Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

Molecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the opt...

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Main Authors: Rajiv Kumar Kaushal, Santosh Menon, Omshree Shetty, Tanuja Shet, Sangeeta Desai, Anurag Mehta, Anuradha Choughule, Bivas Biswas, Divya Midha, Gurudutt Gupta, Jaya Ghosh, Jay Mehta, Kumar Prabhash, Sayed Mahmood Nadeem, S P. Somashekhar, Ujwala Joshi, Veena Ramaswamy, Veeraiah Koppula, Sudeep Gupta
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd.
Series:Indian Journal of Medical and Paediatric Oncology
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1774752
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author Rajiv Kumar Kaushal
Santosh Menon
Omshree Shetty
Tanuja Shet
Sangeeta Desai
Anurag Mehta
Anuradha Choughule
Bivas Biswas
Divya Midha
Gurudutt Gupta
Jaya Ghosh
Jay Mehta
Kumar Prabhash
Sayed Mahmood Nadeem
S P. Somashekhar
Ujwala Joshi
Veena Ramaswamy
Veeraiah Koppula
Sudeep Gupta
author_facet Rajiv Kumar Kaushal
Santosh Menon
Omshree Shetty
Tanuja Shet
Sangeeta Desai
Anurag Mehta
Anuradha Choughule
Bivas Biswas
Divya Midha
Gurudutt Gupta
Jaya Ghosh
Jay Mehta
Kumar Prabhash
Sayed Mahmood Nadeem
S P. Somashekhar
Ujwala Joshi
Veena Ramaswamy
Veeraiah Koppula
Sudeep Gupta
author_sort Rajiv Kumar Kaushal
collection DOAJ
description Molecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the optimization of tissue handling and processing practices in India in the era of precision medicine. This study aimed to evaluate the clinical gaps related to tissue handling for molecular analysis and develop expert recommendations to mitigate preanalytical issues associated with biospecimen processing. These expert recommendations will help in increasing the diagnostic yield and accuracy of biomarker testing in clinical practice. A virtual advisory board meeting was convened with 19 experts, including pathologists, molecular biologists, medical oncologists, surgical oncologists, interventional radiologists, and a senior histology technician from 10 hospitals in India, along with an accreditation officer for testing and calibration of laboratory procedures. The scientific coordinators developed specific questions to address the salient issues associated with the preanalytic phase of tissue specimen preparation. The experts discussed each question until a complete set of recommendations was obtained. The expert panel provided recommendations for tissue collection, processing, fixation, and block preparation to ensure high-quality biospecimens. As per the expert panel recommendations, tissue sampling can be performed from any easily accessible site, regardless of the primary or metastatic locations. In addition, the cold ischemia time should be <1 hour, 10% neutral-buffered formalin should be used as the fixative, isopropyl alcohol should be used as the dehydrating agent, the volume of tissue to fixative ratio should be 1:10, and all the paraffin blocks should be archived in dry, pest-free conditions at room temperature. The experts suggested that the formalin used for fixation should be freshly prepared and its pH should be checked daily; moreover, the pH and date of formalin preparation should be mentioned on the containers. The experts highlighted the need to educate multidisciplinary teams on the optimization of tissue handling practices and emphasized that a pathologist should always check the tissue for adequate quality and quantity for biomarker testing. The existing routine clinical procedures for collecting and handling biospecimens adversely affect their quality. The expert recommendations for preanalytical quality control would ensure high-quality biospecimens for molecular analysis and precision medicine.
