Kidney Week

Abstract: TH-OR45

Evaluation of a Direct-to-Digital Histology Method for Rapid Evaluation of Kidney Biopsies

Session Information

• Pathology of Kidney Diseases: Novel Mechanisms and Clinical Correlations
  October 22, 2020 | Location: Simulive
  Abstract Time: 05:00 PM - 07:00 PM

Category: Pathology and Lab Medicine

• 1602 Pathology and Lab Medicine: Clinical

Authors

• Perincheri, Sudhir, Yale University School of Medicine, New Haven, Connecticut, United States

Sudhir Perincheri, MBBS, PhD



I am a board-certified Anatomic Pathologist specializing renal pathology, hematopathology and genitourinary pathology in the Department of Pathology, Yale School of Medicine. After completing medical school in India, I came to the US where I obtained at PhD in molecular biology at the University of Kentucky. Following post doctoral stints at Columbia and Yale Universities, I trained in anatomic pathology and clinical pathology at Yale followed by subspecialty training in hematopathology and renal/GU pathology also at Yale. After completing training, I joined the faculty in the department of Pathology at Yale School of Medicine. My areas of research interest include renal pathology, transplant pathology and digital pathology.

• Luciano, Randy L., Yale University School of Medicine, New Haven, Connecticut, United States

Randy L. Luciano,

• Moeckel, Gilbert W., Yale University School of Medicine, New Haven, Connecticut, United States

Gilbert W. Moeckel,

• Torres, Richard, Yale University School of Medicine, New Haven, Connecticut, United States

Richard Torres,

Background

Digitization of clinical renal biopsy histology is motivated by the importance of early intervention in acute kidney conditions, assessment by remotely-based experienced nephropathologists, and application of emerging computerized quantitative evaluation tools. Despite the interest, image quality and workflow impact are concerns for digital renal pathology. A newly developed tool for rapid, slide-free microscopic image preparation called Clearing Histology with MultiPhoton Microscopy (CHiMP) has demonstrated high efficiency and high quality morphology for diagnostic review in renal disease in a research environment. We sought to commence clinical validation of CHiMP for renal biopsies, including assessing effects on downstream traditional special stains and ability to detect a broad range of clinically relevant pathologic lesions in renal biopsies.

Methods

Kidney core biopsies were procured from 50 consented individuals undergoing renal biopsy for any reason and CHiMP processing was integrated into the routine clinical workflow, using previously-described methods. Images were obtained through entire core biopsies with a prototype fast, high resolution, multiphoton microscope system (Applikate Technologies, Washington, DC) and visualized with web-based software. Samples were subsequently processed using standard methods for clinical interpretation under transmitted-light microscopy, including special stains. A subset of 20 core biopsies underwent detailed morphologic feature detection analysis and quantitative lesion comparison.

Results

Diagnostic quality remotely-reviewable renal images of 10-16 digital slices were available within < 3 hours of receipt. H&E detected morphologic findings were equally detectable in digital images compared to physical, paraffin-embedded sections including cases showing tubular injury, proliferative glomerulonephritis, glomerular deposition disease, and interstitial nephritis. No significant negative effects on downstream processing were identified.

Conclusion

CHiMP can be used in rapid morphologic evaluation of kidney biopsies integrated into clinical work enabling rapid rendering of preliminary diagnoses while simultaneously making digital images available for remote expert evaluation and digital analysis.Continuing validation will test ability to augment detection of rare lesions and quantitative precision.

Funding

• NIDDK Support