High-definition hematoxylin and eosin staining in a transition to digital pathology

Abstract

Introduction: A lot of attention has been generated in recent years by digital pathology and telepathology. Multiple reasons for and barriers to effective adoption are discussed in the current literature. Digital slides are the most promising medium at this time. The goal of our study was to evaluate whether the change in the methodology, particularly utilizing the so-called high-definition hematoxylin and eosin (H and E) slides, enhanced the quality of the final digital slide, and whether pathologists who tested the results perceived this as a difference in quality.

Methods: THE STUDY WAS A BLINDED COMPARISON OF DIGITAL SLIDES PREPARED USING TWO METHODS: standard H&E batch staining and automated individual "high definition" HD HE staining. Four pathologists have compared 80 cases stained with each method.

Results: The results discussed in this study show potential promise that the utilization of protocol(s) adapted for tissue and for imaging might be preferable for digital pathology in at least some of the pathology subspecialties. In particular, the protocol evaluated here was capable of turning out digital slides that had more contrast and detail, and therefore were perceived to provide enhanced diagnostically significant information for the pathologist.

Keywords: Digital pathology; digital slides; histochemistry; histology; imaging; staining methods; staining protocols; telepathology.

Figure 1

Prostate biopsy stained with the linear-batch method on the left and the HDHE method on the right. One can observe differences especially in the collagen area (screenshot of the Trestle MedMicro interface, approximate magnification 20×)

Figure 2

Contrast the biopsy stained with the linear-batch method on the left and the HDHE method on the right. Eosinophils are more readily distinguished with the HDHE method (screenshot of the Trestle MedMicro interface, approximate magnification 20×)

Figure 3

Lung tissue stained with the linear method (left) compared with the HDHE method (right) - (screenshot of the Trestle MedMicro interface, approximate magnification 20×)

Figure 4

Skin tissue (compound melanocytic nevus) stained with the linear method on the left vs. the HDHE method on the right. In this figure, as well as previous ones, the small differences in the tissue outline arise from the fact that these are two adjacent (or nearly adjacent) tissue levels and are thus not identical (screenshot of the Trestle MedMicro interface, approximate magnification 20×)