seen ever increasing numbers of laboratories adopt a fully digital workflow for metaphase finding and karyotype creation. The benefits of this automation has been seen with improved turnaround times, decreasing test costs and improved quality of service. The same cannot be said, however for the other side of the lab. FISH analysis has remained a stronghold with their reliance on conventional microscopy, often keeping those technologists literally in the dark as they perform their tests. Today, however with the advancements being made in digital imaging, Leica Biosystems is paving their way out of the dark and into the light with on-screen, digital FISH workflows.

Making History of FISH Microscopy

Over the last decade, the Cytogenetics community has seen ever increasing numbers of laboratories adopt a fully digital workflow for metaphase finding and karyotype creation thanks to the workflows provided by such automated systems as the Leica GSL 120 scanning system by Leica Biosystems. The benefits have been seen and felt through shorter turnaround times1, improved quality of service and lowered test costs2.

On the other side of the lab, however, FISH technologists have not seen the same benefits. In that dark room with the boarded-up windows, one will still find many FISH technologists sitting hunched over their old, conventional microscopes reading fluorescent slides the same way it was done 20 years ago.

All that has been true until today. With recent innovations from Leica Biosystems, FISH technologists now have the necessary on-screen tools and image capture algorithms to leave their microscopes behind in the dark and move into the light with a fully digital FISH workflow with CytoVision 7.6

Overcoming Critical Hurdles in FISH Imaging

As in the case of conventional metaphase analysis, the most critical requirement for FISH imaging is the quality of the image provided to the technologist. Historical software on the market could not achieve the same level of detail that was provided down the microscope, and had difficulty managing proper image capture in the presence of unwanted background fluorescence.

Leica Biosystems has once again innovated to develop a new algorithm which allows for optimal image capture in the presence of bright background fluorescence without intervention by the end user. Coupled with a new raw image cell view, the end user can view individual fluorochrome channels with the same detail as that which is seen down the microscope. With these two features, along with new built-in digital workflows that mirror manual microscopy, technologists can finally leave their fluorescent microscopes behind and adopt an on-screen digital workflow for FISH.

Benefits of the Digital Analysis Workflow

Beyond the benefits we know today that comes with automating and digitizing conventional Cytogenetics, automation for FISH will drive additional end user benefits unique to the FISH technologist. The first benefit comes through an improvement in the integrity of the results. With on-screen FISH review, all data is captured and stored with the case, allowing for simple review of each cell by a senior technologist or director for improved traceability, monitoring and auditing of work. Additional improvements come in the form of lower training overhead, consistency in signal counting, ergonomic improvements and improved job satisfaction.

At Leica Biosystems, we acknowledge that this is a passion beyond a job. We will continue to strive for further advancements in our technology to support the needs of our CytoVision customers, providing them with the latest tools and technologies that supports their great work in the field of clinical Cytogenetics.

1Higgins, C., et. al,. Efficacy of an Automated Metaphase Scanner in the Clinical Cytogenetics Laboratory – ASHG (2009)

2 Zanatta, L. Automating the Cytogenetics Process https://thepathologist.com/fileadmin/issues/App_Notes/Leica3._Automating_the_cytogenetics_process.pdf (2016)

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