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series Indian Journal of Medical and Paediatric Oncology
spelling doaj-art-5364bf542ff3434f929f1d4e0c6068652025-08-20T02:32:44ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58510975-212910.1055/s-0043-1774752Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian ExpertsRajiv Kumar Kaushal0Santosh Menon1Omshree Shetty2Tanuja Shet3Sangeeta Desai4https://orcid.org/0000-0002-3588-9888Anurag Mehta5Anuradha Choughule6Bivas Biswas7https://orcid.org/0000-0002-6101-5500Divya Midha8Gurudutt Gupta9Jaya Ghosh10Jay Mehta11Kumar Prabhash12Sayed Mahmood Nadeem13S P. Somashekhar14Ujwala Joshi15Veena Ramaswamy16Veeraiah Koppula17Sudeep Gupta18Department of Pathology, Tata Memorial Hospital (TMC), Mumbai, Maharashtra, IndiaDepartment of Pathology, Tata Memorial Hospital (TMC), Mumbai, Maharashtra, IndiaHomi Bhabha National Institute (HBNI), Mumbai, Maharashtra, IndiaDepartment of Pathology, Tata Memorial Hospital (TMC), Mumbai, Maharashtra, IndiaDepartment of Pathology, Tata Memorial Hospital (TMC), Mumbai, Maharashtra, IndiaDepartment of Laboratory Services, Molecular Diagnostics and Transfusion Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaHomi Bhabha National Institute (HBNI), Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Tata Memorial Hospital (TMC), Kolkata, West Bengal, IndiaDepartment of Pathology, Tata Medical Center, Kolkata, West Bengal, IndiaDepartment of Histopathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, IndiaHomi Bhabha National Institute (HBNI), Mumbai, Maharashtra, IndiaDepartment of Oncopathology, Neuberg Oncopath, Mumbai, Maharashtra, IndiaHomi Bhabha National Institute (HBNI), Mumbai, Maharashtra, IndiaDepartment of Pathology, Nilam and NG Medicare, Kolkata, West Bengal, IndiaDepartment of Surgical Oncology, Aster DM Healthcare - GCC, Bengaluru, Karnataka, IndiaDepartment of Pathology, Tata Memorial Hospital (TMC), Mumbai, Maharashtra, IndiaDepartment of Histopathology, Triesta Reference Lab, A Unit of HCG Hospital, Bengaluru, Karnataka, IndiaDepartment of Radiology, Basavatarakam Indo-American Cancer Institute and Research Center, Hyderabad, Telangana, IndiaHomi Bhabha National Institute (HBNI), Mumbai, Maharashtra, IndiaMolecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the optimization of tissue handling and processing practices in India in the era of precision medicine. This study aimed to evaluate the clinical gaps related to tissue handling for molecular analysis and develop expert recommendations to mitigate preanalytical issues associated with biospecimen processing. These expert recommendations will help in increasing the diagnostic yield and accuracy of biomarker testing in clinical practice. A virtual advisory board meeting was convened with 19 experts, including pathologists, molecular biologists, medical oncologists, surgical oncologists, interventional radiologists, and a senior histology technician from 10 hospitals in India, along with an accreditation officer for testing and calibration of laboratory procedures. The scientific coordinators developed specific questions to address the salient issues associated with the preanalytic phase of tissue specimen preparation. The experts discussed each question until a complete set of recommendations was obtained. The expert panel provided recommendations for tissue collection, processing, fixation, and block preparation to ensure high-quality biospecimens. As per the expert panel recommendations, tissue sampling can be performed from any easily accessible site, regardless of the primary or metastatic locations. In addition, the cold ischemia time should be <1 hour, 10% neutral-buffered formalin should be used as the fixative, isopropyl alcohol should be used as the dehydrating agent, the volume of tissue to fixative ratio should be 1:10, and all the paraffin blocks should be archived in dry, pest-free conditions at room temperature. The experts suggested that the formalin used for fixation should be freshly prepared and its pH should be checked daily; moreover, the pH and date of formalin preparation should be mentioned on the containers. The experts highlighted the need to educate multidisciplinary teams on the optimization of tissue handling practices and emphasized that a pathologist should always check the tissue for adequate quality and quantity for biomarker testing. The existing routine clinical procedures for collecting and handling biospecimens adversely affect their quality. The expert recommendations for preanalytical quality control would ensure high-quality biospecimens for molecular analysis and precision medicine.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1774752biospecimenscold ischemia timefixationtissue processingparaffin blocks
spellingShingle Rajiv Kumar Kaushal
Santosh Menon
Omshree Shetty
Tanuja Shet
Sangeeta Desai
Anurag Mehta
Anuradha Choughule
Bivas Biswas
Divya Midha
Gurudutt Gupta
Jaya Ghosh
Jay Mehta
Kumar Prabhash
Sayed Mahmood Nadeem
S P. Somashekhar
Ujwala Joshi
Veena Ramaswamy
Veeraiah Koppula
Sudeep Gupta
Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
Indian Journal of Medical and Paediatric Oncology
biospecimens
cold ischemia time
fixation
tissue processing
paraffin blocks
title Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
title_full Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
title_fullStr Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
title_full_unstemmed Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
title_short Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts
title_sort optimization of tissue handling and processing in the era of precision medicine a practical recommendation from a multidisciplinary panel of indian experts
topic biospecimens
cold ischemia time
fixation
tissue processing
paraffin blocks
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1774752
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