[Histonet] Ventana Benchmark closed systems vs Open system st ainers - a diatribe

Tue May 30 11:33:40 CDT 2006

Wow Brian, Spring must have hit the Great White North! The sap is starting
to run!

Brian wrote (among other things):

"As technologists we all want to see the perfect machine that allows us to
load individual slides whenever we want, process them completely, error free
and automatically right down to the coverslip, and do it for next to
nothing. "

Brian, you forgot the imaging system! The "Automated IHC System" also has to
deliver the coverslipped slide to an imaging system that scans the entire
tissue section to produce a Virtual Slide. (preferably at 40X and 10 focus
levels, and then saves it (all 800 GB) to a server so anyone, anywhere
(India?) can do the pathology consult (don't laugh, this is now happening in
radiology)).

We've actually heard this from customers. Lets, just say, yes, technically
it can be done. But, few, if any,  labs would have the half-million (US), or
more,  to buy the instrument. And you say you want it on reagent rental?
You'd have to do thousands of slides a day to qualify. Maybe all the labs
will eventually be consolidated into a few big labs and it will be possible.
Not any time soon, though.

Brian also wrote:
"What I hope will happen, is that two or more companies will embrace the
ongoing revenue stream model currently used by Ventana, and then we should
see a rapid evolution towards truly automated IHC stainers. Competition is
always brings out the best in industry. Look at how clinical chemistry
analyzers now are able to process serum samples, with little need for the
technologist to fuss with the process.  That should be the goal of the IHC
stainer manufacturer. "

The dream of a totally automated IHC system for fixed tissue sections is not
at all as simple as a chemistry or blood analysing system. In the clinical
lab they are dealing with FRESH blood or fluid samples,  all taken in
standardized ways.  The samples are nearly identical in every case.  So a
company is much more likely to be able to create  instruments and reagents
that work well over a broad range of labs. 

The big wrench in the IHC system is that no two labs have the same tissue
procurement, fixation and processing system. Dr. Clive Taylor, the guru of
standardization, has almost given up his crusade in convincing all labs to
follow standardized procedures. For all their talk of wanting "the best" for
their patients, no two pathologists can agree on what is "the best."  Even
the advent of "antigen retrieval" which was to overcome the
fixation/processing variation problem, has itself become a complicated
variable (with a slew of attendant instruments).

So, considering infinite variation in tissue fixation and processing, AR and
staining, it is nearly impossible to simply give a batch of reagents and an
instrument to any given lab and have them all work perfectly from day one.
In fact, every single antibody and instrument company in the business
employs a cadre of Quality Control technologists who labor to be sure the
antibodies sold are optimized and indeed "working,"  and they also employ a
legion of "technical reps" who bravely go into unfamiliar labs and atttempt
to "optimize" all the reagents, antibodies and protocols so that the system
"works" in that lab. Believe me, there are very few labs that can do this
successfully without some help. 

Besides that, do histotechs really want to be like Med Techs who just sit
around looking at printouts all day long? Maybe not. We just like fiddling
with things.

Tim Morken
Lab Vision - Neomarkers
www.labvision.com

Free webhosting for US State Histotechnology Societies:
http://www.labvisioncorp.com/demowebsite/index.cfm

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Brian
Chelack
Sent: Sunday, May 28, 2006 1:55 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Ventana Benchmark closed systems vs Open system stainers
- a diatribe

Etc.

Brian Chelack
Prairie Diagnostic Services
2604-52 Campus Drive
Saskatoon SK
S7N 5B4
306-966-7241

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