Like every other aspect of medicine, technology is reshaping the field of pathology, nowhere more dramatically than in the emerging subspecialty of molecular pathology.
Once considered an ancillary service, molecular pathology is fast becoming an essential component of comprehensive diagnostics for cancer and other conditions with genetic origins.
As a leader in molecular pathology, MLabs is making the significant investments in technology, ensuring that we have the right tool for every application:
Sanger sequencing – The original genetic sequencing platform, it is still used to identify genes linked to a variety of conditions from hearing loss to autism to several cancer types.
FISH – Fluorescence in situ hybridization can visualize the single-gene mutations that drive conditions like cystic fibrosis and some cancers.
Chromosomal microarray testing identifies variations (gains/losses) in the genome linked to several inherited physical and intellectual disabilities.
PCR – Polymerase chain reaction technology is employed to amplify DNA or RNA from samples containing only minute quantities of genetic material.
NGS – The need to perform multiple assays for one patient, and the time and expense of performing complex, labor-intensive tests individually, are fueling the emergence of next-generation sequencing (NGS) modalities. NGS makes it possible identify multiple DNA and RNA mutations with one test, while preserving the integrity of a specimen.
While some labs offer only one NGS platform, MLabs has invested in two:
- Ion Torrent - the preferred platform for solid-tumor testing such as the 50-gene Oncomine panel
- Illumina – a superior platform for analyzing the high-quality DNA available in blood samples
These tools, supported by powerful computer clusters, proprietary software and highly trained molecular pathologists and technicians, allow us to conduct molecular testing on numerous patient specimens simultaneously, sequencing thousands of genes at once while maintaining analyzing each patient’s results separately.
Technology to improve quality
Most specimens are small biopsies or aspirates. Our goal is to achieve maximum results from these tiny samples, while minimizing failures due to insufficient specimens – the Quantity Not Sufficient or QNS rate.
Advances in our procedures have resulted in a QNS rate of less than 4% -- lower than most competitors. Read more here.
Technology to better handle and track specimens
MLabs’ microbiology laboratory automated specimen handling in 2018, installing a BD Kiestra system. Other MLabs’ components are in the process of automating specimen handling.
Labs will soon launch PathTrack, a proprietary web-based informatics application to track specimens in real time.
In one of the largest relocation and renovation projects ever undertaken at the University of Michigan, the components of Michigan Medicine’s Department of Pathology, once dispersed across the vast medical campus, were united in one location in 2018.
The initial incentive for the move was to accommodate growth – Michigan Medicine has seen demand for laboratory tests increase nearly eight percent per year since 2013. But the ultimate success of the three-year project was the result of listening to users and customers – reflecting a value-based, rather than a volume-based focus.
The majority of Michigan Medicine’s pathology enterprise – including MLabs, now occupies 146,000 square feet in five contiguous buildings of the North Campus Research Complex, located about 4.5 miles from the main hospital campus.
The space, configured with lean facility design principles, is now home to 150+ faculty members and 700+ laboratory technicians and staff, supporting:
- Molecular pathology – including medical genetics, cytogenetics, histocompatibility, molecular dermatopathology and translational pathology
- Anatomic pathology
- Special chemistry
- Consult accessioning
- Administrative services
How our facilities benefit our customers:
Faster turnaround – an improved workflow results in less congestion and fewer delays. The flexible space plan incorporates redundancy to handle equipment maintenance and upgrades with minimal down time.
Improved quality – attention to detail such as discrete spaces for pre- and post-PCR in the molecular lab protects the viability of samples and test results and avoids cross-contamination.
More collaborative insights – the space encourages both formal and informal communication, making it easier for experts to come together to discuss findings.
Greater efficiencies – changes such as on-site histology in the molecular lab make it possible to request the number and size of sections for every requested test at one time. Performing all sectioning at once reduces the risk of exhausting often miniscule specimens.