Mounting agents with low toxicity and with fast curing time for digital pathology in the intraoperative frozen section laboratory

Aims In intraoperative frozen tissue section laboratories
(FS laboratories) conventional practice for mounting
coverslips on tissue slides involves the use of xylene-based
mounting agents, such as Pertex. However, toxic
vapours pose a risk to biomedical laboratory scientists
(BLS) and pathologists who handle the wet slides to
provide fast and urgent diagnostic results to surgeons
during operations. Our study aims to evaluate non-toxic
mounting agents to substitute Pertex, preferably with
a fast curing time suitable for the demands of the new
digital era in pathology.
Methods Five non-toxic
mounting agents were
purchased and tested through six different protocols
and compared to xylene-based
Pertex as our gold
standard. With light microscopy, tissue slides were
quality assessed by BLS. Mounting agents, which were
evaluated comparable to Pertex, were also evaluated by
a pathologist, hence scanned digitally and re-evaluated.
Results The protocols for Eukitt UV, Eukitt UV R-1
and
Eukitt UV R-2
had significantly more artefacts (bubbles)
compared to gold standard Pertex (p<0.0001, p=0.004
and p<0.0001, respectively) and assessed inadequate
as replacements. Neo-Mount
and Tissue Mount were
assessed applicable regarding quality, but curing times
were long. Tek Select UV showed promising results in
both quality and fast curing time (protocol was <2 min).
Conclusions Toxic mounting agents need replacement
to health guard professionals, and also digital pathology
is revolutionising laboratories. A digitalized FS laboratory
requires fast dry/cured slides for digital scanning.
Therefore, a substitute for the FS laboratory should have
the qualities of being non-toxic
to handle and having a
fast curing time, and a UV-based
mounting agent may
solve both requirements.