LUMEA BxChip Case Study - Hereford County Hospital

Taking biopsies plays a crucial role in understanding tumour characteristics and determining optimal treatment methods, all while prioritising patient comfort and minimising the need for invasive surgeries. Within the histology laboratory, the handling of these fragile samples necessitates special care to preserve their structure and integrity. Given that most patients undergo multiple biopsies simultaneously, the laboratory faces a substantial workload, requiring significant amounts of consumables and incurring expensive labour costs.

In order to support laboratories in their pursuit of enhanced efficiency and diagnostic accuracy, CellPath Ltd supplies the LUMEA BxChip. With the BxChip cores can be processed safely within the sectionable matrix, greatly reducing the manual handling required. This technique allows multiple cores (up to 12) to be processed simultaneously whilst reducing the risk of fragmentation. The BxChip allows laboratories to save time by eliminating several tissue transfer steps and save money by dramatically reducing the number of consumables required.

We spoke to Andrea Johnson, Cellular Pathology Manager, at Hereford County Hospital about her experience using the BxChip.

Wye Valley NHS Trust is the provider of healthcare services at Hereford County Hospital, which is based in the city of Hereford, along with a number of community services for Herefordshire and its borders. They also provide healthcare services at community hospitals in the market towns of Ross-on-Wye, Leominster and Bromyard.

With an annual turnover of around £295 million, serving a population of 186,000, the Trust is one of the smallest rural District General Hospitals in England. They work hard to deliver a standard of care we would want for ourselves, our families and friends.

 

Why did you decide to start using the BxChip?

“We had a lot prostate template biopsies coming through and they take up so much time at every stage of the process, whether that’s in cut up, embedding, or microtomy. We had a procedure in place where we only put two cores per cassette to ensure that the quality was high, and because of this we ended up with so many blocks per case. Because there were so many blocks it took considerably longer at each stage so we thought with the BxChip that we could get more cores in and it would be quicker at dissection, quicker at embedding and quicker at microtomy and saves us a lot of time.”

How easy was it to introduce the BxChip into your process?

“It was quite easy, we were fortunate that CellPath came and actually met with the specialist nurses in urology. We explained what the chips were and that we wanted to give them a try. CellPath showed them how to use the chips and how to put the biopsies in the chip when they were doing the actual procedure with the patient. We were then provided with some BxChips to test using some tissue that would have been for chuck out and we made tiny cores. We then put them into the chips and ran them through tissue processing, embedding and microtomy. Once they had been stained, we looked at them through the microscope to see how well the chips performed through the process. As far as staining, immunostaining, and digital go, they cut and stain perfectly. The immunostaining is fine and we have no problem with scanning them. So it was all very easy, we did a trial, we liked them and found we could use them in the lab. We tweaked some practices with them in our processes, met with the urology team, started to use them with patients, and have used them ever since.”

Have you noticed any savings since using the BxChip?

“Time savings, definitely, there is a lot of time saving in the dissection room because you haven’t got to pull multiple cores out and have multiple cassettes printed. It saves the MLA time in the cut-up room and saves time for the BMS. It’s also a great time saver at the embedding stage as you are just pushing one chip down as opposed to fiddling about making sure that the cores are level and neatly in a row, and not crossing over in the mould or that they don’t move when you add in more wax. It’s great for the microtomy stage too because you’ve got more cores per chip so you haven’t got to cut as many blocks.”

Using the BxChip, more tissue can be seen under the microscope.

Have you noticed any improvement in the amount of fragmentation since using the BxChip?

“Yes, when the pots come up there are less pieces floating in the pot and they are just a lot easier to deal with in general as the cores are already placed inside the chip. Previously when they weren’t inside the chip they could get stuck together, and if you tried to get them apart then they would break up and you’d end up with more pieces, or they’d already broken apart and stick together in the pot. They are protected in the chip when they come to us and prevents that issue and saves us a lot of time.”

Would you recommend the BxChip to others?

Yes, we would certainly recommend them. Mainly for the time-saving aspect because of the volume of urology work that we do. Trying to do that now the old way would just be so much work, from one case we’ve reduced the block numbers from 24 to 6 blocks. They save time, work well, and have been very easy to introduce into our processes. We prefer processing prostate biopsies in the BxChip now.