Clinical Validation of LVEM for Kidney and Heart Biopsy Samples

Transmission electron microscopy (TEM) is an integral part of the pathologic of many medical specimens, especially renal and cardiac biopsies. However, conventional TEM instruments are costly, occupy a substantial floor space footprint, and have significant overhead costs. Delong Instruments offers the LVEM25, a new “compact” TEM instrument, which circumvents some of the aforementioned drawbacks posed by conventional TEM. Recently, a thorough clinical validation exercise was performed comparing the diagnostic utility of images obtained on a conventional TEM and compact TEM, in the appropriately titled report “Clinical Validation of Low-Voltage “Compact” Transmission Electron Microscopy for Ultrastructural Evaluation of Kidney and Heart Biopsy Samples” (Lawrence, et al., 2020).

The study design included 90 consecutive clinical biopsies and 10 pre-selected biopsies which were known to have certain ultrastructural features of interest. A parallel testing validation strategy was employed, where three different pathologists captured images in the course of their routine diagnostic work. The data and images were retrospectively compiled, reviewed, and compared for salient ultrastructural features. The instruments directly compared samples using a JEOL 1010 TEM at 80 kEV with a Veleta side-mount 4MP camera, and a Delong Instruments LVEM25 TEM at 25 kEV using its integrated 5.5MP camera. Samples were prepared for TEM using the routine protocols. Side by side comparison results of TEM images obtained by each instrument are shown in the following figures.

Conclusions

Lawrence and co-authors concluded that “Compact TEM is a clinically valid means of ultrastructural evaluation of renal and cardiac biopsy specimens,” and “Compact TEM maintains comparable ability to discriminate key diagnostic findings in these samples.”

References: 

Lawrence R, Isaac J, Lloyd I, Miller D. Clinical Validation of Low-Voltage" Compact" Transmission Electron Microscopy for Ultrastructural Evaluation of Kidney and Heart Biopsy Samples. InLABORATORY INVESTIGATION 2020 Mar 1 (Vol. 100, No. SUPPL 1, pp. 1701-1702). 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA: NATURE PUBLISHING GROUP.

About the author: 

Robert I. MacCuspie, Ph.D., has over twenty years of experience in nanotechnology and materials characterization, at national laboratories, academia and corporations, working at the interface of business and science.